By Jack Challem
Copyright 2000 by Jack Challem, The Nutrition Reporter™
All rights reserved. This article originally appeared in Let's Live magazine.
About ten years ago, David seemed to have everything going in his favor. He was successful and well liked at work and had recently finished building a new house for his family-an incredible accomplishment. But David suddenly seemed to be subdued and lost in thought. His wife explained the problem. "Dave is turning 40, and he's feeling a little depressed," she said. "He realizes that he's getting to old to realize his dream of becoming a pro-baseball player."
Such feelings are common among men. Between the age of 40 and 55, sometimes a little earlier or later in life, men go through what's being called the "male menopause." The change is not as sharply defined as menopause in women, who by their early 50s start producing substantially less estrogen. Most men don't suffer a significant drop in their testosterone levels until well into their 60s.
Rather, the male menopause encompasses a cluster of physical and psychological changes: your strength and stamina decline, sex drive weakens (though sometimes it increases), and the risk of prostate problems increases. In a nutshell, you're looking and feeling older. Realizing that you're in the second half of your life may have also alter your attitudes toward work, family, and friends. With all these changes, it's not surprising that many men, like David, begin to lose their sense of direction in life, or dwell on what they haven't accomplished.
But middle age doesn't have to be this way. "Male menopause is not the beginning of the end, as most fear, but the end of the beginning," says Jed Diamond, a psychotherapist and author of Male Menopause (Sourcebooks, 1997, $22.95). "It is the passage to the most passionate, powerful, productive, and purposeful time of a man's life."
While aging is inevitable, improving your diet and making some modest lifestyle changes can slow down the process and help you stay active and maintain a more youthful vigor. Here are five areas to focus on to be a better, healthier man.
Maintain Your Sexual Potency
Virtually every man would like to remain sexually potent and active throughout his life. But a recent study left more than egos flagging: researchers found that some degree of impotence-the inability to achieve an erection-affects 52 percent of men ages 40 to 70. Furthermore, the prevalence of complete impotence, or erectile dysfunction, triples between middle and old age.
Spending too much time thinking about your sexual performances can lead to the bedroom equivalent of stage fright. However, the principal physical cause of impotency is cardiovascular. To become erect, your penis needs flexible blood vessels. With advancing age, cardiovascular diseases take their toll on penile blood vessels, just as they do on the heart. Conversely, whatever improves heart function-diet, vitamin supplements, exercise-can usually enhance sexual potency. That's one reason why vitamin E, well known for preventing heart disease, has long been associated with sexual performance. (See the section on keeping your heart healthy.)
Several herbs have also been shown to increase sexual potency. In a German study, researchers reported that Ginkgo biloba increased penile arterial blood flow in half the men who took it. In Asia, ginseng (Panax ginseng) has long be used as a sexual tonic-one recent study found it to be rich in protective antioxidants that work much the way vitamin E does. Yohimbe, obtained from the bark of Pausinystalia johimbe, increases sexual potency in about one-third of the men who take it. It's the basis of the only anti-impotency drug currently approved by the Food and Drug Administration. However, yohimbe should never be combined with antidepressants, including St. John's wort, because of the risk of side effects.
Low levels of some hormones, such as dehydoepiandrosterone (DHEA) and testosterone, can also affect sexual potency and overall stamina. But you don't always have to take hormones to boost their levels. Simple stress-reduction exercises have been found to double DHEA levels. Likewise, zinc can boost testosterone levels in men who are deficient in the mineral.
Stay Fertile
Even if you're not interested in becoming a father, it's important to remain fertile: the health of your sperm is often an indicator of your overall health.
Sperm are especially vulnerable to hazardous molecules called free radicals, which cause damage through a process known as oxidation. In a recent study, Hideya Kodama, M.D., Ph.D., of Akita University, gave antioxidant supplements (containing 200 mg of vitamin E, 200 mg of vitamin C, and 400 mg of glutathione daily) to 14 infertile men for two months. Sperm concentrations and motility (swimming ability) improved and the number of deformed sperm decreased. During the next six months, wives of two of the men became pregnant.
In another study, at the Serlin Maternity Hospital, Israel, Ami Amit, M.D., gave 200 IU of vitamin E daily for three months to 15 men with normal sperm counts but low fertilization rates. According to Amit's article in Fertility and Sterility, the vitamin quickly improved the fertilization rate of the men by about 30 percent.
