Male Sexual Wellness

The World Health Organization (WHO) considers male and female sexual health an essential element of human health and wellbeing. However, many men and women find the topic of male sexual health somewhat difficult to discuss with both their partner and family physician. A 2014 national survey, found that the majority of people (64%) also believe sexual health is correlated with overall satisfaction in life. However, it is interesting to note that more than 25 percent of those people shy away from addressing sexual health concerns with their doctor and a mere 13 percent discussed their sexual issues or feelings with their partner. It is astonishing to know that it is estimated that 1 in 5 individuals avoid sex altogether because of sexual health issues.

A common fundamental question that arises from many of our male patients is, “Am I normal?” It is important to have an understanding of what “normal” is, including a realistic understanding of what constitutes male sexual wellness. Many couples believe sexual problems are a normal part of the aging process and are resigned to the idea that as they continue to mature, they will be more dissatisfied with their sex life. Many believe that male sexual health is purely driven by hormones. However, there are various factors that constitute male sexual wellness, including a range of physical, social, interpersonal and psychological elements that influence a man’s sexual health. There are multiple treatment options available and it is important to talk with your physician if you are experiencing any one of the following issues:

• Problems getting an erection
• Difficulties maintaining an erection
• Loss of interest in sex
• Premature ejaculation
• Issues that are interfering with your ability to enjoy sex with your partner
• Male infertility
• Prostate or urinary concerns
• Sexually transmitted diseases (past or current issues)

Sexual health issues are not uncommon in men. Fortunately, most cases of sexual dysfunction are treatable and it is important to talk with your doctor about any sexual health concerns. A study revealed that 26% of men say, “embarrassment” is a barrier for them in discussing sexual problems with their physician. There are many physical and/or medical conditions that may cause sexual dysfunction in men including the following:

• Diabetes
• Heart and/or vascular diseases (blood vessels)
• Neurological diseases
• Hormone imbalances
• Chronic diseases including liver, kidney, alcoholism and drug abuse
• Prescribed medication reactions (antidepressants, blood pressure and others)
• Peyronie’s disease
• Sleep apnea
• Chemical or toxic exposures

Other psychological or lifestyle factors that may prevent optimal sexual health:

• Depression or mental health problems
• Anxiety (work related, personal, performance anxiety and others)
• Marital or relationship issues
• Past psychological trauma (sexual abuse, PTSD and others)
• Feelings of guilt
• Smoking
• Excess alcohol or alcoholism
• Obesity or poor dietary intake
• Lack of cardiovascular exercise

Weight Loss:

Natural ways to boost your testosterone levels may include weight loss. By shedding excess pounds it may help to boost testosterone levels. According to the Endocrinology Society, overweight middle-aged men with prediabetes can reduce the prevalence of low testosterone by 50% with weight loss. The New England Research Institute (NERI) determined that mid abdominal fat or waist circumference is the most determining factor of low testosterone levels. Also, NERI research revealed that men who became overweight or obese had a rapid drop in their testosterone levels compared to those who kept a normal weight. Obesity can be a deterrent to optimal sexual function as it may result in imbalances in male hormones due to abdominal fat cells converting testosterone into estrogen and disrupting the male hormone balance as well as it can lead to heart disease –the #1 cause of death in men.

Nutrition/Diet:

The good news is that you can increase your testosterone levels naturally as diet plays a key role. There are multiple key nutrients that have been studied with positive findings for increase in testosterone levels. Research has shown a correlation between zinc deficiency and low testosterone levels. One study showed that after six months of zinc supplementation amongst zinc-deficient elderly men serum levels of testosterone were doubled. A group of competitive NCAA football players who took zinc nightly during an 8 week spring training program had 2.5 times greater muscle strength gains than a placebo group. Also, these athletes had around 30 percent increase in their free and total serum testosterone levels compared to 10 percent decrease in placebo group. Other research studies reveals lower zinc levels may also be a cause of infertility. Your diet is the best source of zinc, such as crab, lobster, oysters, chicken, fish, raw milk, raw cheese, beans, whole grains, nuts, seeds, vegetables (mushrooms, kale, broccoli and spinach) and yogurt.

Other dietary factors that have been shown in recent research to boost testosterone levels include an abundance of healthy fats in the diet (approximately 20-30 percent of your daily calories). Be sure to focus on avocados, coconuts, raw nuts or seeds, olives, flax, grass-fed meats, olives or olive oil and cold water fish for healthy fat sources. In addition, Vitamin D (a steroid hormone) can help maintain healthy sperm. In addition, Vitamin D can elevate testosterone levels which may result in increased libido. Be sure to have your physician test your vitamin D level and discuss dietary intake, supplementation as well as sun exposure recommendations for optimal levels of vitamin D3.

