The Complete Men's Health Guide
For Nigerian Men — Straight Talk

Nigerian men die younger than women — by approximately 4–5 years on average. The reasons are not mysterious: more exposure to occupational hazards, higher rates of alcohol use, more cardiovascular risk factors — and a deeply entrenched cultural resistance to seeking medical help until a crisis forces it. This guide is direct, practical, and specifically written for Lagos.

The Three Things Killing Lagos Men Silently

1. Uncontrolled hypertension

35% of Nigerian adult men have hypertension. 60% of those don't know. Of those who know, less than 40% are on treatment. Of those on treatment, less than 30% have controlled blood pressure. That means roughly 7 in 8 hypertensive Nigerian men have uncontrolled blood pressure — silently damaging their kidneys and arteries, quietly setting up the stroke or heart attack that will come years later.

Blood pressure has no symptoms until it's too late. A blood pressure check takes 2 minutes. At Mascot Healthcare, it's done with every consultation. There is no reason every Lagos man over 30 cannot know his blood pressure.

2. Undiagnosed type 2 diabetes

Over 60% of Nigerian diabetics are undiagnosed. In men over 40, the first symptom is often erectile dysfunction — which most men treat with herbal preparations rather than seeing a doctor. By the time they see a doctor, they've had elevated blood sugar for 5–10 years, and kidney and nerve damage has already begun. A fasting blood glucose test could have caught this in year one.

3. Prostate cancer — the ignored cancer

Prostate cancer is the second most common cancer in Nigerian men — and Nigerian men develop it at a younger age and with more aggressive disease than European or American men. The Western guideline of starting PSA screening at 50 was developed based on predominantly White European populations. In Nigeria, the recommendation is PSA from age 40, and from age 35 with family history. Many Lagos men have never heard of PSA, let alone had one tested.

Erectile Dysfunction — The Canary in the Coal Mine

Every Lagos man who presents with erectile dysfunction should have the following tested: blood pressure, fasting blood glucose, HbA1c, lipid profile, testosterone, and prolactin. In a substantial proportion, ED is the first symptom of one or more of these underlying conditions. Treating the underlying condition treats the ED more effectively than any herbal preparation.

The penile arteries are smaller than the coronary arteries. Atherosclerosis (arterial narrowing from cholesterol and hypertension) affects them first — making ED, in men over 40, a marker of cardiovascular risk. A man who develops ED at 42 and has vascular-origin ED has, statistically, a significantly elevated 10-year heart attack risk.

What Every Lagos Man Should Test and When

The Herbal Supplement Problem

Lagos markets are flooded with herbal preparations marketed for "sexual performance," "blood purification," "prostate health," and "diabetes control." Most are ineffective. Some are actively harmful — containing undisclosed pharmaceuticals (often sildenafil or testosterone analogues at uncontrolled doses), heavy metals from unregulated manufacturing, or hepatotoxic plant compounds.

The most common victim: men who take herbal testosterone boosters or performance enhancers and develop liver damage (from herbal hepatotoxins) or cardiovascular events (from undisclosed sildenafil + an underlying heart condition). When a medicine does not tell you exactly what is in it and in what dose, it cannot be safe.

About the author: Dr. Adebayo Okonkwo is a General Practitioner at Mascot Healthcare, Akoka, Lagos, with 8 years of primary care experience including men's health and chronic disease management.