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3. Persistent Pain On One side of the Abdomen

He’s thinking: I probably pulled a muscle.
But it could be: A kidney stone or tumor.

One-sided pain that goes away probably is a side stitch or pulled muscle and nothing to worry about. “But if a dull ache is persistent, it should be evaluated by a physician,” says Dr. Kaplan. “It could be many things, but a tumor is one of the first possibilities we consider.” An ache from a tumor won’t likely move around, and may get better if he takes an over-the-counter pain reliever—but will keep coming back. “Any abdominal pain that doesn’t resolve within three days deserves to be checked out.”

Sharp, excruciating pain that hits suddenly and doesn’t improve within an hour warrants a trip to the ER. “If it’s a kidney stone, the pain will radiate from a specific point and can be intense enough to make you vomit,” Dr. Kaplan says. “I’ve had one myself, and it’s so horrible it makes you want to die.” The problem could also be appendicitis, a perforated ulcer or a hernia, so it’s important to get checked out.


4. Toilet-Time Blood

He’s thinking: Must be something I ate.
But it could be: A kidney stone or bladder cancer if blood is in urine; colon cancer if blood is in stools.

Bright red spots on tissue after wiping are likely from hemorrhoids. But blood in stools that have become narrower and thinner than usual (like the width of a pencil) could be a sign of cancer. Black, tarry stools might also indicate stomach bleeding from an ulcer. His doctor will likely examine the GI tract via a colonoscopy or upper endoscopy to nail down the problem.

Blood in urine may show up as a subtle pink hue, but he shouldn’t dismiss minuscule amounts or chalk it up to eating beets. “You’d have to eat a whole lot for that to happen,” says Mark Pochapin, MD, director of the Jay Monahan Center for Gastrointestinal Health at NewYork–Presbyterian Hospital/Weill Cornell Medical Center in New York City. Assume any reddish color is blood: One drop can turn the bowl pink. “Even microscopic amounts are a warning,” says Martin Miner, MD, codirector of the Men’s Health Center at The Miriam Hospital and clinical associate professor at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. “If he can actually see red color, he should definitely be evaluated.”

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7. Constant Grumpiness

He’s thinking: I’m just under a lot of stress at work.
But it could be: Depression.

 Feeling cranky and low because of work hassles or difficult times is normal, but it should dissipate within a few days. With clinical depression, downbeat irritability lasts weeks at a time. “It’s different from run-of-the-mill blues and time for him to talk to his doctor if you’re saying to him, ‘You haven’t been acting like the person I think you really are for weeks’ or he’s lost interest in activities he used to enjoy or isn’t performing at work,” Dr. Shindel says.

Talk therapy and antidepressant medication are the options his doctor will likely suggest first. But if he has symptoms such as fatigue, low sex drive and loss of muscle mass, Dr. Shindel advises getting a blood test for low testosterone, which is sometimes the root cause of depression, especially in men over 40. Testosterone replacement in the form of gel, skin patches or injections can reverse the symptoms, but he should first talk to his doctor carefully about his medical history and the potential risks of testosterone therapy.


8. Frequent Urination

He’s thinking: I’m drinking too much coffee.
But it could be: Type 2 diabetes or an enlarged prostate.

It might be the coffee—when he’s actually drinking it. But if he often gets up to go twice or more during the night, his body could be trying to get rid of excess blood sugar that’s built up because it can’t get into cells—the problem that defines diabetes. He should first try adjusting what or when he drinks at night to see if that leads to fewer wee-hour trips to the bathroom. “If he still urinates more than he did a month ago, he should get his blood sugar checked, especially if he also has increased thirst, another red flag for diabetes,” Dr. Miner says. Diabetes can usually be controlled with changes in diet and exercise, often combined with medication.

If he’s also feeling like he can’t empty his bladder completely and/or is having a slow or weak stream, dribbling and having trouble getting urine flow started, the problem may be a growing prostate. This small gland surrounds the tube that carries urine out of the bladder, so an increase in size can put the squeeze on urine flow—a common problem in middle-aged and older men. (In men under 50, symptoms could be due to a urinary tract infection.)

Though painless, an enlarged prostate can eventually get worse and lead to acute urinary retention, where he suddenly can’t urinate at all, which is an emergency that often leads to surgery. Treatment ranges from exercises to strengthen muscles in the pelvic floor to medications that relieve symptoms or shrink the prostate. Prostate cancer is also a possibility, especially for men over 50, and if the doctor suspects that, he’ll do a rectal exam and draw blood to check PSA (prostate-specific antigen) levels; higher-than-normal results may indicate prostate enlargement, an infection or cancer.

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