The Everything Guide to Herbal Remedies: An easy-to-use reference for natural health care

CHAPTER 4

Herbs for Men

Some male issues overlap with female concerns—both genders face chronic conditions like heart disease, diabetes, and many cancers, as well as issues of general wellness like sexual functioning, fitness and exercise, skin and hair care—but men also have issues that are theirs alone. And quite often, diseases strike men in a different way, producing a separate set of symptoms and demanding distinct prevention and treatment strategies.

Men Are Different

Because of their physical structure and hormonal chemistry, men face a unique group of health concerns. The good news is that many of them can be treated safely and effectively with herbal remedies.

The most obvious differences between the sexes lie in their reproductive systems. But there are other variables, too. Men are, for the most part, physically bigger than women—they’re taller, with a bigger skeleton (made up of denser, stronger bones), more muscle mass and body fat, thicker skin, and bigger organs. Men also have a higher metabolic rate. They generally sweat more, and they have greater heart and lung capacity.

Even before they’re born, males and females are exposed to the sex hormones that will define them for the rest of their lives. By the age of two, gender-specific physical characteristics start appearing, and as a child approaches puberty, they’ll become more obvious.

In males, these traits are created in large part by the hormone testosterone, which is an androgen, or steroid, hormone produced in the testes and the principal male sex hormone. Among other things, testosterone works to increase the size of the boy’s muscles and bones and, later on, to deepen his voice, change the shape of his skeleton (including the bones of his face), and promote the growth of facial and body hair.

Hormones affect memory. Research shows that women remember more words, faces, and everyday events than men do, meaning a woman will probably remember a conversation in which she got the directions to a friend’s house. Meanwhile, men can recall more symbolic, nonlinguistic information, meaning the man will be better at navigation when it comes to finding his way home again.

As adults, male and female hormones play a big role in health and the development of disease. For example, in women, estradiol levels have been tied to the perception of pain, the development of allergies and asthma, and the initiation and progression of certain cancers. In men, testosterone is related to cardiac and sexual functioning, immunity and response to injury, and the building and maintenance of bone and muscle. It also seems to play a role in prostate health and obesity.

Men’s Herbalism

All of the world’s schools of herbal medicine have treatments and remedies specifically for men. For example, Traditional Chinese Medicine (TCM) views sexual dysfunction in men as a loss of yang, or primary life force, which is stored in the kidneys. It’s therefore treated with kidney-warming herbs like schisandra (Schisandra chinensis) and epimedium (Epimedium sagittatum). Meanwhile, Western herbalists treated impotence with circulation-boosting herbs like cinnamon (Cinnamomum verum, C. aromaticum) and clove (Syzygium aromaticum).

Herbal Hormones

Many medicinal and edible plants contain compounds called phytoestrogens, which are chemically similar to the sex hormone estradiol, the primary estrogen in humans. Although it’s generally regarded as a “woman’s hormone,” estradiol also occurs naturally in a man’s body (it’s produced in the testes). In addition, as in a woman’s body, a man’s body produces precursor hormones (including testosterone), which are converted to estradiol. In a man’s body, estradiol is involved in sexual functioning, the synthesis of bone, cognitive functioning, and the modulation of several diseases (including cancer and heart disease).

Most phytoestrogens are a type of plant chemical known as isoflavones; the best-known source is soy (Glycine max). Another kind of phytoestrogens, lignans, are in flax (Linum usitatissimum). A third type, coumestans, can be found red clover (Trifolium pratense) and alfalfa (Medicago sativa).

In men, dietary phytoestrogens have been associated with lower rates of prostate cancer. However, men should avoid consuming excessive amounts, as some studies have shown that soy intake can reduce a man’s sperm count (other studies have had different results, meaning the jury is still out on the question).

To be safe, men should avoid medicinal herbs that are high in phytoestrogens and stick to sensible amounts of soy and other phytoestrogen-containing foods.

