Posts Tagged ‘testosterone’

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Getting There Early or On Time: Which is Better?

Sunday, January 24th, 2010
Is faster better? Not always.

Is faster better? Not always.

What is the most common sexual health problem affecting men? That’s easy, it’s erectile dysfunction, right? Nope. Try premature ejaculation. Hands down more common than erection issues, affecting 25-40% of men in the U.S.

Variably called early ejaculation, or early or rapid climax, it is defined as male ejaculation earlier than the subject or his partner desires. It used to be defined as ejaculation within 2 minutes of sexual intercourse, until it was realized that 75% of men ejaculate within 2 minutes in over half of their sexual encounters. What the definition really implies is that is some element of poor control over ejaculation that is stressful and may result in interpersonal difficulty.

Is this a medical disorder? In some cases, yes. Think of ejaculation as a reflex, like sneezing. There is a point of no return and this is what comes too soon in men with early ejaculation. The problem has two forms: lifelong and recent. The former is believed to result from low levels of the neurotransmitter serotonin (5HT) that normally modulates the ejaculation reflex. The recent form does not have as clear a biological basis, but may occur from psychological stress or from the need to overcome an erection problem.

The good news is that there are treatments available, and more treatments being reviewed by the FDA. Currently, the most effective treatments are pills called SSRIs, which elevate 5-HT levels and include anti-depressants such as Prozac, Zoloft, Celexa, and Lexapro. A newer form of SSRI drug, called Priligy, is now available in nine countries but has still not been FDA approved in the states. Also, a metered-dose aerosol spray has been developed to increase time to ejaculation by numbing the skin on the penis and decreasing sensation. Maybe this will help. Unfortunately, with all drug treatments for this condition, when the drugs are stopped, the issue generally returns.

What I find interesting is that companies are vigorously trying to drum up sympathy and attention for premature ejaculation as a widespread medical disorder, when in many cases it may be only an occasional annoyance that does not need constant treatment. Treatment might be perfect for a few men with debilitating disease, but it appears that they are trying to create and market a whole new category of disease. Good idea: create a “huge unmet need,” an epidemic that is perfect for a blockbuster, quality of life drug. Well what about a pill for shyness, or talking too fast? Where does it end? The larger issue here might be the “medicalization” of our daily lives in which there is a healthy and wide variation of normal.

Do I believe that some men have debilitating early ejaculation? You bet, and I see them every day. Do I think that a pill will treat this issue? Sure, for many, but only while you take it. Will blockbuster pills be the cure-all for early ejaculation? No way. The cure will come with more holistic treatment, by empowering men through behavioral changes that teach them to control and “own” the problem. Works superbly for my patients, pill or no pill.

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Posted in men's health, sexual health | 4 Comments »

Weighing Your Options

Sunday, January 10th, 2010
Bacchus is no longer a role model...

Bacchus is no longer a role model...

What you weigh affects how your sperm play. And your fertility. Overweight men tend to have lower semen volumes, less sperm and more oddly shaped sperm. The same is also true for men who are too thin. So, along with the many other health hazards associated with obesity, add poor semen quality to the list.

Obesity in both sexes is known to be associated with heart disease, diabetes, hypertension, and metabolic syndrome among other nasty conditions that can shorten your life. Typically, obesity is measured with BMI or body mass index, which looks at weight in relation to height. Not a perfect measure, but reasonably accurate. Using this tool, the ideal BMI for men (and women) is considered to be 20-25. A Danish study of 1600 men showed that overweight men with a BMI > 25 had a 22% lower sperm concentration compared with healthy weight men. Interestingly, a BMI of <20 was also associated with poor semen quality. For optimal sperm production, then, it helps to be not too fat and not too thin.

But what about fertility? Is it also affected by obesity? Yup. Another recent study showed that for every 20-pound increase in a man’s weight, there is a 10% increase in the chance of infertility. And this remained true when other factors that might influence the results were accounted for, including obesity status of the women, the man’s age, cigarette smoking, alcohol intake, and solvent and pesticide exposure. In addition, obesity was associated with infertility in both older and younger men.

So what is it about weight that influences men’s sperm production and fertility? One theory is that sex hormone metabolism is altered by changes in weight. Sex hormones are the “fuel” for the engine (testis) to make sperm. Obesity increases fat stores and fat converts male hormones (testosterone) into female hormones (estrogens). Too much estrogen in men is bad for sperm production. Another theory posits that normal 2-degree difference in testis temperature relative to the body is lost with obesity, as excessive fat provides too much insulation and results in overheating. On the other hand, when a man is too thin, he may take on a “catabolic” metabolic state. With a body in “starvation mode,” fertility is not the first thing on its mind and sperm production and fertility suffer.

