MEN’S HEALTH

Regarding “Men’s Health,” two areas are at the top of the list: genitourinary (reproductive organs and urinary system) and cardiovascular health.  The genitourinary system receives a lot of press with the abundance of commercial advertisements around prostate health and ED (erectile dysfunction).  The primary genitourinary health issues for men are Prostate cancer, BPH (Benign enlargement of the prostate gland), Prostatitis (prostate inflammation), and Infertility.

Prostate Cancer

• According to the WHO, prostate cancer is the second most common form of cancer in men, with over 1.28 million diagnosed worldwide in 2018.[i]

BPH

• BPH and its symptoms (difficulty urinating, straining to urinate, dribbling, accidentally leaking urine, pain, abdominal cramping), such as increased frequency of urination at night, impact an estimated 30 million men worldwide.[ii]
• In the U.S., it is estimated that 50% or more of men 50 or over have this benign enlargement, with the numbers reaching 80% in those 70 and older.[iii]

Prostatitis

• Prostatitis is the most common urinary tract problem for men younger than 50 and the third most common urinary tract problem for men older than 50.[iv]
• Prostatitis accounts for about two million visits to healthcare providers in the United States annually.[v]
• Symptoms of prostatitis are like that of BPH and also include pain or burning when urinating, frequent urination, cloudy urine, and pain in the abdomen or lower back.

Of the three of these conditions, prostatitis is unique in that it impacts men of all ages.

Male Infertility

• Infertility affects an estimated 15% of couples globally, amounting to 48.5 million couples.[vi]
• Males are found to be solely responsible for 20-30% of infertility cases and contribute to 50% of cases overall.[vii]

Prostate 101

It is shocking how many men don’t know much about their prostate until they have a problem. The prostate gland is a small walnut-shaped organ that lies just below a man’s bladder. It surrounds the urethra, the tube that carries urine from the bladder out of the body through the penis.  The prostate gland’s main function is to secrete prostate fluid (one of the components of semen). The prostate gland muscles also help propel this seminal fluid into the urethra during ejaculation. Whether a person has issues with frequent urination, getting up and down at night several times, difficulty in getting a urine stream going, or discomfort, it is recommended that you get a thorough exam to rule out anything more serious than BPH or Prostatitis.

Granted, prostate health is a male problem, yet consider prostate health to be a couple’s problem.  Looking at what the symptoms can be with prostate cancer, BPH, and prostatitis, we can see how these symptoms[viii] may impact our significant other:

• Frequent urge to urinate.
  • Impacts social life
• Need to get up many times during the night to urinate.
  • Impact on all party’s sleep quality
• Pain or burning urination.
  • Steady discomfort may impact other areas of daily life
• Painful ejaculation.
  • Possible decrease in libido or desire for intercourse
• Frequent pain or stiffness in the lower back, hips, pelvic or rectal area, or upper thighs.
• Dribbling of urine.
  • Embarrassing situations either in public or home environment

DEEP DIVE INTO SUPPLEMENTS FOR PROSTATE HEALTH AND INFERTILITY CONCERNS

Lycopene

Just do a PubMed search, and you will find hundreds of studies on lycopene and prostate health.  Lycopene is a carotenoid that is commonly found in tomatoes and other fruits.  The consumption of tomato products, including pasta sauce, ketchup, tomato juice, etc., is the more common ways this nutrient is consumed.  It is one of the most potent antioxidants among dietary carotenoids. Although the antioxidant properties of lycopene are thought to be primarily responsible for its beneficial effects, evidence is accumulating to suggest that other mechanisms may also be involved.[ix]

There are many ways in which lycopene supports prostate health.  Studies with lycopene have shown positive results in all aspects of prostate health, including benign enlargement.  A study published in the Journal of Nutrition showed lycopene inhibits disease progression in patients with benign prostate enlargement.  Patients took either 15mg/day of lycopene or a placebo for six months.  Their results showed those taking lycopene showed no change in the progression of prostate enlargement. Additionally, there was a reduction in PSA levels in those taking lycopene versus no change in the placebo group.[x] Lycopene has repeatedly been shown to inhibit the growth of the human prostate.[xi]

Regarding prostatitis, according to a study published in Korean Journal of Urology, “Chronic bacterial prostatitis (CBP) is the most common urological disease in adult males, with antibiotic therapy being the gold standard for its treatment. However, long-term therapy results in many side effects and bacterial resistance. For these reasons, there is a need for alternative methods to help those with this condition.  The study concluded lycopene might be an “effective material” for those with CBP.[xii]

When looking at lycopene supplements, we need to look for those with solid science, proven absorption, and quality in mind.  Sibelius^TM: LactoMato (LactoMato) is the frontrunner when looking at lycopene supplements.  To better understand the superiority of LactoMato, it is important to understand the complexity of lycopene’s bioavailability (being able to be absorbed into the bloodstream).  Concerning lycopene, several areas play a role in its bioavailability.  First, lycopene absorption from tomatoes increases when they are cooked and when they are ingested with fat.^[xiii]  The process of absorbing lycopene involves many steps that can be complicated and inefficient.  LactoMato absorption and bioavailability studies show impressive results when compared to tomato paste (one of the better accepted and more bioavailable forms of dietary lycopene) and a placebo.  Better bioavailability and absorption often lead to improved effectiveness.

