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Out of the Man Cave

Men's Health Men's Health
Longevity By Nature

Millennial men are the new generation for prostate and fertility support—and they are unique from their predecessors. Here’s why and how to help.

Men’s health is about to get a shot of adrenaline as more Millennial men find themselves in middle age, and endure all the changes that go with it. “Dad bods” may be a light-hearted phrase, but for the men sporting one, it’s a sign that they aren’t as fit and virile as they once were.

“Many Millennial men are assuming more equal roles in their household and that means taking care of themselves as well,” commented practitioner Hanisha Patel, ND, founder of her practice, Mahan Health. “However, many are unaware of the natural options and are resorting to pharmaceuticals including hormone replacement therapy.”

Gen X guys tended to largely ignore their health as more often than not, their other half would buy the supplements. However, pointed out Jacob Teitelbaum MD, author of From Fatigued to Fantastic, Millennial males are simultaneously more health conscious and more anxious about their health.

According to practitioner Corey B. Schuler, FNP, DC, LN, CNS, of Synergy Family Physicians, Minnesota, Millennial men prioritize their mental health, physical fitness and overall well-being, embracing a more holistic approach to health. “Mood, occasional anxiousness and stress are no longer taboo subjects or signs of weakness,” he related.

Vanessa Pavey, ND, education scientist, Florida-based Life Extension, observed that while many Millennial men know that testosterone is needed to build muscle and maintain sexual health, they are not as aware of the link between declining testosterone levels and mood. In agreement is practitioner Rosia Parrish, ND, Colorado-based Naturopathic Wellness, who observed that one of the biggest changes between Generation X and Millennial men “is the openness with which mental health topics like anxiety, depression and stress are approached. These topics used to be stigmatized but now found a place in mainstream discussion among Millennial men.”

She added that Millennial men also tend to value preventive screenings and are aware of the merits of early detection and intervention. “A noteworthy aspect of the Millennial perspective is a growing distrust of conventional medicine,” she stated. Some have developed skepticism towards pharmaceutical companies and conventional medical treatments. In their search to achieve and maintain well-being, many Millennials are leaning toward more natural treatments.

Other key trends helping to define Millennial men in the health arena are digital engagement and clean labels. Dr. Parrish noted that they are the first generation to grow up fully immersed in digital technology and turn to apps for fitness tracking and mental wellness. “They are voracious consumers of digital health content. Their holistic view of health is comprehensive, encompassing factors like sleep, nutrition, stress and environmental influences,” she described. “They’re also highly engaged in online communities and social media platforms, turning to these platforms to share health experiences, seek advice or join fitness challenges.”

Jonathan Group, DC, wholesale account manager, Global Healing, Texas, sees more men moving away from many of the pre-workout and protein products that contain artificial flavors, colors, binders, fillers, harsh stimulants and artificial sweeteners as well as bypassing stevia for monk fruit, as an example. “Historically, men were not as concerned about clean label as they are today. A growing percentage of men are looking for glass or other plastic alternatives for packaging to reduce exposure to microplastics which are routinely being found in the blood of nearly 100 percent of the population. In 2023, it is estimated that we all consume the equivalent of a credit card per week in microplastics,” he noted.

Celine Torres-Moon, senior scientist, Protocol for Life Balance, Illinois, agreed that Millennial men are more aware than their older counterparts about the importance of healthy habits in staying healthy. “This is especially true for those who are well-educated, live in urban areas, and/or participate in sports,” she observed. “Millennials express concerns about their weight, hair, muscle mass and sexual function.”

Getting Testy

Testosterone loss in the 30s and 40s can be a real downer for Millennial men as it has more than one effect. Dr. Pavey noted that as men move into their 40s, the chief health concerns they face are the natural decline in testosterone production, preserving prostate health, and maintaining sexual function. “Millennials are steadily progressing into this decade of life and these facets of men’s health are gaining interest,” she commented.

Starting with supporting natural testosterone production, the combination of pomegranate peel and cacao seed extracts has been shown in two clinical trials to promote healthy levels of free and total testosterone. In one clinical trial, men in the age range of 36-55 years received 400 mg of the combination of pomegranate and cacao extracts or placebo. After eight weeks, the pomegranate and cacao group found a 45 percent increase in levels of free testosterone. They also found an improvement in overall well-being and measures of stress decreased by 26 percent. Effects were also seen in younger men between the ages of 21-35 years. Those who received the pomegranate-cacao combination in this clinical trial found an increase in free testosterone up to 25 percent, meaning even the younger millennials can gain benefit.