So, is the epidemic of obesity the reason why sperm counts have been falling in Western countries over the last 50 years? Maybe. But this problem is unique in that it is utterly and entirely preventable. Eat well and in moderation, sleep well and treat your body like a temple. You used to it for your own health; now do it for the health of your future family.

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Posted in male infertility, men's health, sexual health | 2 Comments »

What Comes After the Pill?

Sunday, November 15th, 2009
Making the world a better place with modern technology.

Making the world a better place with modern technology.

In this forum, I’ve already talked about how erections occur and also about pills used to treat erectile dysfunction in men. But what if they don’t help? What comes after the pill?

There are about 30 million men in the U.S. affected by erectile dysfunction. For 20% or more of men, common prescription therapies – Viagra, Levitra or Cialis – are not effective. For these men, we have many things “up our sleeves” to help. Before reviewing this cornucopia of cures, I really need to emphasize again the idea that erectile dysfunction may be a message that your body is not perfectly healthy. Think of it as a loud noise coming from under the hood of the car. It may run fine if you keep going, but you never know. Similarly, medical conditions such as high blood pressure, heart disease, high cholesterol, diabetes and low testosterone are important “loud sounds” that are associated with erectile dysfunction; they should be treated first and foremost. Often, by treating these illnesses, not only will erections improve, but you might live better and longer too.

Ok, so your cholesterol is fine. How then can erections be improved? Well the answer may be to “go local.” Local therapies attempt to improve erections by going to the source to treat the problem: the penis itself. Help the big guy out without involving the rest of the body. Penile salves, creams and urethral pills are available in many forms and are often compounded by pharmacies. One of these is a pill (MUSE) that is inserted just inside the urethra (the urine tube within the penis) and is absorbed by the penis to stimulate an erection. A little unconventional, but very effective in some men.

Although more difficult to imagine, local therapy can also involve injecting the side of the penis with highly active erectogenic agents such as papaverine, phentolamine and prostaglandins. Not the most palatable way to get an erection, but highly effective for the vast majority of men who fail to respond to pills. A more inviting alternative is based on recent developments in transdermal technology and involves delivering the same three medications in a clear gel into the urethra (TriMix Gel). Rub it in for a minute or two and you are up and running.

Available for 30 years now, penile vacuum pumps will also work in the majority of men. By creating 6 atmospheres of negative suction pressure around the penis, these mechanical devices draw blood directly into the penis. Once filled, a rubber ring is placed around the base of the penis to keep the blood in and away you go. But please don’t keep the ring on too long (more than 45 minutes) as bad things could happen…

In the most resistant cases, surgical implants may be needed to resurrect the erection.  Reliable and realistic, implants are the most invasive kind of local therapy and are effective in virtually all men. They can be rigid but bendable, inflatable, antibiotic coated and can have other neat widgets and gadgets. But they do require surgery, which distinguishes them from other treatments. They are also irreversible in the sense that they permanently alter penile anatomy, rendering ineffective most other treatments discussed here. So, let it be known that “vee have vays” of getting those erections back in case the pill doesn’t work.

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Baby Making Tips

Wednesday, August 19th, 2009
The most fun he ever had without laughing

The most fun he ever had without laughing

You might have “practiced” the art of baby making for quite a while. But have you actually tried to make a real baby? What does it mean when a couple says they’re “trying”, besides jettisoning the condoms, scheduling free time, and practicing your “sore throat” voice for calling in sick to work. No one teaches you the nitty gritty of baby making in sixth grade sex ed classes. So, here are some of the finer points.

First of all, your chances of conceiving decrease if the two of you are under stress. Frequent travelling, major life changes, a long sickness, being vetted for the Supreme Court, running a start up with a gazillion hours weekly, are terrible for getting one “in the mood.” If the body is under stress, it’s in the primitive “fight or flight” response, and it’s not exactly in the mood to reproduce. So to improve your chances, decrease your stress level by eating well, sleeping well, staying healthy and relaxed, and treating your body right. If you are chronically overworked, you may consider decreasing or delegating your responsibilities. If this isn’t possible, force your body to relax with exercise, yoga, massage or acupuncture. Also, quit smoking, drink no more than two glasses of alcohol daily and avoid hot tubs and hot baths (showers are fine).

