They may pride themselves on their large muscles or burly build.

But so-called 'macho' men often lag behind in the health stakes - and are more likely to die young, new research warns.

Not only do many think going to the doctor is for 'wimps', they also try to brave out the symptoms of an illness, the study claims.

In fact this 'stiff upper lip' could be a major factor in why men die earlier than women throughout the world, it added.

Diana Sanchez, professor of psychology at Rutgers University, said: 'The question we wanted to answer was, why do men die earlier than women?

So-called 'macho' men could be putting their health at risk by failing to go to the doctors, a study found

'Men can expect to die five years earlier than women, and physiological differences don't explain that difference.'

Well-established reasons for men living shorter lives include greater exposure to violence and war to a higher use of drugs, tobacco and alcohol.

But a macho attitude could also be to blame, concluded the researchers, writing in the journal Preventative Medicine.

In a series of interviews with men and women they found men were less likely to go to a doctor.

They also chose male doctors because they thought they were more competent than female doctors

Yet when they go to see a male GP, it was found they were less likely to be honest with them about their problem.

A psychological questionnaire among the men taking part in the study looked at their own feelings about masculinity.

It found those who were the most macho were least likely to seek medical advice.

These men also felt they should be 'tough, brave, self reliant and restrained' about potential medical problems,' according to the study.

'That's because they don't want to show weakness or dependence to another man, including a male doctor' Professor Sanchez said.

The study concluded: 'Men have a cultural script that tells them they should be brave, self-reliant and tough.

'Women don't have that script, so there isn't any cultural message telling them that, to be real women, they should not make too much of illnesses and symptoms.'

FROM PROBLEMS IN THE BEDROOM TO NEEDING THE LOO IN THE NIGHT...

Erectile dysfunction can often be an early warning sign of heart disease, doctors warn. Cardiologist Graham Jackson said a man with erection problems will usually develop a heart problem within five years (file photo)

From blood in the urine to 'man boobs', there are a host of signs that things aren't quite right in the male body.

And sometimes seemingly everyday symptoms can be a sign of a more serious disease.

For example, heavy drinking may be a sign of depression, while problems performing in the bedroom is an early indicator of heart disease.

Here, experts reveal to MailOnline the nine health symptoms men should never ignore...

1) ERECTILE DYSFUNCTION

Could be: Heart disease

Doctors are increasingly warning that erectile dysfunction can often be an early warning sign of heart disease.

'The body needs a good blood supply for an erection - and erectile problems are actually a very clear barometer of cardiovascular health,’ said Raj Persad, a urologist at Bristol Royal Infirmary.

Heart disease occurs when the arteries leading to the organ become clogged with fatty deposits, meaning they are thick and furred.

But this effect is seen even more quickly in the vessels carrying blood to the penis.

‘That’s because the penile arteries are smaller than coronary ones, so become furred up faster,’ Dr Persad said.

Cardiologist Graham Jackson, of the Sexual Advice Association, told MailOnline that a man with erection problems will usually develop a heart problem within three to five years.

‘A man in his 40s with erectile dysfunction has a 50-fold greater risk of having a heart attack over the next ten years.

Heart disease occurs when the arteries leading to the organ become clogged with fatty deposits, meaning they are thick and furred. But this effect is seen even more quickly in the vessels carrying blood to the penis

'It’s actually a predictor of death rather than simply heart disease.

‘There isn’t a risk factor higher on this planet.’

Meanwhile, Australian research showed that even in apparently healthy men, slight or moderate erection problems could signal trouble ahead.

The condition increased the risk of heart attacks, heart failure and arterial disease in men aged 45 and over with no previous history of heart conditions.

Experts say men experiencing any degree of erectile dysfunction should seek medical help.

2) DEVELOPING ‘MOOBS’

Could be: Hormone imbalance, liver disease

In most cases, if a man develops what appears to be breasts, it is not breast tissue - but fatty tissue which has grown because he is overweight.

‘They need to lose weight and drink less beer,’ said Professor Ashley Grossman, an endocrinologist from the University of Oxford.

However, sometimes men do form breast tissue, and in this case the condition is known medically as gynaecomastia.

‘Gynaecomastia translates as female breasts,’ Professor Grossman said. ‘It’s usually means female breast tissue in a man.’

The condition is caused by an imbalance between the hormones testosterone and oestrogen, he explained.

Men sometimes develop breasts as they are overweight. But it may be a sign of a hormonal imbalance (file photo)

Oestrogen causes breast tissue to grow, but normally men usually have much higher levels of testosterone, which stops the oestrogen from triggering this.

But if the balance of hormones changes, this can cause a man’s breasts to grow.

‘This can happen as boys go through puberty, as their hormones might be a bit imbalanced,' said Professor Grossman.