Many urologists routinely encourage their infertile patients to take antioxidants. Marc Goldstein, M.D., director of the center for male reproductive medicine and microsurgery at the New York Hospital/Cornell Medical Center, New York City, asks his infertile patients to take vitamin C (1,000 mg/day), vitamin E (400 IU/day), selenium (200 mcg/day), plus a multivitamin/multimineral supplement that contains 20 mg of zinc. The mineral is needed for the body's production of testosterone.
Be Kind To Your Prostate
The prostate gland manufactures and stores much of your seminal fluid, the gooey transport medium for sperm. By the time you reach your early 50s, you're likely to have experienced some prostate problems.
Prostatitis, a painful inflammation of the prostate, affects nearly all men at some time. When caused by bacteria, it's easily treated with an antibiotic. However, many cases of prostatitis are not caused by infection. Antioxidants may be of benefit because they tend to have an antiinflammatory effect. In a recent study, Daniel A. Shoskes, M.D., of the University of California's Harbor Medical Center, Torrance, Calif., gave 1-2 grams of quercetin (an antioxidant flavonoid) to 18 men with chronic non-bacterial prostatitis.
Shoskes reported that 10 (56 percent) of the 18 men had some improvement in symptoms. "Several patients with complete resolution had a return of symptoms when they stopped quercetin only to have them abate when they resumed quercetin," he explained. "Oral quercetin can alleviate symptoms in a significant proportion of men with refractory [difficult to treat] hard-core chronic prostatitis."
Benign prostatic hyperplasia (BPH), more commonly known as an enlarged prostate, interferes with the normal flow of urine. As a consequence, men sometimes suffer from "dribbling" or a feeling that they have not fully emptied their bladder.
Prescription drug treatments for BHP can cause unpleasant side effects, including impotence and a loss of libido. In contrast, three herbal products, widely used in Europe, can usually reduce BPH symptoms safely within a couple of months. Extracts of berries from saw palmetto (Serenoa repens), a species of palm tree, are probably the most widely used herbal treatment for BPH. Studies have shown that pygeum (Pygeum africanum) and stinging nettles (Urtica dioica) are beneficial as well. Each is available in tablet or capsule form.
According to a Chinese study, men with a history of prostatitis and benign prostatic hyperplasia, have a six-fold risk of developing prostate cancer. Long-term consumption of various nutrients can lower this risk. Harvard University researchers have found that diets high in tomatoes and tomato sauces, rich in the antioxidant lycopene, reduce the risk of prostate cancer by 45 percent.
Last year, Harvard researchers also reported that beta-carotene supplements can lower the risk of prostate cancer among men who generally do not eat fruits and vegetables. And just recently, British researchers found that men eating large amounts of green peas, baked beans, and garlic had a very low risk of developing prostate cancer.
Keep Your Heart Healthy
Coronary heart disease, characterized by fatty deposits and hardening of the arteries is the leading killer of American men. Some simple dietary changes and supplements can keep your heart healthy-even in the face of a high-fat diet.
High-fat diets prevent arteries from dilating, or relaxing, and that interferes with the heart's ability to pump blood. You can substantially lower your fat intake by avoiding deep-fried foods, such as french fries and fried chicken. However, don't make the mistake of adopting a zero-fat diet. That's because your body needs a little fat to make testosterone and other hormones.
A recent study by Gary D. Plotnick, M.D., of the University of Maryland School of Medicine, Baltimore, found that supplements of vitamin C (1,000 mg) and vitamin E (400 IU) blocked the effects of high-fat meals. Vitamin E also prevents the oxidation (free radical damage) to cholesterol, which may be a greater cardiovascular risk factor that cholesterol per se. A couple of years ago, British researchers found that people taking 400-800 IU of natural vitamin E had a 77 percent lower risk of suffering a heart attack. To lower cholesterol levels, take natural beta-carotene, garlic, or the niacin form of vitamin B3. (Note: niacin will cause a flushing, tingling sensation for about one hour, but it stops with regular use.)
