Men in the UK die on average four years earlier than women and are more likely to die from the leading causes of death — cardiovascular disease, cancer and respiratory disease — at every age, according to the Office for National Statistics. Yet men are less likely to visit their GP, less likely to attend screening programmes, and less likely to seek help for mental health difficulties.

Community pharmacy is the healthcare setting men are most likely to walk into without an appointment. That makes pharmacy teams a critical touchpoint for men's health — one that is often underutilised.

Prostate awareness

Prostate cancer is the most common cancer in men in the UK, with approximately 52,000 new cases per year according to Cancer Research UK. Community pharmacists encounter prostate-related queries regularly, from men noticing urinary symptoms to those asking about PSA testing.

Lower urinary tract symptoms (LUTS). The most common prostate-related presentation at the pharmacy counter involves symptoms of benign prostatic enlargement (BPE): increased urinary frequency, urgency, nocturia, hesitancy and poor stream. These symptoms affect approximately 40% of men over 50.

Pharmacy role:

• Recognise LUTS symptoms and refer to the GP for assessment (NICE NG97). Do not attribute urinary symptoms to "just getting older" without clinical assessment.
• Be aware that alpha-blockers (tamsulosin — available OTC as Flomax Relief in the UK for men aged 45–75) are a first-line pharmacological treatment for moderate LUTS. Pharmacists selling tamsulosin OTC should ensure the patient has not been previously diagnosed with prostate cancer and is not taking other alpha-blockers or PDE5 inhibitors.
• Know the red flags: haematuria (blood in urine), bone pain, unexplained weight loss — these require urgent GP referral.

PSA testing queries. Men may ask pharmacists about prostate-specific antigen (PSA) testing. The key message: PSA is not a screening test in the UK. The NHS does not offer routine PSA screening because the test has significant false-positive and false-negative rates. Men over 50 can request a PSA test from their GP after an informed discussion about the benefits and limitations. Pharmacists should encourage this conversation rather than recommending or discouraging testing outright.

Erectile dysfunction

Sildenafil (Viagra Connect) has been available OTC from pharmacies since 2018. It remains one of the most common OTC medicine consultations for pharmacy teams.

Key pharmacy considerations:

• Cardiovascular assessment. Erectile dysfunction (ED) is independently associated with cardiovascular disease. A man presenting with new-onset ED may have undiagnosed hypertension, diabetes or dyslipidaemia. The British Society for Sexual Medicine recommends that all men with ED should have cardiovascular risk factors assessed. Pharmacists selling sildenafil should check blood pressure and ask about cardiovascular history.
• Contraindications. Sildenafil is contraindicated with nitrates (glyceryl trinitrate, isosorbide mononitrate) due to the risk of severe hypotension. It should also be used with caution in patients taking alpha-blockers.
• Psychological ED. Not all ED is vascular. Performance anxiety, stress, depression and relationship difficulties are common causes, particularly in younger men. Pharmacists should be prepared to signpost to psychological support services.
• The "pharmacy first" opportunity. The pharmacy consultation for Viagra Connect is often the only healthcare interaction a man has in years. Use it to check blood pressure, ask about general health, and signpost to NHS Health Checks or GP registration if appropriate.

Cardiovascular risk

Men under 75 are approximately twice as likely to die from cardiovascular disease as women, according to the British Heart Foundation. Community pharmacy blood pressure monitoring services are a key entry point for identifying undiagnosed hypertension in men who might never attend their GP.

Pharmacy opportunities:

• Offer opportunistic blood pressure checks to male patients collecting prescriptions or purchasing OTC products
• During Viagra Connect consultations (already requires BP check), discuss broader cardiovascular risk
• Signpost to NHS Health Checks (free for adults aged 40–74 every five years in England)
• For men already on cardiovascular medicines, support adherence (see: Hypertension Medicines Adherence)

Male pattern hair loss

Androgenetic alopecia affects approximately 50% of men by age 50. Two treatments are available through pharmacy:

• Minoxidil 5% solution/foam. Available OTC. Takes 3–6 months to show benefit. Must be continued indefinitely — hair loss resumes on discontinuation. Side effects: scalp irritation, unwanted facial hair growth (from dripping solution). For detailed guidance on minoxidil, see: Female Pattern Hair Loss — the application principles and timeline are the same for men.
• Finasteride 1mg. Prescription-only in the UK. Inhibits 5-alpha reductase, reducing DHT. Side effects include reduced libido and erectile dysfunction in a small proportion of men (1–2% in clinical trials). Patients concerned about sexual side effects should be referred to their GP for a full discussion.

Testosterone and supplements

Pharmacists increasingly encounter questions about testosterone — driven by social media, private clinics and supplement marketing.

Key messages:

• Testosterone replacement therapy (TRT) is a prescription-only medicine indicated for men with confirmed hypogonadism (low testosterone with clinical symptoms, confirmed by two morning blood tests). It is NOT indicated for age-related testosterone decline in otherwise healthy men.
• OTC "testosterone boosters" (tribulus terrestris, D-aspartic acid, fenugreek, zinc) have no robust evidence for raising testosterone levels in men with normal gonadal function. Pharmacists should be direct about this: there is no supplement that meaningfully raises testosterone in healthy men.
• Anabolic steroid misuse. Men who ask about testosterone or muscle-building supplements may be using or considering anabolic steroids. Needle exchange services at pharmacies see significant numbers of steroid injectors. Pharmacists should be non-judgemental and provide harm reduction advice — including referral to steroid harm reduction clinics where available.

Mental health

Men account for approximately 75% of suicide deaths in the UK, according to ONS data. They are less likely to be diagnosed with depression and less likely to seek help. Pharmacy teams may notice:

• Changes in a regular patient's demeanour or appearance
• Increased alcohol purchases alongside mood-related OTC products
• Direct or indirect disclosures during consultations

What pharmacists can do: Ask open questions. "How are you doing?" can open a conversation. Signpost to the Samaritans (116 123), CALM (Campaign Against Living Miserably, 0800 58 58 58), or their GP. The NHS Every Mind Matters platform provides self-help resources.

For antidepressant dispensing, pharmacists play a key role in counselling on expected onset of action (2–4 weeks), common early side effects, and the importance of not stopping suddenly.

Pharmacists interested in men's health, sexual health or mental health roles can explore current vacancies through PharmSee's job search, which tracks over 1,700 active pharmacy vacancies across England.

Sources

• Office for National Statistics. Life expectancy and mortality statistics, 2024.
• Cancer Research UK. Prostate cancer statistics, 2024.
• NICE NG97: Lower urinary tract symptoms in men — management.
• British Society for Sexual Medicine. ED and cardiovascular risk guidelines, 2018.
• British Heart Foundation. Cardiovascular disease statistics by sex, 2024.
• ONS. Suicides in England and Wales, 2024.
• PharmSee pharmacy data: pharmsee.co.uk.