‘It can cause a bit of distress as the boy is usually chubby, he doesn’t want to take his top off during swimming.

‘It normally settles down on its own. We reassure him he’s not turning into a girl, and to tell him to lose weight.’

Oestrogen drugs are available, but they do not work well, he added.

As a last resort, there is a simple plastic surgery operation that can be done to remove the breast tissue, but after it is explained the condition will go away on its own, most people do not opt for it.

In grown men, ‘moobs’ are a sign the testicles are not working properly.

Professor Grossman explained: ‘The pituitary gland stimulates the testicles to produce, but it can’t produce any more so it ends up making more oestrogen.’

It can also be a sign of liver disease, he added, as when the organ becomes damaged, the balance of hormones in the body changes and can cause gynaecomastia.

Men worried they are developing breasts should go to a doctor, who can feel them and see if they ar simply fatty tissue, or breast tissue.

‘The most useful test is to measure the hormone levels in the blood to see if they are imbalanced,’ Professor Grossman concluded.

3) NEEDING THE LOO IN THE NIGHT

Could be: Prostate cancer, enlarged prostate

If you are rushing to the toilet in the night, it could be a sign of an enlarged prostate or prostate cancer, according to Prostate Cancer UK.

The prostate is a gland the size and shape of a walnut whose main role is to make semen, the liquid that carries sperm.

It lies underneath the bladder, and so if there is any change in the size of the gland, it can affect a man’s urination habits as it presses on the urethra, the tube through which urine flows.

The charity warns men to look out for symptoms like include needing to go to the loo more often than usual including needing to rush to the toilet and leaking before arriving.

Having difficulty peeing, straining or taking a long time to finish urinating or having a weak flow when urinating or feeling as though the bladder is not fully empty could also be signs.

Rushing to the toilet in the night could be a sign of an enlarged prostate or prostate cancer (file photo)

Men with these symptoms should contact their GP, who can carry out tests to assess if the man has a benign prostatic enlargement, a non-cancerous growth of the gland.

The doctor could also assess whether there is a chance he has prostate cancer, which can be detected through a blood test, a physical exam and a biopsy.

For many men with prostate cancer, treatment is not immediately necessary, unless they have an aggressive form of the disease, or the cancer has spread to other areas of the body.

Treatments include having surgery to remove the prostate, radiotherapy and hormone therapy.

4) NO SENSE OF SMELL OR A CHANGE IN LIBIDO

Could be: Problems with fertility

‘If a man notices a change in his libido, that could be an endocrine [hormonal] problem,’ said Mr Michael Dooley, a consultant gynaecologist at the Poundbury Clinic at King Edward VII’s Hospital.

It could be indicative of hypogonadotrophic hypogonadism, a condition where, in men, the testicles do not produce enough male hormones.

A man in his 40s with erectile dysfunction has a 50-fold greater risk of having a heart attack over the next ten years. There isn't a risk factor higher on the planet Dr Graham Jackson, cardiologist and chair of the Sexual Advice Association

This leads to a lack of sex drive, and fertility problems, he explained.

‘A lack of smell is another sign that the testicles aren’t working properly,’ he added.

Lack of smell, or anosmia as its known medically, is associated with Kallman’s syndrome, a similar genetic disorder in which the lack of male hormones leads to delayed puberty.

‘Nobody knows why- but lack of smell is one of the key signs,’ Mr Dooley continued.

In both illnesses, the pituitary gland does not produce a hormone called gonadotropin-releasing hormone, he said.

‘If your body doesn’t make it, the testicles will not make sperm, leading to fertility problems.

‘If a man is infertile, you give him gonadotrophic injections.’

He advised men with either of these symptoms to go to their GP, who could refer them on to an endocrinologist or a fertility expert to investigate the problem.

5) LUMP IN TESTICLE

Could be: Testicular cancer

Lumps and swellings in the testicles are a relatively common symptom in boys and men.

The majority of lumps and swellings are caused by benign (non-cancerous) conditions that may not need treatment.

However, a lump could be a sign of testicular cancer, which affects nearly 2,000 men each year in the UK and is the most common cancer in men aged 20 to 35.

Men who notice a lump or abnormality in their testicles should always see their GP, doctors advise.

This is because treatment for testicular cancer is much more effective if the cancer is diagnosed early.

Indeed, it is the cancer with the highest survival rate.

A lump in the testicle could be due to testicular cancer, although the majority of swelling are caused by non-cancerous conditions that may not need treatment (file photo_

6) BLOOD IN THE URINE

Could be: Bladder cancer

Blood in the urine is the most common sign of bladder cancer, and is usually painless.

However half of those with the disease will die from it, figures show.

Most cases of bladder cancer appear to be caused by exposure to harmful substances, which lead to abnormal changes in the bladder's cells over many years.

