I'm 46 year old male. Do I need a physical?

Should have it. It is recommended that you should have a physical evry one-two years after hitting 40....If you have not done so in recent years, getting done is a good idea. Simple things like ekg, tetanus booster, urine test and some basic labs are done as part of your physical...Painless... Good luck.
It depends. When did you last have one? Do you have risk factors like smoking, overweight, family history of heart disease, diabetes, or cancer? Do you get enough physical activity (150 minutes/week)? Have you ever had high blood pressure or high cholesterol? If you've had normal blood pressure and haven't had it checked in a couple years, it's time to see your doctor.