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Older Men

Older men face similar (but less definite) fertility issues to women, and each passing decade generally sees a fall in sperm quality and quantity. The main male sex hormone from the testicles is testosterone, and lower testosterone, plus a range of other factors, affects sperm output. Sperm numbers and the health of the DNA they carry are the most significant issues for older men.

  • When men are under 25, only 8% of fertile couples take a year or more to conceive
  • When men are over 35, about 15% of fertile couples take over a year to conceive i

The relationship between a man’s age and his fertility continues as he gets older, and men with 35 to 40-year-old partners are either under or over 40: ii

  • Annual pregnancy rates are 2.2 times higher when the man is under 40
  • Not conceiving or miscarriage happens three times more when the man’s over 40
  • When men are over 45, couples take five times longer to get pregnant

In real terms, the possibility of “male factor” being part of a couple’s infertility rises from 18% when he’s 35, to 28% when he’s 40 iii

Increasing age has predictable impacts on men’s semen samples:

  • Lower volume
  • Lower percentages of normal sperm
  • Less sperm motility
  • Poorer genetic integrity of the sperm

Why ageing reduces male fertility

  1. Ageing affects the whole body, and noticeable changes occur to cells in the testes and other sexual tissue. This includes the prostate and epididymis, which causes lower semen volumes and sperm activity; however, the testes only shrink when men reach their 80’s (by 31%) iv
  2. Testosterone levels vary a lot in young men, but after 30, all men have a fall in testosterone by about 1% each year; this adds up, and eventually, men experience the andropause” v
  3. Reduced testosterone levels cause many symptoms, including lower libido, lower bone density and less muscle mass.
  4. Low testosterone leads to increased body fat (with central obesity), insulin resistance, emotional irritability and low mood.
  5. Erectile dysfunction and a lower libido are also features of lower testosterone levels
  6. Simply living longer increases our exposure to damage or disease, especially when men have genital or bladder infections. Vascular diseases and the build-up of toxic substances also cause lower fertility as men get older: vi
    • Infections in sexual glands significantly reduce sperm counts and affect 13.6% of men aged over 40, but only 6.1% of men under 25 vii
    • PCB levels reduce sperm counts and motility, and older men typically have higher levels of PCBs viii

Other issues for older men

Several other important issues affect older men and reduce conception rates:

  • Men are usually less sexually active as they get older
  • Erectile dysfunction increases with age
  • Type II diabetes risks increase with age, and it lowers fertility
  • Cardiovascular disease risk increases with age, and it also reduces male fertility

The main issues for older men

  1. Falling testosterone levels
  2. Rising levels of oxidative stress
  3. Changes to their general health
  4. Infections and inflammation

Raising male fertility

Because a range of issues usually applies to older men, in practice, it’s best to use a variety of approaches to improve fertility, which are:

  1. Follow the advice for your PFP
  2. Take herbal supplements that naturally raise testosterone
  3. Reduce exposure to chemicals and toxins
  4. Increase the range of antioxidants in the diet
  5. Reduce stress and support the health of the autonomic nervous system
  6. Get enough sleep

Herbal treatments for older men

Some individual herbs significantly improve semen quality and male hormone levels, and while taking single herbs is straightforward, we recommend herbal combinations that are designed to adjust each person’s health. They’re more balanced, can be adjusted to reflect personal needs and changes, and classic combinations have been used for centuries. These combinations have good research on raising male fertility and dramatically improving semen samples and conception rates.

Older men have various symptoms that are part of the “Ageing Male Syndrome”, and we explain this with the six PFPs in Erectile Dysfunction. However, some individual herbs have compelling research to support them:

Withania somnifera (Indian ginseng)

  1. W.somnifera effectively reduces oxidative stress on sperm by lowering various oxidant levels, and higher levels of multiple antioxidants are found in the semen. The herb also improves sperm counts and motility, and it raises testosterone and other hormone levels in infertile men viii
  2. W.somnifera appears to “reboot” the activity of enzymes and energy metabolism in infertile men, and because of this, there are better sex hormone balances and other vital factors in semen. This herb is suggested as a clinical treatment in male infertility x
  3. Treatment with W. somnifera significantly reduces sperm cell death and “free radical” damage. The men who take the herb have better essential mineral concentrations in their semen and improved semen quality xi
  4. W. somnifera also appears to have a protective function when men are exposed to high levels of external oxidative stress. This type of exposure usually leads to cell death and a reduction in testes size and function xii

Mucuna pruriens (velvet bean)

  1. M. pruriens seeds increase the concentration and motility of the sperm of infertile men. When there are abnormal levels of lipids (fats), antioxidant vitamins, and sugars in semen samples, they normalise after treatment, plus there’s a reduction in “free radical” levels  xi
  2. M. pruriens treatment significantly improves the sex hormone levels of infertile men, plus significantly improves their sperm counts and motility xii
  3. There’s evidence that M. pruriens reactivates the antioxidant defence system and improves the semen quality of infertile men. An additional benefit is that it also reduces the effects of psychological stress on men xiv

Because of its effect on lipids and mood, we suggest this herb is particularly appropriate for men with raised BMI and Flow and Fluids PFPs.