Tobacco smoke is a common cause and it's estimated that half of all cases of bladder cancer are caused by smoking.

Chemicals previously used in manufacturing – now banned - are also known to cause the disease.

Lower back or abdominal pain can be a sign of bladder cancer (file photo)

Other symptoms to look out for include: needing to go to the loo frequently, urine infections that keep coming back, tiredness, lower back or abdominal pain and weight loss for no obvious reason.

Men with any of these symptoms should go to the doctor immediately.

Although it is likely they are due to a problem that is not cancer, such as haemorrhoids or a urinary infection, a doctor will be able to investigate.

7) DRINKING HEAVILY

Could be: Depression

In men, depression does not always display itself in the way we might think.

Classical symptoms include tearfulness, waking up early in the morning and other sleep disturbances, and experiencing loss of pleasure.

But men are more likely to have a ‘front’ and their depression may not manifest itself in these ways, says Dr John Chisholm, a former GP and chair of the Men’s Health Forum.

He told MailOnline: ‘Excessive drinking is something we flag up as a sign that things aren’t well.

‘In the UK there are a lot of people who are drinking in excess of the recommended daily limits. It puts their physical health at risk but it can also be a symptom of depression.

‘It can precipitate behaviour that is to be avoided, for example the association of drinking with domestic violence.’

He pointed to a Danish study which found that men who are depressed don’t emit the classical signals.

Instead, as well as alcohol abuse, anger management, violence, an inability to maintain relationships, or a withdrawal from established relationship can signal depression.

This is something that professionals may not realise, he added.

In men, depression does not always display itself in the way that we might think - and heavy drinking can be a classic warning sign,

‘I don’t want to criticise doctors and nurses, but not all healthcare professionals will be aware of the symptoms men display when they are depressed and suicidal,’ he said.

This is important, Dr Chisholm says, as men are already 20 per cent less likely to go to the doctor in the first place.

‘Men find personal things more difficult to talk about their feelings.

He added: ‘Part of masculinity, of male culture, is to grin and bear it, suppress your feelings. That’s how boys have been brought up; they are taught to put on a veneer of coping.’

Part of masculinity, of male culture, is to grin and bear it, suppress your feelings. That’s how boys have been brought up; they are taught to put on a veneer of coping Dr John Chisholm, a former GP and chair of the Men’s Health Forum

This ‘bottling up’ of feelings means mental health problems can be masked.

It has serious consequences, said Dr Chisholm.

Three quarters of suicides occur in men, a surprising figure given that more women are diagnosed with depression and anxiety than men.

‘The sort of methods men use to kill themselves are more violent and likely to succeed,’ he added.

‘We have to break the cultural stereotypes and teach men that they should be in touch with their emotions. And if those emotions get out of control, it’s not a sign of weakness to seek help.

‘If men are in a family setting or in a relationship with a partner or a spouse or in a network of friends, if those partners or friends are more aware of these things, they can encourage a man under stress or strain seek medical help for that.’

8) PAIN IN THE BIG TOE

Could be: Gout

Gout is three to four times more likely in men than women - and one of the most common symptoms is a painful big toe

Gout is three to four times more likely in men than women.

And it is even more common in older men, with 1 in 7 older men affected, compared to 1 in 16 older women.

The most common symptom of gout is sudden and severe pain in one or more joints, typically the big toe.

A type of arthritis, gout occurs when crystals of sodium urate form inside and around joints.

It happens due to a build-up of uric acid, a waste product made in the body every day, in the blood.

If you produce too much uric acid or excrete too little when you urinate, the uric acid builds up and causes tiny crystals of sodium urate to form in and around joints.

These hard, needle-shaped crystals build up slowly over several years without the person knowing.

Eventually, some may spill over and inflame the soft lining of the joint, causing pain and inflammation.

Some crystals pack together to form hard, slowly expanding lumps of crystals which damage joint cartilage and nearby bone, eventually leading to irreversible joint damage.

The joints then become intensely painful and stiff when used.

Symptoms usually occur after the age of 30 in men.

9) LUMPS AROUND THE NIPPLE

Could be: Male breast cancer

It’s not only women that get breast cancer, around 350 men a year in the UK are also diagnosed with the disease, according to Breast Cancer Care.

Many people don’t know that men can get breast cancer because they don’t think of men as having breasts.

In fact, men have smaller amounts of breast tissue around their nipple, where can, on rare occasions, tumours can develop.

Lumps, often painless, close to the nipple are the most common symptom, although they can also occur away from the nipple.

A tender or inverted nipple, or discharge, which is often blood-stained, are other signs of the disease, as well as swelling in the chest or ulcers forming in the area.

Most men who get breast cancer are over 60, although younger men can be affected.