Like many things in life, timing is everything. Eighty percent of pregnancies occur when sex takes place before or during ovulation, which is the time when a woman’s ovary releases an egg for fertilization. But how to tell when ovulation is occurring? The most accurate way would be with an “ovulation predictor kit” purchased at any drugstore. Like a pregnancy test, it uses urine to determine if ovulation is about to occur. The old-fashioned method, which also works well, would be to pay attention to her basal body temperature. To do this, she should take her temperature first thing in the morning, for a string of consecutive days during the middle of her monthly cycle. There should be a dip in her temperature, followed by a rise. This indicates ovulation.

Once you know that the egg is on its way, intercourse is best performed every other day. Men need time between ejaculations to “reload”, and daily intercourse may not give a man enough time to do so (sorry guys). As for the act itself, studies have shown that no particular position is best. Research is suggesting that the two of you can bend yourselves into pretzels, if desired, with no effect on your chances of conceiving or on the gender of the child.

Baby making is a special experience. And, it’s fun! As Woody Allen said in the movie Annie Hall, ”…sex is the most fun I ever had without laughing.” If you think about it, what I am suggesting is that you and your partner make it a habit to take the best care of yourselves, just as you are going to take the best care of your child. Set the example for the new family and enjoy the ride!

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The Anatomy of an Erection

Monday, August 10th, 2009

Impressive natural rock formations in Cappadocia, Turkey

Impressive natural rock formations in Cappadocia, Turkey

There is a bit of mystery that surrounds the average erection: Where did it come from? How long will it last? Will it be good enough?  They happen when you least expect it (whilst asleep, or in math class). And they happen when you do expect it–hopefully. Biologically, men have less control then they think regarding when or how long they occur. In fact, normal men have at least 3 erections lasting 1 hour every night, while they are asleep, deep asleep. This is the penis “sighing” and relaxing, as it takes more energy to keep a penis flaccid than erect. Believe it or not.

 

The key to an erection lies within the male brain, through visual, auditory, or imagined stimuli, or through manual stimulation. Upon stimulation, the arteries within the penis relax, and blood flows into the penis at more than 20 times the normal rate.  The spongy areas of the penis become firm and engorged with blood, much like filling up a balloon with air. So now that the penis is holding more blood, the veins, which usually drain the penis of blood, are compressed tightly enough that blood cannot exit the penis, in effect tying a knot in the balloon. And now the balloon is ready to go. 

 

Erections last, on average, between fifteen and thirty minutes, and can cause the penis to rise to a fairly stiff angle. They can also curve upward or downward, to the right or to the left. This is why upscale clothiers in London ask men who are ordering custom tailored suits: “To what side do you dress, sir?” Right before ejaculation, a reflex is triggered (bulbocavernosus) which causes the muscles that surround the penis to forcefully compress the penis, such that the blood pressure within the penis reaches levels far higher than normal blood pressure. The penis falls when there are no more energy molecules available, in effect “running out of gas”. Viagra and other erectile drugs work by supplying more “gas” to the penis. Erections also fall from nervous system discharge during ejaculation. This discharge results in a latency period or “down time” during which it is difficult to achieve another erection. Once the nervous system has recovered, then an erection is again possible.

 

One can see what might cause the balloon to wilt (erectile dysfunction). There could be a problem with circulation (not enough pressure), a problem with venous leakage (the balloon has a hole in it) or nerve damage or hormonal issues (no one is blowing up the balloon) which could inhibit penile filling or emptying or the ability to feel sexual stimulation. Drugs, toxins, and conditions such as heart disease and diabetes are all culprits. This is why good health is so important for a healthy sex life.

You may never have ultimate control over something so willful as an erection, but it may be helpful to understand how it occurs. Because, with a finer understanding, hopefully, comes finer appreciation and enjoyment.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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The Ailing Male Pill

Thursday, August 6th, 2009
What shape will the male pill take?

What shape will the male pill take?

A male birth control pill certainly sounds like a good idea. But after 25 years and millions of dollars of research, there’s still no pill. We put a man on the moon faster than we’ve invented a male pill.

The question isn’t really whether it can be done, because it can. The production of sperm is linked to testosterone levels in the body. When testosterone levels are too high, the body stops producing sperm. Witness the testis shrinking (atrophy) that occurs with anabolic steroid use. Such pills have been tested, and are successful. One problem, though, is that the ability of hormone-based male pills to work perfectly (which they really need to do) varies with a man’s ethnicity. Works for some, but not all. This issue alone may prove fatal for the male hormone pill.

