Male longevity is finally entering the exam room: What physicians should screen for now
June is Men’s Health Month, a timely reminder that preventive care remains one of the most powerful tools for improving both lifespan and healthspan. As interest in longevity continues to grow among male patients, physicians are being asked to separate evidence-based screening from wellness hype—making conversations about cardiovascular, metabolic, sexual, and mental health more important than ever.
Industry Buzz
A man is not going to enter a room and say he is feeling depressed or insecure about his appearance.
—Sergey Terushkin MD, FACS, FASMBS
Online masculinity content often pushes the idea that men should 'fix themselves' through discipline alone.
—Ryan Peterson, MD
Male life expectancy in the US reached 76.5 years in 2024, compared with 81.4 years for females. At age 65, men had an additional life expectancy of 18.4 years, compared with 20.8 years for women.[]
Simultaneously, the topic of male longevity is beginning to move from podcasts and concierge clinics into routine visits. Patients are asking about testosterone, biomarkers, sleep, strength, and “healthspan.”
Why this is showing up now
Men often enter care late. At an event prior to the 2025 APHA Men and Boys Health Summit, Jon Gilgoff, research manager at the University of Maryland School of Social Work, said men have “lower levels of health-care seeking,” often waiting until problems become emergencies. []
That matters because “longevity medicine” is already being marketed to them. Some patients arrive with panels ordered by direct-to-consumer platforms. Others ask for testosterone, peptides, CGMs, coronary calcium scans, or full-body imaging.
Sergey Terushkin MD, FACS, FASMBS, bariatric surgeon, says, “A man is not going to enter a room and say he is feeling depressed or insecure about his appearance. He will bring up his libido, his workout performance, self-confidence, ability to reproduce, or how he gets along with other people. These are also valid reasons for a visit to the doctor.”
Physicians do not need to reject the interest. They need to redirect it.
Related: When victims of 'looksmaxxing' end up in your clinic: A clinical rundownStart with cardiometabolic risk
For midlife and older men, the highest-yield screen still starts with blood pressure, lipids, glycemia, tobacco, BMI or waist circumference, sleep, diet, and physical activity.
The American Heart Association’s Life’s Essential 8 includes diet, physical activity, nicotine exposure, sleep health, BMI, blood lipids, blood glucose, and blood pressure. It gives physicians a practical structure for longevity counseling without drifting into unvalidated testing.[]
For patients asking for a “biological age” workup, physicians may translate the request into measurable targets: systolic BP, LDL-C or ApoB, A1c, waist circumference, alcohol use, sleep duration, and weekly resistance training.
Screen for 'strength'
Board-certified physician Alok Mohta, MD, says, “Healthspan depends on function. In older men, or in younger men with inactivity, weight loss, chronic disease, falls, or frailty risk, screen for sarcopenia. Gait speed and grip strength are feasible measures in clinical practice.”
He further stresses that resistance training deserves the same attention as routine counseling about aerobic exercise.
According to Dr. Mohta, “The visit should include direct questions: Can he rise from a chair without using his arms? Has he fallen? Has walking speed changed? Is he losing muscle while losing weight?”
Testosterone: test selectively
Dr. Mohta doesn’t recommend routine testosterone screening in asymptomatic men for hypogonadism. The Endocrine Society recommends diagnosis only in men with compatible symptoms and consistently low testosterone, confirmed with repeat morning testing.[]
The AUA supports total testosterone below 300 ng/dL as a reasonable diagnostic cutoff, but the number alone is not the diagnosis.[]
Betsy Greenleaf, DO, a quadruple board-certified physician, says, “Testosterone testing is appropriate when a man has symptoms that may suggest low testosterone, such as low libido, erectile changes, unexplained fatigue, depressed mood, loss of muscle, increased abdominal fat, or reduced morning erections. But it should not be a random “one-and-done” test.”
Related: The fertility check men aren’t getting—but may desperately needSleep and mood belong in the same visit
Dr. Mohta advocates that sleep quality should be part of male longevity screening. “Snoring, witnessed apneas, resistant hypertension, atrial fibrillation, obesity, daytime sleepiness, and high hematocrit should prompt obstructive sleep apnea evaluation,” he says.
Men often describe depression through reporting of insomnia, anger, fatigue, pain, work dysfunction, substance use, or sexual symptoms, but seldom seek the required care. Board-certified physician Ryan Peterson, MD, says, “Online masculinity content often pushes the idea that men should 'fix themselves' through discipline alone.”
APA guidance notes that stigma around psychological help negatively affects men’s help-seeking behavior. []Dr. Mohta says, “Ask about alcohol, cannabis, anabolic steroid use, suicidal thoughts, firearm access, loneliness, and role strain. Keep the language functional: sleep, work, sex, energy, relationships, and risk.”