Andropause
By the time men are between the ages of 40 and 55,
they can experience a phenomenon similar to the female menopause,
called andropause. As with women, andropause in males begins at a time
when life often offers some of its greatest rewards. But unlike women, men do not have a clear-cut
signpost such as the cessation of menstruation to mark this
transition. Andropausal body
changes occur very gradually in men and may be accompanied by
changes in attitudes and moods, fatigue, a loss of energy, sex drive
and physical agility.
In many instances, testosterone replacement in men with andropause can be highly effective and beneficial. It's not for every man, of course. Even those who show symptoms may have other health problems at the root of it all. You should discuss with your doctor if you would be a good candidate for testosterone replacement therapy.
In various clinical studies, very good responses to testosterone have been reported for men with low-testosterone, and they include:
- Improvement in mood and sense of well-being
- Increased mental and physical energy
- Decreased anger, irritability, sadness, tiredness, nervousness
- Improved quality of sleep
- Improved libido and sexual performance
- An increase in lean body mass, a decline in fat mass
- An increase in muscle strength (hand grip, upper and lower extremities)
- Potentially, a decrease in the risk of heart disease
Male pattern baldness (Androgenic alopecia )
Male pattern baldness is not a disease since the tendency to lose hair is
genetically predetermined. A proper diagnosis is important because
there are other types of hair loss as well. Alopecia is categorized as
either scarring or non-scarring. Scarring forms of alopecia include
types such as androgenic, areata, and secondary syphilis. Alopecia
areata is characterized by sudden hair loss and is thought to be caused
by an autoimmune disorder. Scarring types include those associated with
inflammatory and autoimmune conditions and severe infections.
Treatments
There are two drugs which are reasonably effective, although if
stopped any re-grown hair is lost. Rogaine (minoxidil) can produce up
to 50% hair re-growth although the hairs are often small. How this
medication works is not fully understood. Finasteride (proecia) works
by inhibiting the formation of dihydrotestosternone (DHT) in the scalp.
This drug can re-grow hair and can prevent further hair loss.
To our knowledge there are few proven natural treatment for male pattern baldness. Unfortunately some overzealous marketers and unscrupulous "healers" may try to take advantage of the consumer by touting such claims.
One natural medicine which has shown promise is ViviScal (a food supplement incorporating special marine extracts and a silica compound). We are currently trying to obtain this from Europe and make it available to our patients at a good price.
Good circulation to the scalp is important for bringing nutrients to
the hair follicle so exercise and a healthy naturopathic diet plan are
probably a good idea.
Infertility
Male infertility can be caused by low or no sperm production as well
as erectile dysfunction, and many other factors. A correct diagnosis is
absolutely critical if a successful outcome is to be achieved.
Conventional semen analysis may not be enough because it is not very
accurate. In our office we include an evaluation for hormone
problems such as hypothyroidism, hyperthyroidism, diabetes, etc. Other
causes must also be excluded including the use of drugs that cause
infertility, infection, and a number of other conditions. History of
exposure to toxic chemicals, heavy metals, radiation, use of alcohol,
tobacco, cannabis, and caffeine would also need to be looked at.
Causes of Infertility
- Aging
- Hormone problems
- Alcoholism
- Genetic defects
- Toxic chemical exposure
- Hemochomatosis
- Excess heat exposure
- Hypospadias
- Heavy metals
- Drug usage (legal and illegal)
- Sperm production problems
- Infection
- Nutritional deficiency
- Tobacco smoking
- Varicocele
Naturopathic Treatments
Elevated levels of the heavy metals lead and cadmium are of the most
concern. We like to test for these metals and removal them. Numerous
studies support the association with alcohol, caffeine and tobacco use
and infertility/impotence. These substances must be avoided while
trying to become fertile again.
The following are some supplements used in naturally treating infertility:
- Vitamin C - This vitamin protects sperm from free radical damage and improves the quality of sperm in smokers. When sperm stick together fertility is reduced. Vitamin C reduces sperm stickiness.
- Zinc - For men with low testosterone levels, zinc supplementation raises testosterone and also increases fertility. For men with low semen zinc levels, zinc supplements may increase both sperm counts and fertility.
- L-arginine - Most research shows that several months of L-arginine supplementation increases sperm count and quality and also fertility. However, initial sperm count is extremely low (such as less than 10 million per ml), L-arginine will have little effect.
- Coenzyme Q10 - This nutrient is used by the body in the production of energy. While its exact role in the formation of sperm is unknown, there is evidence that it will increase sperm count and motility.