Luteolin, Dr. Pavey pointed out, is an antioxidant flavonoid found in several fruits and vegetables, can help preserve testosterone levels. In preclinical studies, luteolin helped reduce the conversion of testosterone into estrogen by inhibiting the activity of the aromatase enzyme.

Life Extension’s Testosterone Elite provides 400 mg of the combination of pomegranate peel and cacao seed extract, along with 275 mg of luteolin from Japanese sophora flower per one vegetarian capsule.

Global Healing’s Men’s Hormone Support product provides a healthy way to boost performance, increase energy, sexual virility, stamina and support healthy testosterone levels, according to Dr. Group. “It is a great tasting liquid that is in a clean base of triple distilled water and organic glycerin derived from organic mustard seed with added supercharged minerals to enhance absorption and effectiveness,” he noted. Sex Talk

The one effect of diminishing testosterone that men fear is losing the ability to be ready for a romp and finish a winner. Millennial men are, said Dr. Teitelbaum, “still somewhat bashful about discussing sexual health but are willing to do so.”

Dr. Patel noted that approximately one in five men in their 20s and 30s are using medications like sildenafil or tadalafil. Approximately 35 percemt of Millennial men in general experience some form of ED (erectile dyfunction) “which is more than ever before.”

If this is the case, and your male patient is relatively healthy, getting him to switch may not be as much of a challenge, as he’s already consulting with you about natural ways to optimize health.

Here, higher testosterone levels are the priority, said Dr. Pavey. A man’s sexual function is also dependent on the coordination between the cardiovascular, endocrine, neurological and psychological systems. One solution Dr. Pavey suggests is Kaempferia parviflora, also known as Thai black ginger, which has been used in South Asia to enhance sexual function. Kaempferia parviflora standardized to 5,7-dimethoxyflavone has been shown to support several fundamental elements in promoting a healthy male sexual response independent of hormones. Kaempferia parviflora helps support nitric oxide to enhance blood flow and inhibits the enzyme responsible for winding down the male sexual response to promote sustained activity. Further, she noted, this herb has been shown to stimulate the central nervous system activation of the neurotransmitters involved in processing sexual stimulus.

“Kaempferia parviflora does not cause statistically significant changes to hormone levels of free and total testosterone, estradiol, and DHEA-S; and no significant change in PSA,” Dr. Pavey assured. “This makes Thai black ginger an excellent complement to testosterone-supportive health regimens.”

In her practice, Dr. Parrish sees that younger men are more willing to discuss issues like male factor infertility, ED, premature ejaculation and other sexual health concerns.

She also sees use of generic sildenafil (the brand name Viagra) becoming widely accepted as a trusted solution for ED. Its efficacy and the normalization of its usage in media and advertising have made it a go-to option for many men. “However, there’s a growing interest in natural or holistic treatments for sexual health issues,” she maintained. “Many men are exploring dietary supplements, lifestyle changes and traditional remedies as alternatives or complements to pharmaceutical treatments. These men are often seeking out my care to get comprehensive lab testing, personalized treatment plans that help address men’s sexual health from the inside out.”

In his practice, Weston Holzinger, DC, MS, DABCI observed that prescriptions from online telehealth platforms to address male pattern hair loss and ED are on a definite rise. One issue this presents from a whole-health perspective is that while the complaint is addressed, the underlying cause is often not—such as in cases of ED, poor vascular health, high stress/poor stress management or significant endocrine conditions. “So while general discussion has increased, often this conversation is not being had in a comprehensive setting,” he said.

Protocol for Life Balance provides Raw Maca 750 mg as well as our Virility for Men to support healthy sexual function, and Life Extension’s Male Vascular Sexual Support contains 100 mg of Thai black ginger (Kaempferia parviflora) standardized to 5,7-dimethoxyflavone per one vegetarian capsule.

Who’s Your Daddy

When the delivery system works but the goods are damaged, it may be time to discuss male fertility. When Dr. Parrish addresses male factor infertility characterized by poor sperm parameters, she employs a multifaceted approach.

On a larger scale, Dr. Teitelbaum warned, “One of the most important epidemics facing the survival of humanity is the drop in sperm count. Except for France, which takes the national sperm count very seriously, it seems that Western media has avoided this discussion. I suspect because much of it is caused by chemical pollution of our environment.”

A large meta-analysis showed that the mean sperm count declined, on average, 1.4 percent per year with an overall decline of 52.4 percent between 1973 and 2011. The tip of this iceberg is that more than 1/6 of couples are now dealing with fertility problems.

