June was Men’s Health Month, and even though it is July, today we will be discussing the various ways that Traditional Chinese Medicine (TCM) can help with common afflictions of the male body.

Because TCM rarely makes treatment decisions based on sex, we will focus on disorders that are specific to the male system, particularly sexual health and its relationship to other body systems. The most common presentations for men’s health have to do with the balance of yin and yang within the body. Commonly yin deficiency (xu) or yang deficiency (xu) can be seen.  Blood stagnation and phlegm accumulation also occur but are less common in regards to common male complaints. Yin deficiency and yang deficiency are primarily the product of poor lifestyle choices but can also be the result of aging.

Each pattern requires different strategies. Phlegm accumulation primarily manifests as psycho-emotional disorders that then lead to poor sexual functioning.  Chronic emotional repression, suboptimal diet, drug use, and other indulgences lead to the accumulation of “phlegm” in the sense organs which lead to changes in personality and mentation. This phlegm accumulation also blocks circulation to the kidneys and liver which are responsible for sexual function. These patterns  in the context of men’s health often manifest as anorgasmia, erectile dysfunction, or BPH. Sometimes patterns occur in layers such as yin or yang deficiency coupled with Blood Stagnation or Phlegm Accumulation because long standing patterns will impair other physiological functions.

BALDNESS:

Baldness is something that affects just about every man at some point in their life and can cause a great deal of consternation.  From a TCM point of view there are two types.

Male Pattern: Male pattern baldness is genetic. It is caused by variations of the androgen receptor that respond to dihydrotestosterone (DHT) in the hair follicles of the scalp. The androgen receptor is inherited on the X-chromosome which is passed down from the mother. The mother inherits an X-chromosome from both of her parents, but inherits her father’s X-chromosome in its entirety, and this is why people often point to the maternal grandfather to determine if a man will go bald later in life. Testosterone is produced by the testes and then is transformed to DHT through the enzyme 5-alpha-reductase. DHT is responsible for much of the secondary sexual characteristics of men such as body hair and facial hair (and later prostate swelling). In some men, the androgen receptors in the hair respond to DHT by dying. First the blood flow to the scalp dries up and then the hair follicle dies, never to return. This pattern can occur at various ages and will eventually happen to just about all men but can be especially troubling to men when it occurs in youth. There is no “cure” to this as it is genetic. There are however ways to slow it down. Many longevity herbs contain compounds that block 5-alpha-reductase.

Products such as Rogaine function by ensuring circulation to the scalp hair follicles but this has the side effect of causing hair to grow elsewhere on the body. Increasing circulation to the scalp can be done non-pharmcologically with plum blossom needling and certain herbal remedies. Fresh ginger root applied to the scalp is one way to increase circulation to the follicles. Just keep in mind that whatever technique you use to prevent balding, you will still go bald eventually.

Everything else: caused by any other factor which is typically stress or disease. Balding of this sort is not usually genetic and can be prevented and hair regrown with the proper treatment of the underlying condition.

PROSTATE ENLARGEMENT:

Prostate Enlargement: enlargement of the prostate is another malady that effects many men at some point in life. The TCM etiology of prostate enlargement is varied. It can be yin xu, yang xu, phlegm accumulation, or damp heat accumulation in the pelvis.  The differentiation is determined by secondary symptoms that the man will experience. The secondary symptoms also determine the proper treatment method.

Yin xu would present with feelings of heat and overactive sexual desire. Yang xu would present with feelings of cold and hypoactive sexual function. Damp-heat in the pelvis would present with painfull urination and cloudy urine.  All presentations have difficult urination.  Some western herbs used to treat this are red maca, saw palmetto, and nettle root. Some Chinese herbs used are tu si zi and bi xie.

Often, disorders of the male system occur because of a reduction in the yang qi of a man. The yang qi reduces with age which is why these conditions are more common with advancing age.  When the yang declines, the body’s ability to metabolize moisture also declines and leads to a buildup of dampness.  Once there is significant dampness, the dampness blocks the proper flow of qi and yang, leading to more dampness and more yang reduction.  It is important to stop this process as soon as it starts and to properly differentiate the pattern.  Damp accumulation patterns can sometimes present with yang xu symptoms; treating this pattern with yang herbs will only make the problem worse.

SEMEN RETENTION:

Semen retention: TCM recommends that men do not ejaculate too often, as semen is considered to be the purest form of “essence” that a man can produce and too frequent emission can cause the body to catabolize itself to make more semen. This fits with laboratory experiments on fruit flies that shows if the flies are prevented from mating when they first mature, the flies will maintain their youth to an older age. Someone who ejaculates too often can expect to eventually suffer both yin and yang deficiency symptoms, get sick easier, and to lose their hair earlier. This can even lead to erection difficulty, particularly if the man watches a lot of porn and/or uses recreational drugs. Emission and sexual intercourse are healthy activities for anyone to engage in but TCM recommends that men learn to retain their semen and transform it into mental power through meditative techniques.

