3 Essential Blood Tests for Men’s Health This Movember

That niggling worry about your energy levels. The reluctance to book that overdue health check. The assumption that fatigue and mood changes are just ‘part of getting older.

Sound familiar?

This Movember, rather than growing a moustache and hoping for the best, consider gathering the data that can transform vague health concerns into actionable insights. Three blood tests: PSA, testosterone, and cholesterol. They provide an internal health dashboard that empowers informed conversations with your GP and targeted lifestyle changes.

Here’s what each test reveals and why the results matter more than you might think.

Why Focus on These Three Tests?

These tests address the three most significant health risks for men over 40:

• PSA: Prostate cancer is the most common cancer in UK men
• Testosterone: Affects energy, mood, and muscle mass, often dismissed as “normal ageing”
• Cholesterol: Heart disease remains the leading cause of death, yet high cholesterol has no symptoms

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1. PSA Testing & Prostate Health

What is a PSA test, and why can it be confusing?

The conversation around prostate health, particularly the PSA test, is often fraught with confusion and anxiety. The key to navigating this topic is understanding that the test is not a simple “cancer or no cancer” switch, but rather a sophisticated tool for risk assessment that requires careful interpretation and a collaborative discussion with a healthcare professional.

What does PSA actually stand for?

The prostate, a part of the male reproductive system, is a small gland approximately the size of a walnut. It is situated just below the bladder, and its primary function is to produce the fluid that makes up semen. As part of its normal function, this gland also produces a protein known as Prostate-Specific Antigen (PSA).

A PSA test is a simple blood test that measures the concentration of this protein, typically in nanograms per millilitre (ng/ml). As men age, the prostate naturally tends to enlarge, which can cause PSA levels to rise gradually. Therefore, the test serves as an indicator of potential prostate issues, but it is not, in isolation, a definitive diagnostic tool for cancer.

Why isn’t a high PSA level a straightforward sign of cancer?

A primary reason for the controversy surrounding PSA testing is that an elevated level is not a direct confirmation of cancer. Numerous benign conditions can cause a temporary or persistent rise in PSA, making context and further investigation essential.

Common non-cancerous causes of a raised PSA include:

• Benign Prostatic Hyperplasia (BPH): A non-cancerous enlargement of the prostate, common in older men.
• Prostatitis: Inflammation or infection of the prostate gland.
• Urinary Tract Infection (UTI): An active infection can significantly elevate PSA levels.
• Recent Physical Activity: Vigorous exercise, particularly activities like cycling that put pressure on the prostate area, can cause a temporary spike.
• Recent Sexual Activity: Ejaculation within 48 hours of the test can increase PSA readings.
• Urological Procedures: A recent prostate biopsy, catheter insertion, or even a digital rectal exam can affect results.

This complexity leads to the challenge of “false positives” and “false negatives.” A false positive occurs when PSA is high but no cancer is present; in fact, about three in four men with a raised PSA level do not have prostate cancer. This can lead to unnecessary anxiety and invasive follow-up tests.
Conversely, a “false negative” can occur where cancer is present despite a normal PSA level. Studies show that approximately 1 in 7 men with a normal PSA may still have prostate cancer.

A significant concern is the risk of “over-diagnosis”. This occurs when the test identifies slow-growing, or “indolent” cancers that are not aggressive and might never have threatened the man’s health or lifespan. This situation can lead to men receiving unnecessary treatments, such as surgery or radiotherapy, which carry their own risks of significant side effects, including erectile dysfunction and urinary incontinence, for a condition that may not have required intervention.

Due to these complexities, routine population-wide screening is not offered on the NHS. However, any man aged 50 or over is entitled to discuss the pros and cons with his GP and request a test.

Should I be thinking about a PSA test?

While any man over 50 can ask for a PSA test, certain individuals have a higher risk profile and should consider initiating this conversation with their doctor earlier, from the age of 45.
Higher-risk groups include:

• Men of Black Ethnicity: This group has double the risk of developing prostate cancer compared to white men and may be diagnosed at a younger age with a more aggressive form of the disease.
• Men with a Family History: Having a close relative, such as a father or brother, who was diagnosed with prostate cancer significantly increases personal risk.

Additionally, any man experiencing symptoms that could indicate a prostate problem should see a doctor promptly. These symptoms include urinary changes (increased frequency, urgency, weak stream), blood in the urine or semen, or new-onset erectile dysfunction.

The Reality Check

If you’re over 50 and have never discussed PSA testing with your GP, you’re in the majority. Many men avoid the conversation entirely, but the modern diagnostic pathway has evolved significantly. A high PSA no longer means immediate invasive procedures. Advanced imaging now prevents unnecessary biopsies for over 25% of men.

How should I prepare for the PSA test, and what happens next?

To ensure the most accurate result possible, a few simple preparatory steps are recommended for the 48 hours preceding the blood draw:

• Avoid vigorous exercise, especially cycling.
• Refrain from any sexual activity that leads to ejaculation.
• Inform the clinician of any recent urinary infections, as the test should be postponed until the infection has cleared.