Besides this, there is a litany of concerns regarding the physical side effects of a hormone-based male pill. Immediate concerns have been a big issue in past trials- adult acne, weight gain, moodiness and the like. But what about possible long term effects? The female contraceptive pill has been linked with higher rates of heart disease and breast and liver cancer in women. Although not completely comforting, at least we know these issues in women. But little to no research has addressed similar issues with long term “pill” use in men.

Despite all of this, there is still a healthy interest in a male birth control pill. Studies have shown that men in committed relationships are more interested than single men in a pill– no surprise here. Single men are interested in using condoms for the added bonus of protection against STDs. A male birth control pill might also be a better contraceptive alternative for men who want more control over family planning than that offered by vasectomy. That said, there is still the eternal question of whether or not a pill would sell successfully– would women, in the end, trust their partners to be consistent and compliant in taking the pill? The answer to this question varies from couple to couple, but to get a sense of things, ask yourself how often you fail to take something as simple and uneventful as a daily multivitamin to get an idea of the magnitude of this problem.

There simply aren’t enough options for male contraception on the market today. The main ones are abstinence, rhythm method, withdrawal, condoms, and vasectomy. Given this lineup, there is certainly room for more, and more reliable, contraceptives for men. One thing seems reasonable clear: given the safety and effectiveness of vasectomy, and fact that daily compliance is not needed to keep it effective, anything new has to be this good or better. How about a truly reversible vasectomy? Or a long term, implantable hormonal device? In the end, these are likely to become tasty alternatives to a male pill.

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Sexual Health Pop Quiz #2

Monday, July 20th, 2009
Remember computer test bubble sheets? Get out the #2 pencils...

Remember computer test bubble sheets? Get out the #2 pencils...

You may call me a stern and demanding taskmaster, but because the last one was so much fun, it’s time for another pop quiz on men’s sexual health. This one is based on real-life, case-based questions.

1. In anticipation of a romantic encounter with his partner, and to help him be the best that he can be, a man takes Viagra. His next move should be:

A. Watch Law and Order, a stirring drama to stir the loins.
B. Go to the post office and renew his passport.
C. Eat tacos and drink beer.
D. Play strip poker with his romantic encounter.

Answer: D. Viagra and the other erection pills do not provide an instantaneous erection. They may take from 20-60 minutes to work. In addition, they won’t give you an erection unless you want it to occur. Engaging in stimulation and foreplay is an excellent way to spend your time waiting for the pill to kick in.

2. Good sex ALWAYS involves:

A. Multiple orgasms from your partner.
B. Whatever looks really freaky in the last pornographic film you saw.
C. Kinky stuff.
D. Leather of one sort or another
E. None of the above.

Answer: E. In our society, exceptions to any rule fascinate us. Here, extreme sex performance acts, characteristic of pornography, are the exception. Sex was designed by Mother Nature to be satisfying when undertaken in many different ways, and takes many different forms, all of which can be intimate and pleasurable without having to go to extremes.

3. The problem with porn on the Internet is that:

A. There is no problem! It’s good fun and free!
B. The video is fuzzy and far too pixilated.
C. I can’t watch it at work without getting caught.
D. I can get too used to it, and sex with my own partner could become unsatisfying.

Answer: D. With the increasing availability of porn, a serious problem is arising. Men who are without partners become accustomed to that kind of sexual stimulation and then end up needing that same kind of stimulation to become aroused with a partner. So, when they find themselves face to face with an honest-to-goodness, flesh-and-blood woman, they may have trouble performing. This is an increasingly common issue for sex therapists.

4. TRUE or FALSE: You and your partner have a night in together. You turn off the television, go upstairs, and tenderly give each other long, leisurely massages with body oil in a room lit only by candles. You have a great time. This constitutes a satisfying sexual experience.

Answer: True. “Sex” does not have to involve sexual intercourse and climax and orgasm. The point is to feel satisfaction and closeness with your partner. Of course sex can involve pure carnal pleasure, but that definition should be broadened to include other emotional and physical intimacy.

5. TRUE or FALSE: Since the advent of free love, we’ve become liberated from the sexual taboos of our mothers and  fathers.