The key is moderation. The proper frequency of emission for a man in his 20s is no more than 3-4x per week, 30s 2x per week, 40s 1x per week, 50s 1x two weeks, 60s 1x per month.  This does not exclude sex as intercourse is fully possible without ejacualtion, it is even possible to have an orgasm without ejaculation. Ejaculation is a spinal reflex and orgasm is a cerebral reflex, with practice the two can be separated and a man can have as many orgasms as he pleases without ejaculation. Kegel exercises and breathing techniques are critical for this achievement.

Retaining semen can have profound effects on the health of the body and can renew the strength and vigor of a person. So too, there are some herbal formulas that can help restore someone who has become too depleted, typically these contain rou cong rong, shi hu, lu rong, gan cao, and shi hu.

Semen retention is a cornerstone of certain kinds of Daoist yoga which makes the assertion that after enough proper practice, aging can be controlled and even reversed.

A DISCUSSION ON DECLINING SPERM COUNT

Low sperm count is a challenge for many men trying to conceive with their partner. Unfortunately, declining sperm counts have been occurring world-wide, particularly in the “developed world”, for the last 50 years. What was considered a low sperm count 50 years ago is now considered a normal, or average, sperm count. Why this is occurring is unknown but its prevalence is backed up by public health data.

Numerous culprits have been put forth from endocrine disrupting plastics and pesticides in the water to the now-pervasive electromagnetic radiation, but none have been conclusively proven to be the cause.  Fortunately, there are many treatment options to increase male fertility. These are primarily herbal medicine and lifestyle advice.

HERBS YOU MIGHT SEE IN YOUR FORMULA WITH DR. FEGAN:

Yin yang huo – this herb is a PDE-5 inhibitor (like viagra) and has many beneficial effects upon the hormonal system. It was traditionally used as an anti-aging medicinal for men and women. It features prominently in formulas for menopause. Laboratory studies have shown an ability to regulate bone strength and bone mass and a structural similarity to testosterone (icariin). Despite its similarity to testosterone, it will not help you gain muscle, but it will increase sexual desire. 

Maca – A peruvian herb traditionally used to maintain healthy sperm counts at high altitudes. This plant will increase sexual desire and possibly also sexual satisfaction. The red colored cultivar is anecdotally effective for prostate enlargement.

Bi xie – this herb is used for certain kinds of prostate enlargement with difficulty urinating and cloudy urination. It is potentially toxic if used incorrectly but safe when used properly.

Sea food – sea cucumbers have a reputation as aphrodisiacs for men and also a reputation for reducing allergic responses and speeding the healing of many types of wounds.

Deer products – deer antler (lu rong) is an expensive and very effective substance for helping tissues regenerate. Deer antler velvet is the fastest growing animal tissue on the planet and thus full of growth factors like igf-1, glucosamine, chondroitin, etc. A few years ago there was a controversy with the NFL over whether or not taking deer antler velvet was considered doping. Using the animal product is not considered doping, injecting purified IGF-1 from the antler however, is.

Tu si zi – the seed of a parasitic plant called dodder. It is widely used for increasing fertility in both men and women. This is an herb with verified  5-alpha reductase inhibitory capacity and is considered a longevity herb.

He shou wu – the processed form of an anti-malarial herb. Processing transforms this herb ito a longevity tonic. It is very safe, although can cause liver issues in a minority of people. It is famed for the legend of “Mr. He” who regained his youth, fertility, and hair color by consuming only this herb after a lifetime of mistakes.

Wei ling xian – not specifically for male issues but because of its “piercing” nature can be used with other herbs to help overcome anorgamsia.

Rou gui – cinnamon bark. It is a  vasodilator and tonifies the yang, especially with fu zi.

Fu zi – the processed form of an extremely toxic herb. Even though its toxicity is reduced 1000% through processing, it should never be used without supervision. It is a miracle drug for which there is no substitute. It is irreplaceable in many yang tonic formulas.

Xian mao – curculigo. This herb is also used in ayurvedic medicine. It is a very strong yang tonic that can increase sperm count and motility. Excess use or use by people without yang deficiency can cause yin deficiency side effects like night sweats and irritability.

SAFETY CONSIDERATIONS:

Although there are many herbs that can raise lowered testosterone levels, increase a reduced sex drive, or improve impaired semen parameters, it is not a good idea to use these herbs without proper guidance. Using these herbs to gain muscle or become a Casanova will only backfire.

If someone is taking drugs such as digoxin, heart medications, certain blood pressure drugs and anti-coagulants, or HIV medications, they should not take these herbs.

Acupuncture rarely if ever has contraindications to treatment. It is milder in treating internal conditions but is nevertheless very useful and adds to the effects of the herbal medicine.

The best way to prevent the development of these patterns is to eat healthily – this includes eating meat, vegetarian and vegan diets are neither healthy nor balanced from a TCM point of view – , exercise, take life easy, and have the proper amount of sexual contact.

Dr. Brendon Fegan, DAOM, EAMP, L.Ac