Health check after 40: what men should actually test

Emil Aldyrakov — urologist-andrologist
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Why 40 is the threshold

With age the hormonal balance shifts and the risk of prostate, cardiovascular and metabolic disease rises. The catch is that almost all of it is silent in the early stages — these conditions are found by testing, not by symptoms. That is why international guidance converges on the same advice: from around 40, men should have a preventive review every year.

The core set

• Urology consultation — history, examination, risk assessment. This is the starting point: the doctor decides what you actually need.
• PSA (prostate-specific antigen) — a blood test, the main tool for early prostate cancer detection. Per the American Urological Association guideline (AUA/SUO, 2023), a baseline PSA should be discussed at 45–50, or from 40–45 for men at higher risk (family history, certain genetic variants), then repeated every 2–4 years.
• Ultrasound when indicated — kidneys, bladder or scrotum: quick, painless and informative.
• Hormone profile — testosterone and related markers, which affect energy, weight, sleep, mood and libido.
• Metabolic basics — glucose, lipid profile, blood pressure: cardiovascular risk is the single most common threat to men over 40.

What not to do

Do not order "everything at once". Dozens of markers without a clinical question do not make the assessment better — they produce false alarms and unnecessary procedures. Current guidance (AUA, USPSTF) is explicit that screening is a shared decision between doctor and patient based on individual risk, not reflex testing. The right order is: consultation first, tests second.

How it works here

At GMS a urology consultation and ultrasound happen in a single visit, and PSA (AED 150) or a full hormone profile (AED 900) can be taken straight after. For a broader assessment there are men's check-up programmes.

References

• AUA/SUO. Early Detection of Prostate Cancer (2023)
• USPSTF. Prostate Cancer: Screening

This article is for information only and does not replace a consultation. If you have symptoms, see a doctor.

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