Saw Palmetto

The herb saw palmetto seems to have received the most attention for prostate health in the areas of support for BPH[xiv] and prostatitis[xv].  Some studies found that saw palmetto increased the urine flow rate in men with BPH compared to placebo.[xvi]

Pygeum

The herbal extract pygeum has been extensively studied regarding BPH, with the results being positive yet inconsistent[xvii].  Pygeum does not have successful studies on other prostate or fertility health areas.

Beta-sitosterol

Beta-sitosterol, like pygeum, impacts BPH mostly on symptoms such as but does not impact the prostate size.[xviii][xix][xx]

Rye Grass Pollen

Rye grass pollen benefits BPH, prostatitis, and chronic pelvic pain.  Taking rye grass pollen extract orally seems to improve symptoms such as frequency, nocturia (getting up at night to urinate), urgency, flow rate, dribbling, and pain in patients with mild to moderate BPH.[xxi][xxii]  One study showed rye grass pollen relieved some symptoms of chronic prostatitis and associated pelvic pain.[xxiii]  It is clear to see that though these herbs support different areas of genitourinary health, none have the impact across the board as that of lycopene.

INFERTILITY

Lycopene

Finally, there is great research on the benefits of lycopene on infertility.  A study from 2014 noted, “Excessive amounts of free radicals result to decreased sperm viability and motility (ability to move). Elevated levels of free radicals are a major contributor to male infertility.”[xxiv]  Lycopene is found in high concentrations in the testes, and decreased levels have been seen in men suffering from infertility.[xxv]   According to the review above, “various lycopene supplementation studies conducted on both humans and animals have shown promising results in alleviating male infertility, while sperm count and viability, and general immunity were increased.  Human trials have reported improvement in sperm parameters and pregnancy rates with supplementation of 4-8 mg of lycopene daily for 3-12 months.”[xxvi]

L- carnitine

l-carnitine has some great science showing that taking L-carnitine significantly increases sperm count and sperm motility in men with infertility.[xxvii][xxviii][xxix]

CoQ10/Ubiquinol

CoQ10 also has excellent research. One study showed that infertile men with decreased sperm motility who take CoQ10 200 mg/day have increased sperm motility after six months.[xxx]  In another study, taking a higher dose of 300 mg daily significantly improves sperm density and motility after 26 weeks.[xxxi]

CARDIOVASCULAR SUPPORT

Cardiovascular health issues are the most common form of death for men.  While the topic is too vast to cover in depth in this blog, some key supplements mentioned previously also support cardiovascular health; Lycopene, CoQ₁₀, and l-carnitine.  There are several areas of cardiovascular health in which consuming lycopene has shown a significant benefit: blood pressure[xxxii][xxxiii], a general reduction in risk of cardiovascular disease[xxxiv][xxxv] and elevated cholesterol[xxxvi][xxxvii].  CoQ₁₀ or Ubiquinol (the bioactive form of CoQ₁₀) is one of my favorite cardiovascular health antioxidants.  Finally, l-carnitine is a key supplement for muscle health, energy, and endurance.  While sometimes it isn’t looked at as a cardiovascular supplement, I believe it plays a key role in the health of your heart (a muscle).

Let’s also consider some other key supplements I consume daily for cardiovascular health:  Omega-3s from fish, HydroCurc® (Curcumin), Magnesium, and green tea.  While green tea can be considered a beverage, it lessens the load of pills you need to consume.  Of these suggestions, I would never do without my fish oil, HydroCurc®, and magnesium.  In addition, I suggest getting your omega-3 index and magnesium scores done every six months to be certain you are consuming enough to be healthy.

Conclusion

While the content above flags lycopene as an obvious choice for men, keep in mind that life and health are also about balance.  Relying solely on one supplement may not always get you where you want to go.  Be sure to have all aspects of your life be healthy and healthful.  Avoiding processed foods, being cautious with alcohol consumption, consuming moderate amounts of red meat, increasing fruit and vegetable consumption, getting proper amounts of sleep, exercise 150+ minutes per week are all great additions to a healthy daily lifestyle.  In addition, considering combining other health-promoting supplements such as omega-3s, probiotics, and even a multivitamin (men’s) will get you on your way to better men’s health.

Author: David Foreman

References:

[i] World Health Organization website,  Cancer, www.who.int/news-room/fact-sheets/detail/cancer

[ii] Egan K, The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms Prevalence and Incident Rates, Urologic Clinics of North America 43 (2016) 289-297

[iii] Egan K, The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms Prevalence and Incident Rates, Urologic Clinics of North America 43 (2016) 289-297

[iv]  Nickel JC. Prostatitis and related conditions, orchitis, and epididymitis. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 10th ed. Philadelphia: Saunders; 2012: 327–356.

