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Fertility, Men's Health

The Three Mountains of Men’s Health

Yvonne Lau |

When most of us think of men’s health issues, what immediately springs to mind might be cardiovascular disease, musculoskeletal issues, or possibly type 2 diabetes. Another viewpoint from which to understand men's health specifically might be to start with three diseases some consider to be the top obstacles affecting men’s health: benign prostatic hyperplasia, erectile dysfunction, and male infertility. At least one of these three obstacles, or “mountains” will likely affect a man at some point in his life, and especially as he ages.  These complex challenges can severely impact life plans and reduce general quality of life. Here at Mayway, we have many great articles that dive deeply into these topics which you can find links to at the bottom of this article. Please continue reading for an overview of these specific challenges discussed from a traditional Chinese medicine (TCM) approach, as translated from excerpts of an interview with Dr. Guo Jun, Director of the Department of Andrology at Xiyuan Hospital, China Academy of Chinese Medical Science.  

Let’s start off with an overview:

Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH) is a common prostate disease manifesting as a noncancerous enlargement of the prostate gland, and is the most common benign tumor found in men, most often seen in middle-aged and elderly men over 50 years old. 

image of three mountains

BPH produces symptoms by obstructing the flow of urine through the urethra, which can cause urinary retention and even chronic renal failure. Symptoms related to BPH are present in about one in four men by age 55, and gradually increases with age, so that it affects about half of men by the age of 75. It is estimated that BPH cases increased by 122% between 1990 and 2021, reaching over 137 million, with the highest burden in Asia. Although treatment is only necessary if symptoms become bothersome, by age 80 some 20% to 30% of men experience BPH symptoms severe enough to require treatment. 

Erectile Dysfunction (ED)

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough for sexual activity. It is often a warning sign of an underlying medical issue, such as heart disease, clogged blood vessels, or diabetes, psychological issues such as stress, anxiety, and depression and/or lifestyle issues such as smoking, excessive alcohol, drug use, and lack of physical activity. ED affects roughly one-third of men, with prevalence rates ranging from 3% to 76.5% depending on study criteria and population age. In some regions, ED prevalence in men aged 60–80 reaches nearly 57%.

Male Infertility

Male infertility is the inability to conceive a child after one year of regular, unprotected sex, with male factors contributing to roughly half of all infertility cases. Primary causes range from low sperm count and poor motility to physical blockages and hormone imbalances. Approximately 55 million men were estimated to be living with infertility in 2021. The global age-standardized prevalence rate for male infertility was estimated at 1,354.76 per 100,000 in 2021.

To explore this further, here are some excerpts on the three main “mountains” that men might face during their lifetime from an interview published in 2015 between Dr. Guo Jun and reporters Gao Qing and Zhao Rui of Life Times. Dr. Guo is the Director of the Department of Andrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences.

While these three men's health issues may appear to be localized, and stemming from problems within the reproductive system, Traditional Chinese Medicine (TCM) views them as closely connected to multiple organs, including the Liver, Spleen, Kidneys, and Heart. TCM emphasizes a holistic approach, treating both the body and mind in relation to male diseases, combining systemic and local treatments. This holistic approach relies on daily health maintenance, cultivating healthy lifestyle habits, and preventing illness before it occurs.

I often tell my patients, 'Only when the body is in good condition will sexual function be good,' which is also the holistic philosophy of TCM andrology.

The symptoms of Benign Prostatic Hyperplasia (BPH) are located in the lower part of the body, but in my experience the TCM treatment focuses on the upper part. BPH falls under the category of "urinary retention" (癃闭), and treatment is based on the principle of "the bowels function by unblocking." Here, "unblocking" does not simply mean using diuretics, but rather using herbs that promote Lung function to facilitate the flow of Qi and thus the smooth flow of fluids. This is called "treating the lower body by addressing the upper body": "lower body" refers to BPH, and "treating the upper body" refers to opening the Lungs and Orifices. Simultaneously, it is also necessary to combine this with herbs that tonify the Kidneys, invigorate blood circulation, and dissipate Blood stasis, such as Di huang/Rehmannia glutinosa, Shan yao/Dioscorea opposita, Shan zhu yu/Cornus officinalis, Dan shen/Salvia miltiorrhiza, Ji xue teng/Spatholobus suberectus, San leng/Sparganium stoloniferum, and E Zhu/Curcuma zedoaria, which can soften the hardened prostate and reduce its size, achieving the therapeutic goal.

Another characteristic of prostate diseases is that symptoms often tend to worsen in winter with colder weather. This is because cold stimulation increases the burden on the prostate, and people generally drink less water in winter, leading to concentrated urine and reduced urination frequency. This can cause prostate congestion and edema, resulting in difficulty urinating or even urinary retention, which can lead to acute urinary retention and hydronephrosis in severe cases. Therefore, patients with BPH should pay special attention to winter care and timely treatment, keeping warm, drinking plenty of water, avoiding holding urine, and avoiding prolonged sitting that compresses the prostate. Dietary restrictions include avoiding spicy and stimulating foods and consuming foods like white melon seeds and cooked tomatoes.

