If you read the previous blog post by Janice Mao on Chinese Medicine for Male Fertility, then you know about the precipitous decline in male fertility in the last several decades. A 2017 meta-analysis which included nearly 43,000 men from Western, industrialized nations showed that sperm counts had decreased more than 50% since the 1970s (Levine, 2017). This worrisome trend indicates that rather than being an individual problem, male fertility is diminishing on a broad scale in modernized nations. What are the potential causes for this shift? And what can men do to preserve or improve their fertility? Read Part 1 here with Part 2 to come.
1. Get checked out.
While I examine societal causes for a decline in male fertility in this post, it’s important to look at each case individually. That’s why I recommend that men consult with a urologist, get a physical exam and pursue sperm testing if they suspect they may have a fertility challenge. Note that your partner’s not getting pregnant isn’t the only sign that you may have a fertility issue. Early miscarriage can also be due to a problem with sperm quality. The most common cause of male infertility found is a varicocele—an enlargement of veins within the scrotum. It’s a treatable condition, both through Western medicine and using traditional Chinese medicine. Other common causes of male infertility include hypogonadism, chromosomal abnormalities, cryptorchidism, a history of radiation, orchitis, or obstruction of the vas deferens (Krammer-Pojer). First things first—you and your doctor should rule out any of these particular causes.
2. Must be something in the water.
What happened in the 1970s that could have impacted male fertility for the worse? A few things including the burgeoning use of plastics (we’ll talk about that next), but also the birth control pill. While it had many great outcomes for women’s liberation, hormonal birth control is likely part of the nexus of villains when it comes to male fertility. According to a CDC survey from 2015 to 2017, about 9 million U.S. women use oral contraceptives (CDC). The birth control pill consists of exogenous hormones (namely, estrogen) which, when excreted via the urine, are passed on to the groundwater. In addition to this source of hormones, others used in commercial meat and dairy farming for expedited growth in animals also run off into water.
These often don’t get adequately filtered out by municipalities before ending up in tap water. Therefore, we are drinking water with a splash of estrogen. That’s not great for either sex since our modern world already exposes us to many outside sources of estrogen or estrogenic- compounds. Scientists have observed reproductive abnormalities in fish and other aquatic life exposed to estrogen-tainted runoff. Their offspring are often infertile and have both male and female genitalia (Scientific American). While men produce some estrogen naturally, being exposed to too much can lead to low sperm counts, erectile disfunction, and gynecomastia (breast growth). While this is all quite distressing, one action that you can take is to filter your drinking water at home. The best system for removing hormones from water is a combination of a reverse osmosis filter augmented by pre- and post-activated carbon filters (Scientific American).
I use the https://www.bigberkeywaterfilters.com/ at home; it doesn’t include the reverse osmosis step, so for best results, you would incorporate both methods. Check out the purity of your local tap water and how to best filter it here.
3. Plastics make it (im)possible.
I recently took a continuing education class on male infertility. The teacher summed up a complex analysis of research when she exclaimed, “Plastic is a sperm killer!” Plastics contain xenoestrogens—chemical compounds which mimic the effect of estrogen in the body. Once again, men (and women) are exposed to too much estrogen. Xenoestrogens are found not only in plastic bottles, straws, cutlery and saran wrap, but also in cans, sunscreen, deodorants, preservatives in food, pesticides, industrial waste, solvents, washing and cleaning agents. Phthalates are another group of synthetic chemicals which are known endocrine disruptors. They act as anti-androgens, meaning that they interfere with testosterone in the body. Phthalates are added to many plastic products and can also be found in cosmetics, hairspray, shampoo, and soap. In short, a lot of products we are exposed to on a daily basis contain endocrine disruptors (Krammer-Pojer).
In order to reduce your plastic exposure, shop at farmer’s markets (where less plastic packaging is present), re-use cloth or paper bags, and store food in glass, not plastic. Especially avoid microwaving food in plastic as this breaks down and releases xenoestrogens into the food you’re about to eat. Consult the various guides and apps provided by the Environmental Working Group to keep phthalates and other toxins out of your personal care and cleaning products.
4. Keep your cucumber cool.
Have you ever heard of the blood/testes barrier? It’s a natural separation in the male reproductive tract that protects the developing sperm in the testes from immunological cells in the bloodstream that could attack them. Sounds important, right? Unfortunately, there are a few things that can compromise this barrier and one of them is heat. This is why the testes are located outside the abdominal cavity—they need to stay below 93ºF for healthy sperm production (Krammer-Pojer). Therefore, in the name of fertility, avoid saunas, hot tubs, hot baths, standing in front of ovens, tight pants, and perhaps the most common culprits—using your laptop on the lap and keeping your cell phone in your front pocket.
An interesting consideration for the fertility of your future male children . . . is the correlation between the rise of disposable diaper use in the U.S. since the 1970s and the male fertility problem. Some theorize that disposable diapers negatively impact male fertility as they are made of plastic (which we poo-pooed earlier ;) and they keep the developing male gonads too hot with their hermetic fit (Krammer-Pojer). Opt for cloth diapers instead.
Stay tuned for Part Two where I will give more lifestyle, dietary and supplement recommendations to maximize your mojo.
REFERENCES:
“Can Birth Control Hormones Be Filtered from the Water Supply?” Scientific American, Scientific American, 28 July 2009, www.scientificamerican.com/article/birth- control-in-water-supply/.
“Contraceptive Use.” CDC website: https://www.cdc.gov/nchs/fastats/contraceptive.htm
Krammer-Pojer, Dr. Olivia. Treating Male Fertility Problems with Chinese Medicine: February 8-9, 2020 Retrieved from http://healthyseminars.com
Levine H, Jorgensen N, Martino-Andrade A. Temporal trends in sperm count: a systematic review and meta-analysis. Human Reproductive Update 2017; 23 (6): 646–659