Dr. Teitelbaum recommended advising potential future dads to avoid soy-based foods, meats with estrogen, melatonin, elevated scrotal temps (wear boxer shorts only), avoid hot tubs, aspirin, Motrin and anything that blocks prostaglandins. “Tylenol is okay in moderation if your client/patient really needs it but he should also supplement with 500 to 1,000 mg NAC daily as Tylenol suppresses glutathione. Also, increase liquid vegetable oils and avoid cottonseed (may contain gossypol which inhibit sperm function), palm or coconut oils or trans, hydrogenated or saturated fats as comfortably able.”

“As male factor infertility is implicated in over 30 percent of infertility cases, it’s helpful to recognize sperm’s regenerative potential,” remarked Dr. Parrish. Sperm’s 75 to 90-day production cycle presents a promising opportunity for improvement through lifestyle and supplement changes.

To support overall sperm quality, the combination of flavonoid complexes, glutathione, acetyl-L-carnitine, L-carnitine, ashwagandha and arginine can be beneficial, she pointed out. These supplements work together to improve the vitality and function of sperm. For those aiming to increase sperm count, Dr. Parrish recommends antioxidants like CoQ10, along with glutathione, acetyl-L-carnitine, and ashwagandha can play a vital role. These supplements have shown potential in boosting sperm numbers, enhancing their viability.

When addressing improved sperm motility, she added, CoQ10, L-carnitine, acetyl-L-carnitine, royal jelly and arginine can be especially helpful. These supplements support the energy and functionality needed for optimal sperm movement. “Lastly, for improving sperm morphology, which relates to the shape and structure of the sperm, antioxidants like CoQ10 and vitamin C are beneficial. Alongside these, compounds that offer a mix of essential vitamins and minerals can support the genetic material within sperm, ensuring a healthier structure and form,” she described.

Interestingly, noted Dr. Patel, if your still relatively young and otherwise healthy client feels the need to use sildenafil or tadalafil, “then it’s a huge sign there may be issues with sperm quality. If a man is not having a morning erection daily, has low energy levels throughout the day, weight gain, loss of muscle mass, increased fat gain, hair loss or low libido, these are all signs there may be an issue with sperm health,” she stated.

She said that it is crucial for men to address their sperm health because poor sperm quality can increase risk of miscarriages and genetic abnormalities in children. “A ‘normal’ sperm analysis today would have been considered abnormal just 15 years ago, which means it’s not just about assessing the sperm analysis but ensuring their sperm health is optimal,” she stated.

When the goal is to optimize fertility, Dr. Patel likes to recommend five lifestyle factors:
• Eat an anti-inflammatory diet: avoid processed foods and focus on whole foods
• Exercise daily with several days of strength training
• Avoid smoking, vaping or any type of marijuana use
• Limit/avoid alcohol consumption
• Stay hydrated with electrolytes

According to Dr. Holzinger, some of the most common things seen in practice concerning male fertility are poor metabolic health and mineral insufficiencies. Reproduction is really one of the big picture reflections of health. Metabolic syndrome, pre-diabetes and type 2 diabetes mellitus have significant impacts on sperm quality as a few of the most common male infertility causes.

Another cause is inadequate mineral intake, and notable minerals for sperm health are zinc, magnesium, selenium and boron. Dr. Holzinger likes to recommend increasing dietary sources of high-quality meats, vegetables, nuts and seeds. Finally, “exposure to endocrine-disrupting chemicals in the environment are also worth noting.” Reviewing the contents of personal care products like soaps, shampoos and items with fragrance can make a significant impact on overall sperm health.

A crucial step in understanding male reproductive health is a comprehensive semen analysis using the strict Kruger criteria morphology, revealing information on sperm’s count, motility, morphology and how the immune system, infections, autoimmunity and hormones are playing a role with sperm health. DNA fragmentation tests can also be utilized to examine the chromosomal integrity of sperm, and sperm antibody tests can detect potential immune system responses detrimental to sperm function.

When working with the client/patient to improve sperm health, it may also be necessary to test for mycotoxins, heavy metals, autoimmune biomarkers, pesticides, infections and mycotoxins and other environmental toxicants to fully address the underlying issues of poor sperm parameters that contribute to male factor infertility.

Further, Dr. Parrish advised, “Tests for free and total testosterone provide insights into the hormonal underpinnings of sperm production. Moreover, evaluating adrenal hormones offers clues about stress response and its potential impact on fertility, while thyroid hormone levels can influence metabolic and reproductive health. Functional lab testing should also be comprehensive, checking for micronutrient deficiencies and other potential imbalances.”