If a PSA test comes back with an elevated result, it is crucial to understand that this is the beginning of an investigative process, not the end. The modern diagnostic pathway has evolved significantly, reducing the need for immediate invasive procedures. A high PSA result no longer leads directly to a biopsy.

The introduction of multiparametric MRI (mpMRI) scans as an intermediate step has been a revolutionary change. This advanced imaging can identify suspicious areas within the prostate with high accuracy and helps more than a quarter of men avoid an unnecessary biopsy altogether.

The typical follow-up pathway is:

1. Repeat Test: The GP will often recommend a second PSA test a few weeks later to confirm the level is persistently high.
2. Clinical Assessment: This may include a Digital Rectal Examination (DRE) to physically feel the prostate for any hard or lumpy areas.
3. Specialist Referral & Imaging: If concerns remain, a referral is made to a urologist, who will typically arrange for an mpMRI scan.
4. Biopsy: Only if the mpMRI reveals a suspicious lesion is a biopsy, i.e. the collection of small tissue samples, performed to provide a definitive diagnosis.

Understanding this pathway is key. A comprehensive cancer screening process involves not just a single test, but a thoughtful, staged approach to diagnosis, ensuring the right care at the right time. While “normal” PSA levels can vary, clinical guidelines use age-adjusted thresholds to help GPs determine when a specialist referral is warranted.

Table 1: Age-Adjusted PSA Levels for GP Referral

Data based on Cancer Research UK guidelines.

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2. Testosterone Testing

Could low testosterone be affecting my energy and mood?

“I’m just tired all the time.”
“I’ve lost my motivation for everything—work, exercise, even things I used to enjoy.”
“My wife says I’m always irritable.”

These aren’t just signs of a busy life or getting older. They could indicate low testosterone, a condition that affects up to 40% of men over 45, yet remains dramatically underdiagnosed.

Many men over 40 accept symptoms like fatigue, low mood, and reduced libido as an inevitable part of ageing. However, these can be signs of a correctable hormonal imbalance. A testosterone test can provide crucial insights, reframing the conversation from one of passive acceptance to one of proactive health management.

What does testosterone do beyond the bedroom?

Testosterone is the primary male sex hormone, or androgen, but its influence extends far beyond the bedroom. It acts as a master regulator for numerous critical bodily functions, impacting everything from physical strength to mental clarity.

Its system-wide roles include:

• Energy and Vitality: Maintaining energy levels and preventing persistent fatigue.
• Mood and Cognition: Regulating mood, supporting a sense of well-being, and aiding concentration and memory.
• Musculoskeletal Health: Building and maintaining lean muscle mass and strength, as well as ensuring bone density.
• Metabolic Function: Influencing body fat distribution and the production of red blood cells.

Could these symptoms be a sign of low testosterone?

While it is true that testosterone levels begin a gradual decline of about 1% per year after age 30, a significant drop can lead to a condition known as male hypogonadism. The symptoms are often subtle and easily dismissed as consequences of stress or ageing. Recognising a potential pattern is the first step.

Common symptoms include:

• Physical: Persistent fatigue, reduced muscle mass, increased body fat (particularly abdominal), loss of body hair, and, in some cases, breast development (gynecomastia).
• Sexual: A noticeable decrease in libido (sex drive) and erectile dysfunction.
• Mental/Emotional: Depressed mood, increased irritability, difficulty concentrating or “brain fog,” and poor memory.

These symptoms can create a debilitating feedback loop. For instance, low testosterone can lead to fatigue and weight gain, while obesity itself can further suppress testosterone production. A man might be advised to “lose weight” or treated for depression without addressing the underlying hormonal driver that makes those very actions feel impossible.

Identifying and correcting low testosterone can be the key to breaking this cycle, restoring the energy and motivation needed to improve overall health.

What does the testosterone test involve?

A testosterone test is a straightforward blood test, but the timing is absolutely critical for an accurate diagnosis. Testosterone levels follow a diurnal rhythm, peaking in the early morning. Therefore, the blood sample must be taken between 8 am and 10 am.

A test performed later in the day could yield a falsely low result or, more problematically, a “low-normal” reading that causes a clinician to dismiss genuine symptoms. Anyone who has had a previous test at a different time of day should consider its validity.

The test measures “total testosterone,” which is all the testosterone circulating in the blood. Sometimes, further tests for “free” or “bioavailable” testosterone, i.e. the portion not bound to proteins and actively usable by the body’s cells, may be conducted for a more detailed picture.

What will my testosterone results tell me?

In the UK, testosterone is measured in nanomoles per litre (nmol/L). While reference ranges vary between laboratories, the NHS often considers a total testosterone level below 8 nmol/L, confirmed on two separate morning tests, as a strong indicator of deficiency requiring further investigation. Other Medical bodies agree that a level below 12 should be considered deficient, or 14 if you are overweight and/or diabetic.

