Men's Health: Male Hormones, Genitals and Gout

Men have different health priorities, risks and physical concerns than women.Nearly 70 percent of men over the age of 20 are overweight, 27.5 percent have hypertension and 25 percent smoke (National Center for Health Statistics, 1999-2002).However, most men who reach out for more integrative health services go because of pain or libido issues.

Health issues that I explore most often with male patients involve the prostate, testosterone and libido levels, and gout. Heart-related issues such as elevated lipids, hypertension and weight loss are other concerns, but since these are more common, they will be explored in another article.

Testosterone is an androgen or male hormone. Testosterone production decreases at the rate of 1 percent a year after the age of 40. Saliva and blood hormone testing can assess testosterone levels, and bioidentical choices or testosterone patches, gels, lotions, and capsules can be prescribed. Just be careful to check the protein called sex hormone binding globulin (SHBG) and albumin levels if only using serum testing, because a normal blood test may not indicate normal levels of "free" testosterone, which can affect daily moods, libido, erections, and lean muscle mass (J Clin Endocrin and Metab2000;85(8):2839-2853). Men undergo a more gradual hormonal change with aging than women. Men are fertile most of their lives!

A natural approach to libido and arousal may include herbs such as ginkgo, Asian or panax ginseng, yohimbe, maca, or the amino acid arginine, all of which can increase blood flow and enhance sexual arousal.

A more natural approach to libido and arousal may include herbs such as ginkgo, Asian or panax ginseng, yohimbe, maca, or the amino acid arginine, all of which can increase blood flow to the penis and enhance sexual arousal. Yohimbe has been rated as "possibly effective" for erectile and sexual dysfunction by the Natural Medicine Comprehensive Database. DHEA and HGH dietary supplements are other possible options, but I highly recommend that hormone testing, health professional guidance and high-quality supplements be undertaken on an individualized basis. Watch for interactions with prescription medications: Do not take ginkgo with blood thinners; yohimbe can cause irritability, anxiety and sleep disturbances; and Asian ginseng can elevate blood pressure and provoke insomnia.

Prostate conditions are the most common ailments men deal with from age 40-80. According to the Prostate Cancer Foundation, prostate cancer strikes one in six American men. The main role of the prostate gland is to manufacture an alkaline liquid that makes up part of the semen. It is a walnut-shaped gland located beneath the bladder.

Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland. BPH is believed to be caused by lowered active levels of testosterone; elevated estrogen and dihydrotestosterone (DTH) levels; aging; being married; and/or having a family history of BPH.

Prostate enlargement blocks the flow of urine; then the trouble and symptoms start: weak or hesitant urine flow, nighttime urge to urinate, pain or straining with urination, and blood in the urine. A digital rectal exam and a blood test to measure prostate-specific antigen (PSA) levels are recommended. There are controversies about the evidence of these screens being helpful; further tests may be warranted, such as an ultrasound, to rule out prostate cancer (Ann Intern Med, Dec. 3, 2002;137(11):917-29).

Preventative and therapeutic approaches include increasing fruit and vegetable intakes, regular activity, dietary supplements that include vitamins/minerals, herbs and omega-3 fatty acids. The National Cancer Institute (NCI) and the U.S. Department of Health and Human Services (HHS) are urging men to "shoot for 9" by eating nine servings of fruits and vegetables per day. Only 3 percent of men polled in a recent national survey knew that they should eat nine fruit and vegetable servings per day (National Cancer Institute. Omnibus telephone survey of 1,015 Americans age 18 and older, November 2002). Saw palmetto, pygenum, stinging nettle, green tea, selenium and lycopene are all substances that may promote a healthy prostate.

Erectile dysfunction (ED) affects approximately 25 million men in the U.S., according to the American Urological Association. ED is the inability to achieve or maintain an erection sufficient for intercourse. ED is a complicated issue because it can include psychological issues, partner issues, depression or physical components. Cardiovascular disease, diabetes, medications, nicotine, and alcohol can impair the blood flow to the penis as well as sexual functioning. Again, the herbs yohimbe and Asian ginseng can be helpful (J Urol November 2002;168(5):2070-3).


"Prostate conditions are the most common ailments men deal with from age 40-80. According to the Prostate Cancer Foundation, prostate cancer strikes one in six American men."


Gout is a metabolic disorder that occurs because high concentrations of uric acid form in the blood. Purines, substances naturally found in the body, can break down to excessive amounts of uric acid. Many foods, including organ meats, sardines, dried beans, peas and alcohol, as well as health issues such as kidney challenges, being overweight, taking niacin and stress, can increase the risk of gout. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, "Gout is one of the most painful forms of arthritis."

Gout often represents itself in the big toe with pain, redness and swelling. Joint pain often occurs in conjunction with or following big-toe pain. The act of standing and medications such as aspirin, diuretics, cyclosporine, and Levodopa also can increase the amount of uric acid in the body.

Gout may need to be treated with anti-inflammatory drugs, cortisone injections; lifestyle changes that affect diet, weight and stress; acupuncture; dietary supplements such as cherry extracts; and homeopathic therapies. As with other men's preventative and therapeutic recommendations, reduce alcohol, caffeine and red meat intake, lose weight, increase your intake of red and purple fruits, and stay active and hydrated.

Do men have other health risks and concerns? Yes, of course! Changes in abdomen and waist circumference (maintain a waist:hip ratio of 1:1 or less), memory, pain, heart health, libido and the prostate all cause men to worry. Remember to have regular preventative checkups, limit alcohol and stress, get plenty of exercise and fruits and vegetables (antioxidants), and take individualized recommended, high-quality dietary supplements.


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