Health Checks for Men Over 40: Which Tests to Have and How Often

Men visit doctors less often than women, undergo screening later and are more likely to enter the healthcare system only after a heart attack, diabetes with complications or advanced cancer. Mortality statistics in Poland are clear: men live several years less on average, and much of this difference is attributable to diseases that can be detected through blood tests years before symptoms appear. Turning 40 is a natural opportunity to establish a baseline for your health and develop a routine of annual check-ups. Below is a list of tests organised according to the conditions they help detect or prevent, with guidance on how often to repeat them. Test interpretation and treatment decisions should be made by a doctor.

Heart and blood vessels: the biggest health risk after 40

Lipid profile

Lipid profile (cholesterol) – laboratory test measures total cholesterol, LDL, HDL and triglycerides, with non-HDL cholesterol and ApoB also increasingly included. LDL is the main modifiable risk factor for atherosclerosis. The target LDL level depends on your overall cardiovascular risk (below 115 mg/dl for people without additional risk factors, and considerably lower for those at high risk). It is worth measuring lipoprotein(a) at least once in your lifetime. This inherited risk factor is independent of lifestyle and is elevated in approximately one-fifth of the population. Frequency: annually, or every 3 years if your results are optimal and you have no additional risk factors.

Glucose and HbA1c

Type 2 diabetes can develop without symptoms for years, damaging blood vessels throughout that time. Have a fasting Glucose – laboratory test annually after the age of 45 (or earlier if you are overweight or have a family history of diabetes). Glycated haemoglobin (HbA1c) provides additional information and does not require fasting.

Creatinine with eGFR, uric acid and urinalysis

High blood pressure and diabetes can silently damage the kidneys. eGFR and albuminuria testing can detect kidney damage at a potentially reversible stage. Uric acid is a risk factor for hypertension, gout and kidney disease, and is often elevated in men over 40 because of diets rich in meat, alcohol and fructose. Useful investigations include Creatinine – laboratory test with eGFR, uric acid and Urinalysis.

Homocysteine and high-sensitivity CRP

Additional tests for people with a family history of heart disease: high-sensitivity CRP (hs-CRP) can indicate chronic vascular inflammation, while homocysteine increases with folate and vitamin B12 deficiency and is associated with the risk of thrombosis.

Liver health and metabolism

Alanine aminotransferase (ALT) – laboratory test, Aspartate aminotransferase (AST) – laboratory test and Gamma-glutamyl transferase (GGT) – laboratory test once a year. Fatty liver disease affects approximately one in three adult men and can be reversed by losing weight and reducing alcohol consumption. GGT is also a sensitive marker of excessive alcohol consumption. Thyroid-stimulating hormone (TSH) – laboratory test every 2–3 years or if symptoms appear (fatigue, weight gain or low mood). 25-hydroxyvitamin D (25 OH) – vitamin D test in autumn, because vitamin D deficiency is widespread in Poland and affects muscles, bones and immune function.

Hormones: testosterone and related tests

After the age of 40, testosterone levels decline by an average of approximately 1% per year. However, in healthy, lean men, levels often remain normal well into old age. Symptoms of deficiency (reduced libido, erectile dysfunction, loss of muscle mass, increased abdominal fat, low mood and fatigue) are non-specific and more commonly result from obesity, sleep apnoea, diabetes or depression than from so-called ‘andropause’. Investigation begins with a Total testosterone – laboratory test, performed in the morning (7:00–10:00), after fasting and a good night’s sleep. A low result should be confirmed by a second measurement. Additional tests include SHBG (used to calculate free testosterone), LH and FSH (to distinguish a testicular problem from a pituitary disorder), Prolactin – laboratory test and Oestradiol – laboratory test. Testosterone treatment without confirmed deficiency can be harmful: it increases haematocrit, lowers HDL, may worsen sleep apnoea and may accelerate the growth of prostate cancer.

Prostate health: PSA

Prostate-specific antigen (PSA) levels increase in prostate cancer, but also with benign prostate enlargement, inflammation, following sexual intercourse, cycling and a digital rectal examination. PSA is therefore not a definitive ‘cancer test’, but one component of an assessment conducted by a urologist, alongside a physical examination, the free PSA ratio and, where appropriate, magnetic resonance imaging (MRI). Recommendations: an initial PSA test at the age of 45–50 (from 40 if your father or brother has had prostate cancer), followed by testing every 1–2 years depending on the baseline result. Before testing: avoid ejaculation, cycling and a digital rectal examination for 48 hours, and do not undergo testing during a urinary tract infection.

Blood, iron and bowel health

Full blood count once a year. Iron deficiency anaemia in men is always a warning sign: a common cause is chronic gastrointestinal blood loss (ulcers, polyps or bowel cancer). Therefore, low ferritin in men should prompt investigation rather than supplementation alone. Faecal occult blood testing (faecal immunochemical test, FIT) every 1–2 years from the age of 50, and screening colonoscopy once every 10 years or according to the NFZ (Narodowy Fundusz Zdrowia, Poland’s National Health Fund, which finances public healthcare) screening programme. Screening should begin earlier if you have a relevant family history.

Non-laboratory health checks you should not overlook

• blood pressure: whenever possible, including at home every few months,
• body weight and waist circumference (above 94 cm indicates increased risk; above 102 cm indicates high risk),
• resting ECG every few years, more frequently if you have hypertension,
• abdominal ultrasound every few years (liver, kidneys, aorta and prostate),
• skin and mole examination, dental check-ups and eye examinations including intraocular pressure measurement,
• spirometry and chest X-ray for smokers.

Suggested screening schedule

Preparing for your tests

Attend in the morning after fasting (12 hours) and a good night’s sleep, having avoided alcohol for 3 days and strenuous exercise the previous day. Testosterone and PSA testing have additional preparation requirements described above. Take your regular medication as agreed with your doctor. It is worth keeping several years of test results together: trends in LDL, glucose or PSA provide more useful information than a single result.

Frequently asked questions

Does a healthy 40-year-old man without symptoms really need health checks?

Yes. High blood pressure, elevated LDL cholesterol, prediabetes and fatty liver disease can remain symptom-free for years, yet they are among the main contributors to heart attacks and strokes after the age of 50.

Should testosterone be tested every year?

No, only if you have symptoms of testosterone deficiency or are undergoing treatment. Routine annual testosterone testing is not recommended for men without symptoms.

Do I need a referral?

No. Comprehensive preventive screening packages for men are available privately: purchase online, have your blood taken at a collection centre, receive your results online and discuss them with a doctor.

Sources

• Polish Ministry of Health, NFZ (Polish National Health Fund), pacjent.gov.pl, My Health Programme: Scope of Tests, 2025. pacjent.gov.pl
• European Association of Urology, EAU Guidelines on Prostate Cancer: Diagnostic Evaluation, 2025. uroweb.org
• Visseren FLJ et al., Eur Heart J, 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice, 2021. academic.oup.com