A confirmed diagnosis of hypogonadism empowers an individual to have a clear, data-backed conversation with a specialist about the next steps. This can involve investigating potential causes, such as obesity, medication side effects, or issues with the pituitary gland. Treatment options are varied and can range from targeted lifestyle modifications to Testosterone Replacement Therapy (TRT), which is available in forms like daily gels or periodic injections.

If you’re experiencing these symptoms, dismissing them as ”just ageing” is no longer necessary. A simple blood test can provide the clarity needed to start a conversation about overall men’s health.

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3. Cholesterol Testing

Why is a cholesterol test so important for my heart health?

Your cholesterol level could be dangerously high right now, and you’d have absolutely no idea. Unlike blood pressure, which might cause headaches, or diabetes, which can cause thirst and frequent urination, high cholesterol produces no warning signs. The first symptom is often a heart attack. This is why a cholesterol test is essential preventive intelligence.

Cholesterol is a waxy, fatty substance that is produced by the liver and is also present in some foods. It is essential for building healthy cells, but an excess of certain types of cholesterol in the blood is dangerous. Over time, this excess cholesterol can deposit in the walls of arteries, forming hard plaques in a process called atherosclerosis. These plaques narrow the arteries, restricting blood flow and creating the conditions for a heart attack or stroke.

The entirely asymptomatic nature of high cholesterol makes proactive screening fundamentally essential. Unlike conditions that present with warning signs, the damage from high cholesterol occurs silently over decades.

For many, the first line of defence is lifestyle modification. This typically involves shifting to a heart-healthy eating plan (one that reduces saturated fat intake), incorporating consistent physical activity, and stopping smoking.

What do all the different numbers on my cholesterol test mean?

A cholesterol test is a panel of results known as a lipid profile, which provides a detailed breakdown of the different fats in the blood. Getting a clear picture of all these markers is a fundamental part of any proactive health screening.

The key components are:

• Total Cholesterol: The overall sum of all cholesterol in the blood.
• High-Density Lipoprotein (HDL): Often called “good” cholesterol. HDL acts like a scavenger, transporting excess cholesterol away from the arteries and back to the liver, where it can be broken down and removed from the body. For HDL, a higher number is better.
• Non-HDL Cholesterol: This has become one of the most important markers for assessing risk. It is calculated by subtracting the HDL value from the Total Cholesterol value (Total Cholesterol – HDL = Non-HDL). It represents the sum of all the “bad,” artery-clogging lipoproteins. Many clinicians now view this as a more accurate predictor of cardiovascular risk than LDL cholesterol alone.
• Triglycerides: This is another type of fat found in the blood. High levels are often linked to diet, alcohol consumption, and lack of exercise, and they also contribute to the risk of atherosclerosis.

How do doctors work out my personal heart health risk?

Historically, public health messages focused on a single “total cholesterol” number. However, modern medical practice has evolved to a more sophisticated and personalised assessment of risk. Cholesterol levels are not interpreted in a vacuum; their significance depends heavily on an individual’s overall health profile.

GPs in the UK use a calculation tool called QRISK (Cardiovascular Risk Score) to estimate a person’s risk of having a heart attack or stroke over the next 10 years. This tool integrates the cholesterol results into a bigger picture, providing a far more accurate and meaningful assessment.

The factors considered in a QRISK score include:

• Cholesterol levels (specifically the ratio of total cholesterol to HDL)
• Age and sex
• Blood pressure
• Smoking status
• Family history of cardiovascular disease
• The presence of other conditions like diabetes or chronic kidney disease

This shift from a single number to a multi-variable risk score is critical. It allows for a tailored approach to prevention, ensuring that treatment and lifestyle advice are appropriate for an individual’s specific level of risk.

What can I do with my cholesterol results?

The combination of a lipid profile and a QRISK score provides a clear, actionable roadmap for protecting heart health. It quantifies risk and empowers individuals to take specific steps to lower it.

For many, the first line of defence is lifestyle modification, including adopting a heart-healthy diet low in saturated fats, engaging in regular physical activity, and stopping smoking. If lifestyle changes are insufficient to lower risk to a safe level, or if the initial risk is very high, doctors may prescribe medications such as statins, which are highly effective at lowering the production of bad cholesterol.

Table 2: UK Healthy Cholesterol Target Levels (mmol/L)

Data based on NHS guidelines. These are general targets for healthy adults. Individual goals may vary based on overall cardiovascular risk.

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Your health is in your hands

Movember rightfully encourages men to think about their health. This year, the most meaningful action is to move from general awareness to personal action by gathering concrete data. The three blood tests outlined: PSA, testosterone, and a cholesterol panel. They provide profound clarity on prostate health, hormonal balance and vitality, and cardiovascular risk.

These three tests transform uncertainty into clarity. They replace “I feel fine, so I must be healthy” with concrete data about your prostate, hormonal balance, and cardiovascular risk.

This Movember, move beyond awareness to action. Book a men’s health consultation with Dr Natalie Summerhill to discuss a comprehensive screening and take control of your long-term wellbeing—because your health is too important to leave to chance.

A man’s health is his greatest asset; it is time to invest in it.