Has Movember Outgrown The Mustache?

Perhaps awareness alone isn’t enough anymore

We’re a week late with this post—but better late than never. Between ACIP happenings and everything else unfolding in public health right now, Movember slipped past us before we could hit publish. Apologies for the lag. The conversation about men’s health doesn’t end when the calendar flips to December, so here we are.

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For more than two decades, Movember has asked men to grow mustaches to raise awareness of men’s health issues. And it worked at least for a time. But today, the biggest threats to men’s health aren’t a lack of awareness. These threats are silence, stigma, and delay in getting care. Men are still far less likely to seek help for mental health struggles, and they still avoid the simple screenings like prostate-specific antigen (PSA) blood tests that could save their lives. After twenty years of growing mo’s, the question is no longer if men are noticing. It’s whether they act on it.

The Original Promise of Movember

My first experience with Mustache November - or Movember - came during my first industry job after graduate school about 15 years ago. A coworker who always had a mustache showed up clean-shaven on November 1st. If you know anyone with facial hair, you know that growing it is subtle, but when it disappears, you notice it instantly. It certainly piques your curiosity.

After talking with him, I learned about Movember and his personal connection to prostate cancer, and how the movement aimed to draw attention to men’s health issues that were too often ignored. What surprised me, as I researched Movember for this article, was how little I actually knew about its origins - something that probably reflects my own blind spots when it comes to men’s health.

Movember began in 2003 with two Australian friends who wanted to “bring back the mo.” They recruited 30 of their mates, each tossing in ten Australian dollars (AUD), and were inspired by a friend’s mother, who had run a breast cancer fundraiser, to focus their effort on men’s health and prostate cancer (PCa). The following year, the “Mo Bros” grew to nearly 500 men across Australia, the UK, and Spain, ultimately raising 54,000 AUD for the Prostate Cancer Foundation of Australia (PCFA) - the largest single donation the foundation had ever received.

Since then, the movement has gone global, raising more than 730 million AUD and expanding its missions to include testicular cancer and men’s mental health. Movember undeniably succeeded at putting these issues on the map.

But after two decades of mustaches, we have to ask: is awareness enough? If the message is everywhere, why are men still so hesitant to act?

The Modern Men’s Health Crisis Looks Different

Once you start looking at the numbers, it becomes painfully clear why men’s mental health has become a quiet crisis - especially in the United States. Globally, more than 700,000 people die by suicide each year, and in every region of the world, men die at significantly higher rates than women. In the U.S., men die by suicide at roughly four times the rate of women, and that imbalance has barely changed over several decades. Today, 75-80% of all suicide deaths in the U.S. are men, which means roughly 100 men die by suicide every single day.

There is a narrow, technical silver lining: the global age-adjusted suicide rate has decreased by about one-third since the 1990s, mainly because of significant declines in highly populous nations like India and China. But that global trend hides a stark reality at home. In the U.S., suicide rates rose by 37% between 2000 and 2018, dipping slightly through 2020, and then rose again during the pandemic years, returning to their previous 2018 peak. The absolute numbers remain high, and the gender gap shows no sign of closing.

What makes this even more troubling is how few men seek help. In the past year, nearly 1 in 4 U.S. adults experienced a diagnosable mental illness, yet only 22.9% received any mental health treatment at all. Among those with a diagnosable mental illness, just more than half (52.1%) received care. And the gender divide is stark: 1 in 4 women received mental health treatment in the past year, compared with only 1 in 8 of men. Nearly 1 in 10 men experience depression or anxiety - but less than half seek treatment.

For many men, mental health struggles stay invisible until they’re impossible to ignore. I’ve felt this in my own life - the instinct to push through, to handle everything alone, to avoid admitting something might be wrong. The pandemic only amplified that instinct. It disrupted our routines, isolated us from the social connections we rely on, and layered stigma and fear onto every interaction. For a lot of men, myself included, the combination of isolation and self-reliance created a kind of psychological pressure cooker that has a hard time finding the release valve. And collectively, that silence is costing us, especially men, their lives.

Why Men Still Avoid Care

If self-awareness were enough, the numbers would look very different. Men avoid care not because they don’t know better, but because they’re conditioned to pretend they don’t need it. I can see that conditioning in my own childhood. I was an emotional kid - disappointed by missed trips, embarrassed by mistakes at school, quick to cry in front of family and friends. And I remember the subtle corrections from adults: “That’s not the right reaction,” “You need to toughen up.”