Estrogen, like any other hormone, can be both beneficial and harmful. Research has shown that a few chemicals, called estrogenic xenobiotics, can mimic estrogen in the body and cause health problems the same way that excessive estrogen might do naturally. For example, the chemical nonylphenol, found in cleaning products, paints, herbicides, and pesticides, can damage human sperm.

Using Herbs Wisely

Here are some tips for men on using herbs and preparations:

• Keep Your Doctor Informed. Talk with your doctor about any herbs you’re considering, especially if you’re being treated for a serious and/or chronic condition.

• Do Your Homework. “Natural” doesn’t necessarily mean “good” (or even “safe”). Herbs are considered supplements—not drugs—and so are handled more like foods than pharmaceuticals. The Food and Drug Administration (FDA) doesn’t require supplement manufacturers to prove an herb’s safety, quality, or efficacy. So be sure to buy from reputable sources, and always follow the manufacturer’s guidelines.

• Pay Attention. Everyone responds differently to medicines, whether they’re from a plant or a pharmacy, so everyone requires a different dose. This is especially true with herbs, which can vary significantly in potency from one product to another. Most herbs have very low risk of interactions or side effects, but you should monitor yourself when starting any new therapy.

• Give It Time. Most herbal remedies take a bit longer to produce effects than pharmaceuticals do. Experts advise allowing several weeks before deciding if a remedy is working for you.

Sexual Functioning

Male sexual difficulties involve getting or keeping an erection, ejaculating too rapidly, having difficulty reaching orgasm, or failing to impregnate a woman after regular unprotected sex (see “Fertility and Infertility,” below). Most men experience these problems at some time or another, but if a problem is chronic, a man (and his partner) will want some answers.

In the United States, roughly half of all men over fifty—as many as 30 million individuals—have some degree of erectile dysfunction, or ED (also called impotence). ED is the repeated inability to get or keep an erection firm enough for sexual intercourse, and chronic ED affects about one in five American men.

Erectile dysfunction can be caused by many things, including age (it’s fairly common in men over sixty-five) and the use of some drugs (including depression and blood pressure medications). It’s also associated with obesity, smoking, and high cholesterol, as well as certain diseases (as many as 80 percent of diabetic men develop ED).

Conventional treatments for ED most often include the prescription drugs sildenafil citrate (Viagra), vardenafil (Levitra), and tadalafil (Cialis). Another option is the drug alprostadil (Caverject), which you inject directly into your penis or insert, in pellet form, into your urethra. Doctors also prescribe mechanical vacuum devices and, in some cases, will surgically implant a prosthetic. Needless to say, each of these options has its own set of drawbacks and potential side effects. For example, sildenafil has been associated with serious cardiovascular and nervous system problems and priapism (prolonged, painful erections), as well as more minor side effects such as headache and excessive sweating.

Two other common sexual difficulties in men include premature ejaculation and low libido. Premature ejaculation happens when a man reaches orgasm during intercourse sooner than he or his partner wishes. Low libido is a case of lower-than-normal (or lower-than-desired) sex drive. Both are caused most often by psychological stress or anxiety.

Herbal remedies for ED, ejaculation problems, and low libido include:

• Asian ginseng (Panax ginseng)

This is a classic remedy for impotence. Modern studies show that Asian ginseng extracts can improve symptoms of ED.

• Ginkgo (Ginkgo biloba)

Ginkgo is known to improve circulation throughout the body, which might help with ED (it also contains the amino acid arginine, which can help relieve impotence). Ginkgo extracts also can reduce the sexual side effects of certain antidepressant drugs.

• ava (Piper methysticum)

Kava root can be used to increase sex drive. It’s been shown to directly affect brain chemistry, instilling a sense of well being and alleviating the anxiety that can lead to sexual dysfunction.

• Maca (Lepidium meyenii)

Extracts of this hardy Peruvian plant have been proven to increase sexual desire in otherwise healthy men.