- Vitamin B12 - This vitamin is needed to maintain fertility. Vitamin B12 injections have increased sperm counts for men with low numbers of sperm. These results have been duplicated in double-blind research.
- L-carnitine - L-carnitine is necessary for normal functioning of sperm cells and has been found to improve sperm motility and sperm maturation.
- Selenium - In a double-blind study with infertile men, supplementation with selenium significantly increased sperm motility, but had no effect on sperm count.
- Asian ginseng - Asian ginseng may prove useful for male infertility. A study found that Asian ginseng given for three months led to an improvement in sperm count and sperm motility.
Erectile Dysfunction (ED)
There are three main categories of ED: psychological, hormonal and
neurovascular. Various tests need to be done by a doctor to determine
what type of ED a person has. Without a proper diagnosis treatment will
not be effective. A physical cause is the most common.
Causes of ED
- Neurogenic - Disruption of nerve impulses from the brain.
- Disease - Damage to nerves, arteries, smooth muscles, and other tissues, as a result of disease, is the most common cause of ED. Diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease—account for about 70 percent of ED cases. It is very common for men with diabetes to get ED.
- Surgery - Can harm nerves and arteries near the penis, causing ED.
- Drugs - blood pressure drugs, narcotics, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine can cause ED.
- Psychological factors - stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. .
- Smoking - This affects blood flow to the penis.
- Hormonal abnormalities - not enough testosterone or other hormones.
Naturopathic Treatments
If allopathic options such as surgery, drugs or vacuum devices are not
appealing to you Naturopathic medicine does have some alternatives to
offer. Our approach involves addressing the underlying causes of ED and
enhancing libido.
Few natural medicines actually produce erections, but many will enhance libido.
Stress
According to a report in the February 11th, 2002 issue the Archives
of Internal Medicine, chronic work and marital stressors increase the
risk of death from all causes and cardiovascular disease in men. Over a
16-year period, 12,336 men with work stress, and 10,904 men with marital
stress were studied. There was an positive association between high
work stress, marriage problems and risk of dying early. Men with at
least three work stressors had 1.26 times the chance of dying, compared
with those reporting no work stress. Men who divorced during the trial
had 1.37 times the chance of dying, compared with those who remained
married.
Diseases strongly linked to stress include:
- Angina (chest pain)
- Asthma
- Autoimmune disease
- Cancer
- Cardiovascular disease
- Colds and Flu
- Diabetes (adult onset - type II)
- Depression
- Headaches
- High blood pressure
- Immune suppression
- Irritable bowel syndrome
- Rheumatoid arthritis
- Ulcers
- Ulcerative colitis (ulcers in the intestines)
How stressed are you?
Like an athlete who is over-training, typical symptoms of over-stressing include insomnia,
depression, fatigue, headache, upset stomach, digestive disturbances,
and irritability. Some deal with this by using drugs, overeating,
watching excessive television, having emotional outbursts, feeling
helpless, or overspending. The best way to find out if you are
overstressing is to have a complete workup, including an adrenal stress
profile.
Naturopathic Stress Treatments
How an individual handles stress plays a major role in determining
their level of health. For years researchers have been looking at the
association between stress and heart disease, including the beneficial
effects of relaxation therapies. Chronic diseases are usually caused by
an inability of a person's body to maintain optimal balance. Stress
profoundly affects the delicate balance primarily through altering your
body's output of hormones, central nervous system, and immune system;
although other systems are affected as well.
According to Hans Selye (the father of modern stress research), stress alone should not be viewed negatively. It is not the stressor that determines the response; instead it is the individual's reaction which triggers the response. This internal reaction is highly individual. One person's stress may be another person's medicine.
While eliminating excess stress might be optimal, usually is is not practical (we all have to work and live). Our goal is to help you develop an appropriate response to stress by "preparing you body to take it."
Before any herbs or supplements can be recommended for stress reduction, it is very important to have a physical examination and some tests done. Treatment will take into consideration blood levels of stress hormones, blood pressure, lifestyle, work and family situation, family history, and many more factors. It is not appropriate, for example, to start taking Panax ginseng when you feel stressed, because this could actually make things worse by raising blood pressure and stress hormones.
Get a comprehensive stress evaluation. This may include a complete
history, physical exam and laboratory or functional tests depending on
the case. Dr. Bronner's treatments will vary depending on your
situation, and can include relaxation training, dietary modification,
natural medicines, nutrition, and eliminating food allergies or
sensitivities.
