The Importance of Clinical Trials: Improving Treatment Options for Men’s Health

Your health is a complex and intricate interaction between a multitude of things. Genetics, environment, and lifestyle all play a role, and so does your biological sex. Male and female bodies develop and function differently and can be predisposed to different health conditions. This makes clinical trials that explore the treatment and diagnosis of these conditions critical to our understanding of sex differences and why these conditions may have a greater prevalence in males or females.

Conditions that are more likely to affect men

Cardiovascular disease

Cardiovascular disease encompasses conditions that affect the heart or blood vessels, of which there are four main types:

1. Coronary heart disease (CHD) – this happens when the flow of oxygenated blood to the heart is reduced or blocked, which can cause angina, heart attacks, and heart failure¹. In the UK, CHD is the biggest killer of men and kills one in eight men compared to one in fourteen women².
2. Stroke and transient ischaemic attack (or mini-stroke) – a stroke occurs when blood flow to part of the brain is stopped, which can lead to brain damage and even death. A mini-stroke is similar, except the blockage is temporary¹. In the UK, men have a higher incidence of stroke than women³.
3. Peripheral arterial disease (PAD) – blood flow to the limbs, usually the legs, is blocked, leading to pain, numbness or weakness, and persistent sores on the feet or legs¹. While the prevalence of symptomatic PAD has decreased overall, men are still more likely to be diagnosed than women⁴.
4. Aortic disease – this category involves conditions affecting the aorta (the blood vessel that carries blood from the heart to the rest of the body), which can lead to the aorta bursting, causing life-threatening bleeding¹. Men are six times more likely than women to have an abdominal aortic aneurysm⁵.

Parkinson’s disease

Parkinson’s disease is a progressive neurological condition that occurs when the brain cannot make enough dopamine (a chemical in the brain) to properly control movement. This results in many different symptoms, but the three main ones are a tremor, slowness of movement, and muscle stiffness⁶. Men between the ages of 50 and 89 years old are over 1.5 times more likely to be diagnosed with the condition⁷.

Mental health and other conditions

There are many other conditions more likely to affect men, with higher incidence or morbidity rates for males. For example, men are more likely to be diagnosed with⁸ and die from⁹ melanoma skin cancer. Men are also more likely to develop gout¹⁰, kidney stones¹¹, and diabetes¹².

Additionally, despite having fewer diagnoses of mental health conditions overall¹³, men are three times more likely to die by suicide. The reasons for this are complex, but a contributing factor is that men are less likely to discuss their mental health and less likely to access psychological therapies than women, in part due to societal expectations and stereotypes¹⁴. Only 36% of NHS talking therapy referrals are for men, but research indicates that men engage with help that meets their preferences and is easily accessible¹⁴. Therefore, the development of psychological therapies tailored to men’s mental health is critical.

The importance of clinical trials

Clinical trials can help us discover and develop new ways to diagnose and treat mental and physical health conditions. Research can help us further our understanding and potentially lead to better prognose. It can also help improve healthcare for all as we may gain knowledge about health in general. Whether you live with a condition or not, research can benefit you or others like you in the future.

Men are underrepresented in clinical trials for mental health conditions, and research has found that in some cases, men make up less than a third of participants¹⁵. Consequently, any treatment options developed for depression may not be as effective for men as the participant sample in the trials would not be representative. It is necessary to our understanding and treatment of mental health conditions that men are represented in clinical research.

Are you interested in depression research? We are currently conducting a study to test an investigational drug for treatment-resistant depression. Find out how you could help yourself and generations to come by visiting our depression study webpage.

References

1 NHS – Cardiovascular disease

2 BHF UK CVD Factsheet

3 Peters et al. (2020) – Sex differences in the association between major risk factors and the risk of stroke in the UK Biobank cohort study

4 BMJ Open – Time trends in peripheral artery disease incidence, prevalence and secondary preventive therapy: a cohort study in The Health Improvement Network in the UK

5 BHF – What is an aortic aneurysm?

6 Parkinson’s UK – What is Parkinson’s?

7 NICE – Prevalence | Background information | Parkinson’s disease | CKS

8 Cancer Research UK – Melanoma skin cancer statistics

9 BBC News – UK skin cancer deaths higher in men than women

10 BMC Primary Care -Cohort study investigating gout flares and management in UK general practice

11 NHS Inform – Kidney stones – Illnesses & conditions

12 NHS England Digital – Adults’ health: Diabetes

13 Mental Health Foundation – Men and women: statistics

14 Mental Health Foundation – Men and mental health

15 Knox et al. (2022) – Male involvement in randomised trials testing psychotherapy or behavioural interventions for depression: a scoping review