Answer: Profoundly False. Although we’d like to think so, sex therapists still see tales of embarrassment and lack of communication between couples, now more than ever. Being able to express our needs, both emotional and physical, without embarrassment or shame, is a problem of the ages.

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Pop Quiz on Men’s Sexual Health

Monday, June 22nd, 2009

Did the artist Roy Lichtenstein truly understand women?

Did the artist Roy Lichtenstein truly understand women?

Ok, you have been reading about men’s health on this blog for months. Now it’s time for a little quiz. Number two pencil’s out?

1. True or False: Real men don’t cry or express emotion.

False. Ever see Marlon Brando in Streetcar Named Desire, yelling Stella’s name in the streets? Too bad that men who cannot express their feelings are portrayed as monsters on film. Think of Arnold Schwarzenegger in the Terminator. Or Al Pacino in the Godfather (part two), where he has his brother killed with barely a trace of emotion. Simply not true. Real men feel but often they are not able to recognize and name the feelings. In any case, expressing feelings is as primitive and important as eating.

2. True or False: A healthy man always wants sex.

Tricky, but false. Testosterone influences a man’s libido, and men, on average, have a higher libido than women. When women state that “men always want to have sex,” it’s an exaggeration. According to the Kinsey Institute, 54% of men think about sex every day, or several times a day, but 46% think about it a few times per month, a few times per week, or less. Remember, stress also affects sexual desire. Men may not think about sex as much when they are older compared to when they were younger in part because of how much more complicated and stressful their lives have become.

3. True of False: A man who is good in bed should be able to keep it up for 45 minutes straight.

False. This would be fun it were true all the time. But actually, every man is different. In this case, it’s time to bury that competitive streak or any issues of inadequacy, because this expectation is a bit high. Although drug makers warn us on TV about erections lasting for several hours (which in fact can be painful), the average erection lasts 15 to 30 minutes. The average time to sexual climax in U.S. men is 7- 9 minutes, believe it or not.

4. True or False: I had five hours of sleep, worked a 9 hour day, then came home, helped with dinner, and worked on a pet project. Exhausted, I went to bed, and my lady love wanted sex. There must be something wrong with me if I don’t feel like it.

False. I wrote about this previously. Wanting to have sex is linked with stress and also sleeping well. This means between 6.5 and 7.5 hours of sleep each night. According to sleep researchers, the people that live the longest also sleep about that much. It’s well known that sleep deprivation has a direct impact on libido, and in some cases, on erectile function.

5. True or False: When I have sex with a woman, I need to attend to her needs before attending to mine.

True and False. It is gentlemanly and attentive to respond and pay attention to what a woman wants, but to tell the truth, women’s libido’s are a funny, wily thing. Only 26% of women in a committed relationship climax every time they have sex. Men often put themselves under undue pressure to give their partner an orgasm when it may cause more stress than satisfaction. Some advice: Take care of yourself and let her take care of herself.

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Testosterone, Steak and Eggs

Monday, June 15th, 2009

One strong arm does not a man make...

One strong arm does not a man make...

Testosterone is one misunderstood molecule. It has such great influence over the human body that it has gained a reputation, a mystique. Society associates testosterone with Arnold Schwarzenegger (circa 1980s), with strength, virility, aggression, violence, square jaws and six-pack abs. We also tend to blame it for certain male tendencies and traits in our society, as well as certain medical disorders, although there is little scientific basis for this reasoning.

Testosterone is the major sex steroid hormone in men, and its effects are wide-ranging and powerful. It will make a boy into a man, for one thing. It sparks the development of facial and pubic hair, Adam’s apples, deeper voices, bigger muscles, broader chests. In the adult male, testosterone is necessary for sexual desire, erection maintenance, and sperm production. It also affects other body functions not directly related to sex–important ones–such as maintaining a normal blood count, bone strength, muscle mass and mood.

Testosterone might explain the perpetual sexual desire of a sixteen year-old whose previously unannointed body is now seeing it for the first time, but it does not explain away acts of violence. One popular belief is that excessive testosterone can make one uncontrollably aggressive. However, men actually tend to feel moodier and more anxious with lower testosterone levels, and there are reports that testosterone treatment can disperse these negative feelings. Also, studies show that there is a higher correlation between acts of violence and a past history of violence, than between violence and testosterone levels.