• Maritime pine (Pinus pinaster)

Pine bark extracts can improve sexual functioning in men with ED.

• Yohimbe (Pausinystalia yohimbe)

Research has shown that extracts of the bark of this African evergreen are effective treatments for male sexual dysfunction and impotence and can treat ED that’s caused by structural, circulatory, and psychological problems.

Fertility and Infertility

For many men, fathering a child is an important, almost essential, part of life, so problems related to fertility can be extremely distressing. Infertility is defined as the condition in which a sexually active couple has had difficulty getting pregnant for several months or longer.

A difficulty in fertility is referred to as “male factor” infertility if it is traced to a problem with the man’s sperm—either there aren’t enough, they are damaged in some way, or they’re having a problem with motility (the ability to move freely and spontaneously).

Depending on the diagnosis, conventional medical treatments for male factor infertility can involve drugs (antibiotics to treat an infection, for example), hormones (to treat low testosterone levels), or surgery (to treat a pituitary tumor or an enlargement of the veins in the scrotum, called varicocele).

If your doctor can’t trace your problem to any of these conditions, you might want to try an herbal remedy that’s known to boost male fertility.

• Astragalus (Astragalus membranaceus)

This is a classic remedy in Chinese medicine for male factor infertility. Modern research has shown that extracts can enhance sperm motility.

• Eleuthero (Eleutherococcus senticosus)

This herb, also known as Siberian ginseng, can enhance the body’s response to stress (and thus can help with stress-related infertility problems). Research has shown that eleuthero extracts can enhance sperm motility.

• Goji-berry (Lycium barbarum, L. chinense)

The fruits of the lycium plant, also known as wolfberries, are considered a tonic, or superior, medicine in Chinese herbalism and are used to treat impotence, sexual debility, and low sperm count (the plant is also known as matrimony vine). Modern research shows that goji-berry can improve sperm quantity and quality.

Male infertility can be tied to genetics, problems with your immune system, the use of some medications (including steroids, antihypertensives, antidepressants, and anticancer drugs), chronic infection, hormone disorders (in the pituitary gland or testicles), or a physical issue such as a blockage in the sperm duct.

Prostate Health

Although it’s often involved in urinary problems in men, the prostate is technically part of the reproductive system (it makes semen, the fluid that carries sperm). The prostate is a walnut-sized gland that sits on top of the urethra, which is the tube that carries urine from the bladder. It naturally gets larger as a man ages, but if it gets too big it can cause urinary complications and other problems.

There are three types of problems that can occur in the prostate. The first is inflammation or infection, also known as prostatitis, which is usually indicated by a burning sensation while urinating. The second is prostate enlargement, or benign prostatic hyperplasia (BPH), which is a noncancerous enlargement of the gland generally accompanied by the urge to urinate frequently, a weak urine stream, and dribbling of urine. Nocturia, or increased urination at night, is another symptom. BPH is the most common prostate problem for men over fifty. By the time they’re sixty, over half of men have some prostate enlargement (that number goes to 90 percent by age seventy).

Benign prostatic hyperplasia, or BPH, can be more than an annoyance. Recent research shows that as many as one in four men admitted to a hospital with acute urinary retention (AUR), which is a sudden inability to pass urine and is a common complication of advanced BPH, will die within a year.

The third type of prostate problem is cancer. Prostate cancer is the second most common type of cancer in American men, with 186,000 new cases and 29,000 deaths each year.

Conventional medicine treats BPH symptoms with drugs like finasteride (Proscar) and dutasteride (Avodart), which shrink the prostate gland by blocking the actions of testosterone. Other BPH drugs include alpha-adrenergic receptor blockers, which help relax the muscle of the prostate and bladder to relieve pressure and improve urine flow; they include doxazosin mesylate (Cardura) and tamsulosin hydrochloride (Flomax). Common side effects include dizziness, headache, and fatigue. Herbal alternatives include:

• Nettle (Urtica dioica)

Nettle has been used for centuries in Europe to treat the symptoms of BPH. Modern studies suggest that it can slow the growth of prostate cells and blunt the BPH-related effects of testosterone.