Over time, those lessons changed me. I learned to hold everything in, to stay controlled, to become stoic. In some ways, that served me well professionally. But it came at a cost. I can already hear echoes of those same lessons in the things I say to my own kids - old habits slipping out without even thinking about them.

I’ve never lost my empathy for others, but somewhere along the way, I lost the ease of showing emotion, even when the situation called for it. Maybe simply writing this down is the first step toward improving my own life moving forward.

These messages don’t just fade; they follow us into adulthood. The same beliefs that once taught me to “toughen up” now shape how men respond to everything from depression to routine medical care. They influence who gets help, who waits too long, and who avoids something as simple as a PSA test. It isn’t that men don’t know what’s at stake - it’s that silence was taught long before risk ever was.

Stigma is still the single most significant barrier to getting help, and the isolation of the pandemic magnified it for men in particular. Studies show that men avoid treatment for five reasons: social expectations, conformity to masculine norms, self-stigma, limited understanding of mental health symptoms, and the lack of mental health campaigns designed with men in mind. And the numbers back this up - 71% of people who didn’t seek help said they believed they should “handle it on their own.” That belief is woven deep into how many men are raised, and it quietly shapes how they respond to mental strain.

The Prostate Cancer Paradox

And this same pattern shows up just as clearly in the way men approach their physical health. Men don’t just delay seeking help for emotional pain - they often ignore or minimize physical symptoms too, especially when it comes to male-specific conditions. Prostate cancer is one of the clearest examples of how silence, stigma, and avoidance can shape outcomes.

Prostate cancer is the most common cancer in men in the United States. About 1 in 8 men will be diagnosed in their lifetime, and many more will have microscopic, undetected tumors found only at autopsy. It is, in many ways, a “quiet” disease - highly prevalent, frequently slow-growing, and often asymptomatic for years or even decades.

But the quiet nature of prostate cancer doesn’t make it harmless. After declining from 2007 to 2014, U.S. prostate cancer incidence has been rising by about 3% annually from 2014 through 2021. Globally, prostate cancer still accounts for roughly 30% of all male cancers and remains a significant cause of cancer-related death. Awareness is widespread - Movember helped with that - but awareness doesn’t necessarily translate into action when stigma, fear, or misconceptions about screening still stand in the way.

PSA vs. DRE: The Test Men Fear The Most

A surprising number of men still avoid prostate cancer screening because they dread the digital rectal exam (DRE) - even though the DRE is no longer recommended as a routine screening test.

As I get older, staying healthy has become less of an abstract idea and more of a priority. Certain tests quietly become part of the yearly routine, and for older men, the PSA (prostate-specific antigen) blood test is one of them. PSA is simple: it measures a protein produced by cells in the prostate and can signal changes in the gland, including the possibility of prostate cancer. But like many screening tools, it has limitations. PSA can be elevated for reasons that have nothing to do with cancer, such as benign prostate hyperplasia (BPH) or inflammation. Many men with higher PSA values do not have cancer, which is why elevated PSA often leads to further evaluation rather than immediate intervention.

Then there is the DRE, or the test most men dread. The anxiety around it is so intense that it can deter some men from screening altogether. But it’s important to understand what the science actually says, because fear of the DRE is one of the most persistent and least necessary barriers to early detection.

Current evidence shows that PSA is highly sensitive but not very specific for prostate cancer, which is why it can generate both important early warnings and occasional false alarms. For that reason, the American Urological Association and Society of Urologic Oncology recommend the PSA blood test as the primary screening tool for prostate cancer. The DRE, once considered essential, is no longer recommended as a standalone screening test and is optional even as an adjunct. In other words, the test men fear most is the one they often don’t need to have at all.

The data support this shift. In the long-running European Randomized Study of Screening for Prostate Cancer (ERSPC), which followed participants for 23 years, PSA-based screening reduced prostate-cancer mortality by about 13%. Earlier versions of the ERSPC protocol included DRE along with PSA, but more recent analyses show that DRE adds little to no diagnostic value in modern screening settings. Multiple reviews and meta-analyses confirm this: whether used alone or in addition to PSA, the DRE has poor diagnostic performance and contributes minimally to early cancer detection.