Minimize Stress:

Stress can negatively impact male and female hormone levels. There are many studies showing the adverse effects of stress on adrenal glands and increased cortisol production. Unnatural elevations in cortisol can eventually lead to reduced testosterone levels. Stress can cause individuals to increase their daily caloric intake which results in weight gain with harmful body fat storage. Your adrenal glands have a primitive mechanism in which they are geared to help you manage stress such as the infamous “fight or flight stress response”. Berkeley Researchers have found that stress acts in the brain to reduce another hormone known as gonadotropin-inhibiting-hormone produced by the pituitary gland which eventually leads to reduced testosterone levels. At NaturoMedica our physicians offer adrenal testing which may help to identify adrenal dysfunction. Results of this test may provide insight into adrenal stress pathways and recommendations for supporting and/or boosting your adrenal glands. For optimal health and hormone levels, it is important to reduce repetitive stressful situations in your life. Be sure to focus on a diet based on whole foods, regular exercise, good sleep patterns and laughter -- all of which can reduce stress and result in improved health and testosterone levels. Other tools to manage stress may include counseling, meditation or other therapies including acupuncture.

Cardiovascular:

What is good for the heart is also good for sexual health. One of the best ways to improve your overall health is cardiovascular exercise. Aerobic exercise may not only raise your heart rate, but improve your sexual performance by keeping your heart and vessels in shape. Exercise is another way to boost neurotransmitters (mood) and reduce anxiety in your life which may be inhibiting optimal sexual performance. The American Heart Association recommends 150 minutes per week of moderate intensity exercise or 75 minutes per week of vigorous intensity exercise (or a mix of moderate and vigorous intensity exercise). Cardiovascular exercise may result in weight loss which may improve hormone levels as outlined above and improve self-esteem. At NaturoMedica, we offer advanced cardiovascular testing called Cardio Wellness which includes the following labs: genetic tests, diabetes risk assessment, inflammatory markers, advanced lipoprotein particles, comprehensive nutrition panel and other labs in a general workup for sexual health concerns. Blood work should also include general fasting and urinalysis lab tests. NaturoMedica physicians can offer various supplements as well as prescription medications that can lower blood cholesterol levels. This may result in improved vasodilation for men with erectile dysfunction and reduce cardiovascular disease risk.

Nutrients, Herbals, Medications and Non-Drug Options:

There are many nutraceuticals or herbal formulations that our NaturoMedica physicians may consider such as DHEA, Panax ginseng, Rhodiola rosea, L-arginine or others that may promote bodily or penile vasodilation and improved vascular circulation. Be sure to contact your physician or one of our NaturoMedica doctors to discuss options that are best for you and your health, before staring any new supplements. Non-drug options for erectile difficulties may include penile vacuum pumps, penile injections or penile vascular surgery and others. Prescription drug options approved by the FDA include Cialis, Viagra, Levitra or others which work by boosting blood flow to the penis to make erections easier to occur. The mechanism of action for most of these drugs are very similar with only subtle variances in how quickly or how long the drug works. Naturopathic physicians may consider customized vasodilation prescriptions through a compounding pharmacy which may have improved outcomes as the medication can be customized to an individual’s needs vs “one size fits all” approach.

Hormones:

Any disruption or imbalance of one or more male hormones (testosterone, DHEA, and estradiol) can compromise optimal sexual health. Many men are turning to the prescription testosterone as the “fountain of youth hormone” to resolve their fatigue as well as sexual health disorders. Researchers estimate that men’s testosterone levels, beginning in their 40’s, drop 1% per year on average. Around two to six million American men in their 50s, 60s and beyond may suffer from symptoms of low sex drive, vitality, decreased bone and muscle mass, hair thinning, weight gain, fatigue, anemia and other issues as a result of hypogonadism (lowered functioning of the testicles). Testosterone does not come without its health risks, but is a viable option for men to consider with sexual health concerns, if imbalances are detected via blood tests and careful consideration of each individual’s family health history. Testosterone replacement therapy (HRT) can be prescribed through use of gels, creams, patches, pellets or injectables. As Naturopathic physicians, we offer many types of male hormone tests and treatments including options for pharmaceutical or customized testosterone prescriptions. At NaturoMedica, we have many supplements in our dispensary that may be clinically recommended as safe and viable options for hormone imbalances and regulation.

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Beyond the obvious, sexual intercourse has many health benefits. It can help you feel happier, be healthier, and live a longer life. It can also protect against disease and possibly prevent cancer. There are many known causes and treatments for male sexual issues, but having an honest and open dialogue with your trusted doctor is a great first step to starting the process of determining the “cause”. A thorough evaluation including physical examination along with lab testing and assessment of current medications and supplements are key. Some medications, supplements, sexually transmitted diseases, infections of the prostate, or other causes may result in sexual dysfunction. Additionally, there are treatments not mentioned above in which our naturopathic physicians may discuss with you including: acupuncture, counseling, exercise regimens and IV therapies to support you in your desire for optimal sexual health. Please contact one of our NaturoMedica physicians to begin your first step towards optimal sexual wellness.