• Pumpkin (Cucurbita pepo)

Extracts of pumpkin seed oil, taken alone or combined with other herbs, can reduce BPH symptoms and shrink prostate tissues. Pumpkin contains a cholesterol-like substance called beta-sisterol, which seems to inhibit prostate enlargement; it’s also found in soy (Glycine max).

• Saw palmetto (Serenoa repens)

Several studies have shown that saw palmetto can relieve frequent and painful urination, urgency, and nocturia, and improve urinary flow. Its effects are similar to the drugs Flomax and Proscar—and it’s better tolerated.

• Pygeum (Prunus africana)

Numerous studies show that pygeum decreases nocturia, increases peak urine flow, and reduces residual urine volume.

• Rye grass (Secale cereale)

Rye grass extracts have been shown to decrease frequency, nocturia, urgency, and prostate size, and increase urine flow.

Conventional nondrug treatments for BPH include transurethral microwave thermotherapy, which uses a catheter to administer microwaves that destroy excess prostate tissue; water-induced thermotherapy, which accomplishes the same thing with hot water; and transurethral resection of the prostate, which is the most common type of BPH surgery.

Sleep Problems

Many men have problems with sleep: getting enough sleep, getting good quality sleep, and fighting sleepiness throughout the day.

Insomnia in men is most often tied to lifestyle factors like obesity, alcohol consumption, or physical inactivity, but it can also be the result of a psychiatric or medical problem such as joint or lower back pain, asthma, or acid reflux.

Conventional treatments for insomnia include sedating or sleep-inducing drugs—over-the-counter drugs like diphenhydramine HCI (Nytol, Sominex) and prescription meds like zolpidem tartrate (Ambien) and eszopiclone (Lunesta)—all of which carry the risk of side effects like dependence and “rebound insomnia” (when you stop taking the drug, your insomnia is worse than before).

Snoring and Sleep Apnea

Men—especially men who are overweight—often snore at night, which can be infuriating for their partners and can also cause health problems. Snoring reduces the quality of your sleep and can leave you feeling chronically tired, cranky, or mentally fuzzy.

Some snorers develop a condition called obstructive sleep apnea, or OSA, which is caused by a blockage in an upper airway. OSA involves loud, irregular snoring, which is broken up by repeated episodes of interrupted breathing—from ten to thirty seconds each. These episodes cause the body to release hormones that interrupt sleep, usually not so much that you regain consciousness but enough to leave you exhausted in the morning.

In many cases, OSA is tied to allergies, which can be treated with herbs such as flax (Linum usitatissimum) and evening primrose (Oenothera biennis) oils (see Chapter 9). Apnea that’s tied to obesity can also be treated herbally (see Chapter 16).

Conventional medicine generally treats OSA with continuous positive airway pressure (CPAP), which is administered via a mask and machine that blows air into your mouth and nose at night to keep your airways open.

Some doctors also prescribe stimulant drugs like modafinil (Provigil) and armodafinil (Nuvigil), which can combat the daytime sleepiness associated with OSA but can also produce side effects such as anxiety, dizziness, headache, loss of muscle strength, and tingly or prickly sensations.

Herbal Answers

Herbal remedies for sleep problems include:

• Kava (Piper methysticum)

Research shows that this herb can be as effective as the drug Valium in creating the changes in brain waves that help you fall—and stay—asleep.

• Lemon balm (Melissa officinalis)

Studies show this mildly sedating herb can help relieve stress-related sleeplessness.

• Valerian (Valeriana officinalis)

Centuries of use (and modern research) show that valerian can shorten the time it takes to fall asleep (sleep latency) and improve sleep quality.