Taken together, the message is straightforward. PSA is the real screening tool. DRE is optional, not required, and in many cases, not sensitive enough to be helpful. Yet the fear of the DRE persists so strongly that many men avoid screening altogether - not realizing that the test they fear is no longer part of standard screening. That misconception shouldn’t stop men from getting a simple blood test that can save their lives.

The Common Thread: Silence is Deadly

When we look at men’s mental health and prostate health side by side, the same pattern emerges. Asking for help or getting tested is stigmatized, feared or dismissed as something a man should deal with quietly. And the data around prostate cancer screening make this painfully clear–the stigma around getting screened of any kind remains strong.

Across studies in different countries, the same pattern emerges: men often fear screening more than the test itself. Among African-American and Afro-Caribbean men in the U.S., screening rates are lower, and fear or worry about prostate cancer is higher than among white men.

Across these studies, one theme stands out: the anxiety is highest before the test, not after. Once men actually go through screening, most say the experience was far easier than expected and that they would do it again. That alone offers a hint of a path forward - fear thrives in silence, not in experience.

Focus groups with Black and Latino men reveal additional barriers: cultural beliefs, misconceptions about prostate cancer screening, and fears shaped by historical and medical mistrust. Interventions that combine culturally sensitive education with patient navigation show promise in closing these gaps. When misinformation is replaced with clarity - and when men feel supported rather than judged - screening rates improve.

I can’t help but feel that these communities, often the most underserved and most affected, are also showing us the way. Their responses reveal what men everywhere need: safe conversations, clear information, culturally grounded support, and the chance to replace fear with familiarity - even when the test itself is as simple as a blood draw. Silence is deadly, but it’s also something we can unlearn.

What Needs to Change After 20 Years of Movember

Movember began in 2003 with a simple goal: to generate awareness. And it succeeded. Two decades later, the issue isn’t whether men know about prostate cancer, mental health, or suicide risk. It’s whether awareness is being converted into action. The epidemiology is clear that male suicidality is shaped not just by psychological symptoms, but also by relational and existential pressures - loss of purpose, unemployment, financial strain, legal trouble, substance use, and relationship breakdowns. These are experiences many men endure silently.

Men often communicate differently, too - through action rather than words, through withdrawal, protectiveness, humor, or long stretches of silence. These responses are communication, just not the verbal kind that awareness campaigns usually target. To reach men effectively, we need to meet them where they are, both mentally and physically.

There is evidence for what actually moves the needle. A recent systematic review and meta-analysis of 97 randomized trials involving more than 43,000 young people showed that well-designed interventions can produce meaningful short-term improvements in stigma-related knowledge, attitudes, and help-seeking behavior. The strategies that worked best combined psychoeducation, social contact, and targeted approaches to reduce self-stigma, often by helping people reframe unhelpful thought patterns.

The takeaway for men’s health is straightforward: if we want to turn awareness into behavior change, our campaigns need to evolve. The most effective programs are those that:

• Co-design with the communities they aim to reach, ensuring the message feels relevant rather than imposed.

• Use real stories and social contact, which reduce stigma more effectively than abstract information.

• Acknowledge men’s communication styles and normalize both verbal and non-verbal expressions of distress.

• Address real-world stressors - financial strain, job loss, identity, purpose - not just symptoms.

• Guide men through the system, using patient navigation, culturally competent support, and clear next steps.

Awareness mattered in 2003. It still matters. But in 2025, action, access, and connection matter far more.

A New Kind of Men’s Health Conversation

Credible male role models speaking openly about their health can play a decisive role in normalizing conversations about what men often avoid. Ben Stiller’s experience is one example, not because everyone should get tested at his age, but because he had an honest dialogue with his doctor. At 48, with no symptoms or family history, his doctor suggested a PSA test “just to establish a baseline.” That conversation led to an early prostate-cancer diagnosis - one Stiller has said saved his life. His message isn’t about testing outside of guidelines; it’s about engaging, asking questions, and making decisions together with a clinician rather than waiting in silence.

It’s a reminder that cuts across everything in this article. Whether it’s mental health or prostate health, silence doesn’t protect us. Avoidance doesn’t protect us. Early conversations do. A simple blood test can save a life. So can saying, “Something doesn’t feel right.” If awareness alone were enough, we wouldn’t still be losing so many men. What we need now is action, support, and a willingness to speak up long before something becomes urgent.

Stay Curious,

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