Another point to note is that springtime is an excellent time to treat BPH. Traditional Chinese medicine theorizes that the prostate gland is located along the Liver meridian, and spring is the season when Liver Qi rises and the flow of Qi and blood in the Liver Meridian is easily regulated. Treatment at this time can achieve twice the result with half the effort.

Next, regarding Erectile Dysfunction, the TCM treatment strategy is to soothe the Liver, tonify the Kidneys, and strengthen the Spleen. Erectile dysfunction, commonly known as "impotence," refers to the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse, lasting for more than three months. The main causes of impotence include psychological factors such as anxiety, depression, and high stress levels. Secondly, chronic diseases such as hypertension, hyperlipidemia, and hyperglycemia can damage penile blood vessels, nerves, and smooth muscles. Men with unhealthy lifestyle habits such as long-term smoking, excessive alcohol consumption, staying up late, and lack of exercise are also a major group affected by erectile dysfunction. Excessive or insufficient sexual activity is also a cause of erectile dysfunction; therefore, moderation is key. A suitable frequency is one where both partners are satisfied, and neither partner experiences fatigue or discomfort.

According to Traditional Chinese medicine erectile function is related to the Liver, Kidneys, and Spleen. Therefore, the treatment principle would be to soothe the Liver and promote blood circulation to improve penile microcirculation, while also tonifying the Kidneys to enhance immune function, and strengthening the Spleen to improve appetite and sleep, thus regulating overall health. This approach is done along with removing Blood stasis.

Erectile function according to TCM is most closely related to the Ren and Du Meridians. Cupping helps to unblock the body's main meridians, which is beneficial for improving erectile function. Patients with prostate problems can also focus on massaging or applying moxibustion to the Guanyuan acupoint (Ren 4, located four finger-widths below the navel) and the Shenshu acupoint (Bladder 23, located at the midpoint of the lower back). People with Yin deficiency and internal heat should undergo cupping only under the guidance of a doctor. In addition, daily diet should include high-quality protein such as soybeans and lean meat, as well as seafood such as oysters and shrimp.

Next, regarding male infertility, Traditional Chinese medicine states that "the Kidneys govern reproduction" and believes that the pathogenesis of male infertility is mostly "deficiency of both Kidney and Spleen with Blood stasis," meaning that Kidney deficiency, Damp-heat, and Blood stasis constitute the core of the disease. Therefore, when reproductive function is impaired, treatment focuses on the Kidney, Liver, and Spleen meridians. Employing medications that tonify the Kidney, replenish Essence, invigorate blood circulation, remove Blood stasis, and clear Damp-heat help achieve a balance of Yin and Yang--tonifying while promoting flow, and clearing while tonifying, thus achieving good therapeutic results. By nourishing Yin and tonifying the Kidneys, invigorating Qi and promoting blood circulation, we can increase sperm count and motility, which has significant advantages in treating oligospermia and asthenospermia.

TCM emphasizes syndrome differentiation and individualized treatment. For example, for patients with challenges of weight management, the treatment often focuses on resolving Dampness and eliminating Phlegm in addition to tonifying the Kidney, invigorating blood circulation, and clearing Heat. Patients are also advised to strengthen exercise and lose weight. After a period of treatment, semen quality improves. For patients with poor erection, premature ejaculation, or an ejaculation, it is necessary to clear Damp-heat, invigorate blood circulation, remove Blood stasis, and unblock the Meridians to both improve the quality of sexual life and the quality of semen.

Infertile patients must also quit smoking and drinking. Under the guidance of a doctor, they can take a series of sperm-boosting formulas and aphrodisiac oral liquids. They should also regularly eat fruits such as mulberries and supplement their diet with dietary therapy, such as porridge made with yams [Dioscorea root], chestnuts, and lotus seeds, or stewed rabbit with Gou qi zi [Lycium/Goji berries], which can help strengthen the body, nourish the Kidneys, and replenish Essence.

We hope you have enjoyed this exploration of the Three Mountains of men’s health and are grateful to Life Times for permission to share excerpts from this interview. For some additional deep dives into these issues, please check out the links to the Mayway articles below!

Benign Prostatic Hyperplasia (BPH)

Erectile Dysfunction (ED)

Male Infertility

Resources

About the Author

Yvonne Lau has been the President of Mayway Herbs since 1997 and has worked in the family Chinese herb business since childhood. She first visited China in 1982, and still travels there annually for business and pleasure. She has had the good fortune and honor to work with many people both in China and the US who are passionate about Chinese Medicine and about herb quality.

Yvonne has also been active as the Vice President of the Chinese Herb Trade Association of America since 1998, a trade group founded in 1984 representing over 300 Chinese herb importers, distributors, and retailers primarily in California.

She chairs the Regulatory Compliance Committee for the Association, and in this role has lectured about Good Manufacturing Practices and best business practices, as well as organized and moderated meetings between regulatory agencies and the Association.

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