There are several supplements that can be recommended to support healthy sperm production. Fairhaven Health’s (Middletown, CT) FertilAid for Men is a patented formula for male reproductive health, designed to support sperm health that is clinically studied. In a 90-day study involving 14 men receiving either Fertilaid for Men or a placebo, the Fertilaid for Men group showed significant improvement in the total count of normal-motile sperm, according to the company. It contains methylfolate in place of folic acid as methylfolate is the bioactive form of vitamin B9; methylated vitamin B12 as methylcobalamin and l-carnitine. The company also offers MotilityBoost to support sperm viability and motility, that may be used with Ferilaid. It provides quercetin, CoQ10 and Mucuna pruriens to boost levels of L-carnitine, as well as B12 for energy, and L-arginine for improved reproductive health.

Fixing the Plumbing

Millennial men may start to experience the signs of a growing prostate—burning/pain with urination, frequent urination and the feeling of the bladder still not empty. “This is another condition that has many holistic strategies to investigate once larger concerns such as infection or cancer are ruled out,” commented Dr. Holzinger.

And while men are highly aware of preserving or increasing flagging testosterone levels they also need to be aware of their estrogen and dihydrotestosterone (DHT) levels, especially for prostate health, said Dr. Pavey. She explained that since testosterone can be converted into DHT via 5-alpha-reductase, adding saw palmetto into a nutritional regimen can help slow this enzyme down and thus help keep DHT in check. Saw palmetto can also impede the binding of DHT to androgen receptors, inhibit inflammation, and support healthy cell growth and division of the prostate gland.

Protocol for Life Balance’s Ortho Multi Softgels for Men is a multivitamin enhanced with saw palmetto extract, phytosterols, alpha lipoic acid, grape seed extract, inositol, CoQ10, lycopene, lutein and vitamin-K2, according to Torres-Moon.

Dr. Teitelbaum elaborated that chronic burning on urination with urinary urgency (especially when there is stool in the rectum) suggests chronic prostatitis. “We are seeing a rise in this problem as the prevalence of autonomic dysfunction has been rising with both societal stress and long COVID,” he commented. “This chronic prostatitis is being shown to be both infectious (although not contagious) and associated with autonomic dysfunction.”

He also noted that the PSA (prostate-specific antigen) blood test is not meant to be used to test for prostate cancer. It is estimated that for every 1,000 men offered PSA testing, 240 will have a positive result, leading to positive biopsies in 100. But 20.7 to 50.4 percent of these men will actually have indolent disease that never grows or metastasizes, according to the evidence report. “It’s important for practitioners to realize that PSA is also normally elevated in prostatitis from prostate inflammation, and this does not necessarily suggest prostate cancer as the cause of the person’s symptoms. To distinguish? Six weeks of antibiotics (septra or Cipro), despite having their definite problems, can markedly decrease both prostate and overall symptoms. And if the PSA is rechecked while they are still on antibiotics towards the end of the six weeks, the PSA will often normalize confirming prostatitis.”

Supplementation to get ahead of prostate enlargement may be a good idea. For example, Global Healing’s Prostate Health liquid formula is “formulated with an advanced blend of organic herbs and all-natural ingredients, carefully selected for their proven benefits in promoting a normal prostate size and function,” described Dr. Group.

Life Extension’s PalmettoGuard Saw Palmetto and Beta-Sitosterol includes 320 mg of saw palmetto fruit extract, 90 mg of beta-sitosterol from pine, 3 mg of boron and 400 mcg of rosemary leaf extract per one soft gel.

Dr. Schuler takes a holistic approach to men’s urological and sexual health. He likes to recommend Gaia Herbs’ PRO (Brevard, NC), which includes Prostate Support, Stamina & Libido and Ashwagandha 700.

Of course, men have other concerns that they share with women—digestive complaints, cardio support, allergies. It’s a great idea to ask about their sexual health as well as fertility and prostate concerns. There should be no shame in their game!

Healthy Take Aways

• The combination of pomegranate peel and cacao seed extracts has been shown in two clinical trials to promote healthy levels of free and total testosterone.
• In preclinical studies, luteolin helped reduce the conversion of testosterone into estrogen by inhibiting the activity of the aromatase enzyme.
• Sperm’s 75 to 90-day production cycle presents a promising opportunity for improvement through lifestyle and supplement changes.
• Metabolic syndrome, pre-diabetes, and type 2 diabetes mellitus have significant impacts on sperm quality as a few of the most common male infertility causes.

For More Information:

Fairhaven Health, www.fairhavenhealth.com
Gaia Herbs, www.gaiaherbs.com
Global Healing, https://globalhealing.com
Life Extension, www.lifeextension.com
Protocol for Life Balance, www.protocolforlife.com