The concepts of “health” and “illness” have different meanings when viewed through the lens of evolutionary biology. For men, health is a currency that fluctuates significantly in response to energetic, social, cultural, and genetic constraints, as well as age. Moreover, it is a currency that is defined and valued differently between medical professionals and human evolutionary biologists. In strict evolutionary terms, health is only relevant to the extent that it allows animals to acquire the mates and resources needed to optimize lifetime reproductive success. During the course of human evolution, fitness trade-offs affecting men’s health over the life course have likely coevolved with changes in extrinsic mortality and concurrent selection for a wide range of reproductive strategies. Seen in these evolutionary terms, many men’s health issues, like prostate cancer, can be understood as a result of physiological compromises between the primacy of reproductive effort, the need for somatic maintenance, and plastic responses to ecological conditions.

To promote a fuller understanding of men’s health in evolutionary medical context, human evolutionary biologists need to expand their repertoire of experimental regimens, and medical professionals need to embrace the utility of thinking about medical issues in evolutionary context. The incorporation of evolutionary and life history theory—including the concept of endocrine pleiotropy—into our understanding of health and disease is at the core of the field of evolutionary medicine (Nesse et al. 2010; Stearns et al. 2010).

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