Eurycoma longifolia (Tongkat Ali)

This herb has been used for centuries in South-East Asian countries as a male fertility tonic, and more recent research reveals a wide range of effects: xv

  1. It reduces weight by about 5% and, more importantly, abdominal fat by over 30%
  2. It raises testosterone levels by 30%
  3. Fertility improves, with sperm concentration, motility, and vitality all increasing significantly after taking the herb

Men with Late-Onset Hypogonadism (decreased testes function later in life) given 200mg of E. longifolia extract for a month experienced significant improvements, as measured by the Ageing Males’ Symptoms (AMS) and serum testosterone concentrations: xv

  • Before treatment, 89.5% of the men had AMS complaints, and 35.5% had normal testosterone levels
  • After treatment, 28.3% had AMS complaints, and 90.8% of the men had normal testosterone levels

There haven’t been any adverse effects recorded with E. longifolia, which appears to be a safe and effective treatment for male infertility. It seems to be especially appropriate when there’s a need to reverse problems associated with male ageing.


References
i The male biological clock is ticking: a review of the literature. F. Pasqualotto; E. Júnior; E. Pasqualotto. Sao Paulo Med. J. vol.126 no.3 São Paulo May 2008.
ii Paternal age ≥40 years: An important risk factor for infertility. Elise de La Rochebrochard, Patrick Thonneau, American Journal of Obstetrics and Gynecology: Volume 189, Issue 4, October 2003, Pages 901–905
iii Increased Infertility With Age in Men and Women. D Dunson, D Baird, Donna; B Colombo. Obstetrics & Gynecology: Jan 2004 – Volume 103 – Issue 1 – pp 51-56
iv Mahmoud AM, Goemaere S, El-Garem Y, Van Pottelbergh I, Comhaire FH, Kaufman JM. ‘Testicular volume in relation to hormonal indices of gonadal function in community-dwelling elderly men.’ J Clin Endocrinol Metab. 2003;88(1):179-84.ix Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. ‘Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study’. J Urol. 1994;151(1):54-61
v Kidd SA, Eskenazi B, Wyrobek AJ. Effects of male age on semen quality and fertility: a review of the literature. Fertil Steril. 2001;75(2):237-48.
vi Ford WC, North K, Taylor H, Farrow A, Hull MG, Golding J. ‘Increasing paternal age is associated with delayed conception in a large population of fertile couples: evidence for declining fecundity in older men.’ The ALSPAC Study Team (Avon Longitudinal Study of Pregnancy and Childhood). Hum Reprod. 2000;15(8):1703-8.
vii ‘Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males’ Mohammad Kaleem Ahmad, Abbas Ali Mahdi, et al. Fertility and Sterility Volume 94, Issue 3 , Pages 989-996, August 2010
viii ‘Efficacy of Withania somnifera on seminal plasma metabolites of infertile males: a proton NMR study at 800 MHz.Gupta A, et al. J Ethnopharmacol. 2013 Aug 26;149(1):208-14.
ix ‘Withania somnifera improves semen quality by combating oxidative stress and cell death and improving essential metal concentrations’. Kamla Kant Shukla, Abbas Ali Mahdi et al. Reproductive BioMedicine Online Volume 22, Issue 5 , Pages 421-427, May 2011
ixiii ‘Protective Effect of Withania somnifera (Linn.) on Cadmium-induced oxidative injury in rat testis’ Elumalai Prithiviraj et al. Phytopharmacology 2013, 4(2), 269-290
x‘ Effect of Mucuna pruriens on semen profile and biochemical parameters in seminal plasma of infertile men’ Mohammad Kaleem Ahmad, Abbas Ali Mahdi, et al. Fertility and Sterility Volume 90, Issue 3 , Pages 627-635, September 2008
xi ‘Mucuna pruriens improves male fertility by its action on the hypothalamus–pituitary–gonadal axis’. Kamla Kant Shukla, Abbas Ali Mahdi et al. Fertility and Sterility Volume 92, Issue 6 , Pages 1934-1940, December 2009
xii ‘Mucuna pruriens Reduces Stress and Improves the Quality of Semen in Infertile Men’ Kamla Kant Shukla, Abbas Ali Mahdi et al. Evidence-Based Complementary and Alternative Medicine Volume 7 (2010), Issue 1, Pages 137-144
xiii ‘In vivo effects of Eurycoma longifolia Jack (Tongkat Ali) extract on reproductive functions in the rat’ M. C. Solomon et al. Andrologia. 6 MAR 2013.
xv Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? M. I. B. M. Tambi, M. K. Imran, R. R. Henkel. Andrologia Volume 44, Issue Supplement s1, pages 226–230, May 2012
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