It is also untrue that high testosterone levels cause male pattern baldness and prostate cancer. Baldness is not a sign of virility, and is not associated with high testosterone levels. It is associated with genetics, specifically from the mother’s side of the family (male pattern, crown centered baldness) or the father’s side (overall baldness). Prostate cancer, meanwhile, appears to be associated with low levels of testosterone, and not high ones. So, basically, despite being the cause of hairiness, sweatiness, smelliness, and horniness, testosterone is very good for men.

Does it deserve the bad rap it gets? Taken appropriately, as replacement for naturally low levels, testosterone is not dangerous, nor is it illegal. If taken as a supplement, things are different. Anabolic steroids are synthetically produced variants of natural testosterone. Some common street or slang names for anabolic steroids include arnolds, gym candy, pumpers, roids, stackers, weight trainers, and juice. There are about 100 different types of anabolic steroids circulating nowadays and you will get over 1 million hits on Google by entering “buy steroids,” if you’re interested. When anabolics are taken as a supplement to boost normal testosterone levels, they can lead to some interesting side effects: shooting blanks instead of having a normal sperm count, getting tender breasts when you really don’t want them, and acne like when you were fourteen. Here’s where the bad rap enters the picture. And with steroid abuse, all bets are off regarding the healthy benefits that normal testosterone balance has on cholesterol balance, liver and heart health, blood pressure and mood. So be just like the power hitter Jim Thome, who said: “The strongest thing I put into my body is steak and eggs.”

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You Are The Pill That You Eat

Tuesday, June 9th, 2009

Amber waves of grain, the stuff of our Neolithic ancestors

Amber waves of grain, the stuff of our Neolithic ancestors

At some point as we evolved, well after the Neolithic period, we started thinking that there must be a better way to get nutrients, something faster and more efficient, than through the food we have eaten for tens of thousands of years. Our fantasy of the future was encapsulated with TV shows like The Jetsons and Star Trek, where roast chickens and earl grey tea were produced by the touch of a button. Nowadays, grocery stores offer fruit smoothies, breakfast bars, energy drinks and microwave pizzas, so we can fuel up quickly and efficiently. Why sit down when you can eat while running? We take vitamins with the idea that we can rectify any potential deficiencies and even prevent illness, with the swallow of a pill. How simple, how easy, how efficient.

As a society, we are in love with “nutriceutical” supplements. About half of all adults take a multivitamin everyday and it is estimated that $75 billion worldwide is spent annually on nutriceuticals. And nonvitamin and nonmineral natural product use is so prevalent in the U.S. (40% of Americans) that the National Institutes of Health has even commissioned a new branch devoted entirely to the pursuit of complementary and alternative medicine research. This effort will undoubtedly unleash the true potential of alternative medicine. But let’s drill down on vitamins for a minute. What does the evidence really show? Well, it appears that taking vitamin supplements may not as beneficial as previously thought. Several major studies have now shown that vitamin supplements do little to prevent cancer and heart disease, while other studies report that vitamins and antioxidant supplements may actually increase cancer rates. One study concluded that folic acid supplements actually increased rates of precancerous colon polyps, and another study linked beta-carotene to higher lung cancer rates. Are vitamins then, failing us as supplements?

No one discounts the necessity of vitamins for our body’s function. Indeed, many diseases are associated with a deficiency in one or another vitamin. But we do place rather high expectations on vitamins. It’s rather narrow-minded of us to tout only a few particular nutrients in food and assign them letters of the alphabet, when many others may be just as essential to our primitive bodies, yet are unfamiliar to us intellectually. Vitamins do not exist in a void, but are part of a complex mixture of substances called food that is the real stuff of life. If anything, the fact that vitamins are getting an F in cancer prevention suggests that the way that they are absorbed in a pill is not the same as the way we extract them from whole foods that we eat.

My patients frequently ask me what supplements they should take to enhance their sexual health or fertility. The truth is that because sexual health is so thoroughly intertwined with overall health, I emphasize a whole-body approach. I don’t recommend a specific course of supplements, but antioxidants may have some value. If they wish to take a supplement, they may, but the important thing is that they get all nutrients necessary for their bodies to function optimally. The real solution to this is a well-balanced diet low in fat and sugar, emphasizing whole grains, fruits, and vegetables. That said, I do realize how resistant many people can be to changing their diet. If a patient feels they must take a supplement to compensate for poor eating habits, I steer them towards whole food supplements that contain a larger and more complex spectrum of nutrients than that found in traditional multivitamins. In all honesty however, I firmly believe in carrots from the earth and apples from trees, just like our Neolithic ancestors did.

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