In addition, folic acid and vitamins B6 and B12 lower the risk of coronary heart disease by reducing blood levels of homocysteine, which damages blood vessel walls. Also, don't forget about maintaining the health of your capillaries, the microscopic blood vessels that form the foundation of your body's cardiovascular system. Consider taking 1,000 mg of vitamin C and 25-50 mg of Pycnogenol® (a flavonoid complex) daily.
Stay Strong As You Age
Strength decreases with age, along with muscle tone. But with a combination of exercise and supplements, it is possible to stay reasonably fit and strong. The key is increasing production of adenosine triphosphate (ATP), the chemical that actually stores and releases energy in muscle cells.
Several nutrients play key roles in increasing ATP levels and energizing your muscle cells. Alpha-lipoic acid, found in spinach and red meat, helps muscle cells burn glucose (blood sugar), and German researchers recently reported that it increased ATP levels. Carnitine, a component of protein, transports fats into cells where they're also burned for energy. Richard Kunin, M.D., of San Francisco, recommends carnitine to treat fatigue in his patients.
Coenzyme CoQ10, a vitamin-like nutrient, promotes the production of ATP. Some cardiologists, such as Peter Langsjoen, M.D., of Tyler, Texas, use it to increase energy levels in heart muscle. Others have used CoQ10 to successfully treat muscular dystrophy. Another component of protein, creatine, helps cells recycle and reuse ATP. A recent study by William J. Kramer, Ph.D., of Pennsylvania State University, University Park, found that creatine supplements increased strength during weight-lifting exercises.
Used individually or as a group, these nutrients increase the production of ATP. However, their effect is amplified with exercise. So get moving: walk, jog, ride a bike, go swimming, or lift some weights.
Navigating the Male Menopause
Middle age is a time of transition, but many men have difficulty grappling with it. Their bodies are aging, and they often feel as though their manliness is slipping away. Feeling isolated and uncertain about the future are common feelings and, perhaps not surprisingly, three times as many middle-age men as women commit suicide.
Part of the problem is that our society doesn't encourage men to cultivate deep, nonsexual bonds with other men or to express their thoughts and more "feminine" emotions. In a recent interview, Jed Diamond, a psychotherapist and author of Male Menopause (Sourcebooks, 1997), offered five tips to help men navigate their "change of life."
· Join a men's group. "In traditional societies throughout the world, boys were initiated into manhood with their peers and formed life-long support groups with those men," says Diamond. Men still need that kind of ongoing support-watching sports games and having beers with a buddy aren't the same. Men's groups can deal with what "really going on in most men's hearts-their feelings about jobs, relationships, and children," Diamond adds.
· Become an "initiated elder." Organizations like New Warriors and the Sterling Institute of Relationship do more than just pound drums on weekend retreats. They show that manhood is a collective experience, and help men "connect" with other men, their spouses, and their communities.
· Explore your life-long calling. Most men spend the first half of their lives building a career. But is your current job what you want to do with the rest of your life? Men, says Diamond, should spent part of the second half of their lives exploring what they'd really like to do. That could mean going into business for yourself or cultivating an interest in the arts.
· Embrace a sexuality appropriate to the second half of life. Young men like to "score," but sexuality in the second half of life can be slower, more intimate, passionate and "more connected to a particular partner," says Diamond.
· Become a mentor to young men. "If we don't become mentors, we never really grow up," he says. "Without elder males committed to the well-being of younger males, the society becomes increasingly savage and destructive." -JC
Getting a Prostate Test
A blood test for a protein called prostate-specific antigen (PSA) is the most common method of diagnosing prostate problems. PSA levels generally increase with age, but normal PSA levels falls in the range of 0.4 to 4.0 ng/mL.
PSA levels above 4.0 can indicate prostatic disease. About 30-50 percent of men with an enlarged prostate have elevated PSA levels.
A high PSA level can also be a sign of prostate cancer. However, PSA tests miss about one-third of all prostate cancers, and false-positive results are common-suggesting cancer when there actually is none.
To get a PSA test, ask your doctor to draw a small amount of blood, which he'll then sent to an analytical laboratory. My first PSA test, at age 47, was 0.8, which was very good.
The information provided by Jack Challem and The Nutrition Reporter™ newsletter is strictly educational and not intended as medical advice. For diagnosis and treatment, consult your physician.