[v] Barry MJ, Collins MM. Benign prostatic hyperplasia and prostatitis. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia: Saunders; 2011: 805–810

[vi] Agarwal A, Mulgund A, Hamada A, Chyatte MR. A unique view on male infertility around the globe. Reprod Biol Endocrinol. 2015 Apr 26;13:37. doi: 10.1186/s12958-015-0032-1. PMID: 25928197; PMCID: PMC4424520.

[vii] Agarwal A, Mulgund A, Hamada A, Chyatte MR. A unique view on male infertility around the globe. Reprod Biol Endocrinol. 2015 Apr 26;13:37. doi: 10.1186/s12958-015-0032-1. PMID: 25928197; PMCID: PMC4424520.

[viii] NIH National Institute on Aging website, Prostate Problems, https://www.nia.nih.gov/health/prostate-problems

Last reviewed July 1, 2016, Accessed November 17, 2019

[ix] Agarwal S, Rao AV. Tomato lycopene and its role in human health and chronic diseases. CMAJ 2000;163(6):739-44

[x] Silke Schwarz, Ute C. Obermüller-Jevic, Eva Hellmis, Winfried Koch, Günther Jacobi, Hans-Konrad Biesalski, Lycopene Inhibits Disease Progression in Patients with Benign Prostate Hyperplasia, The Journal of Nutrition, Volume 138, Issue 1, January 2008, Pages 49–53, https://doi.org/10.1093/jn/138.1.49

[xi] Ute C. Obermüller-Jevic, Estibaliz Olano-Martin, Ana M. Corbacho, Jason P. Eiserich, Albert van der Vliet, Giuseppe Valacchi, Carroll E. Cross, Lester Packer, Lycopene Inhibits the Growth of Normal Human Prostate Epithelial Cells in Vitro, The Journal of Nutrition, Volume 133, Issue 11, November 2003, Pages 3356–3360, https://doi.org/10.1093/jn/133.11.3356

[xii] Yang C , Sohn D , Cho Y, Anti-inflammatory Effect of Lycopene on Chronic Bacterial Prostatitis Rat Model,

Korean J Urol. 2006 Dec;47(12):1348-1353.

[xiii] Gartner C, Stahl W, Sies H. Lycopene is more bioavailable from tomato paste than from fresh tomatoes. Am J Clin Nutr 1997;66:116-22

[xiv] Wilt T, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA. 1998;280:1604-1609.

[xv] Aliaev, IuG, Vinarov, A. Z., Lokshin, K. L., and Spivak, L. G. [Efficiency and safety of prostamol-Uno in patients with chronic abacterial prostatitis]. Urologiia. 2006;(1):47-50

[xvi] Gordon AE, Shaughnessy AF. Saw palmetto for prostate disorders. Am Fam Physician. 2003;67:1281-1286.

[xvii] Ishani A, MacDonald R, Nelson D, Rutks I, Wilt T., Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. Am J Med. 2000 Dec 1;109(8):654-64.

[xviii] Berges RR, Windeler J, Trampisch HJ, et al. Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Beta-sitosterol Study Group. Lancet 1995;345:1529-32

[xix] Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. Br J Urol 1997;80:427-32.

[xx] Wilt TJ, MacDonald R, Ishani A. beta-sitosterol for the treatment of benign prostatic hyperplasia: a systematic review. BJU Int 1999;83:976-83.

[xxi] Buck AC, Rees RW, Ebeling L. Treatment of chronic prostatitis and prostatodynia with pollen extract. Br J Urol 1989;64:496-9.

[xxii] Yasumoto R, Kawanishi H, Tsujino T, et al. Clinical evaluation of long-term treatment using cernitin pollen extract in patients with benign prostatic hyperplasia. Clin Ther 1995;17:82-7

[xxiii] Buck AC, Rees RW, Ebeling L. Treatment of chronic prostatitis and prostatodynia with pollen extract. Br J Urol 1989;64:496-9

[xxiv] Durairajanayagam, D., Agarwal, A., Ong, C., & Prashast, P. (2014). Lycopene and male infertility. Asian journal of andrology, 16(3), 420–425. doi:10.4103/1008-682X.126384

[xxv] Gupta NP, Kumar R., Lycopene therapy in idiopathic male infertility–a preliminary report., Int Urol Nephrol. 2002;34(3):369-72

[xxvi] Durairajanayagam, D., Agarwal, A., Ong, C., & Prashast, P. (2014). Lycopene and male infertility. Asian journal of andrology, 16(3), 420–425. doi:10.4103/1008-682X.126384

[xxvii] Lenzi, A., Lombardo, F., Sgro, P., Salacone, P., Caponecchia, L., Dondero, F., and Gandini, L. Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial. Fertil.Steril. 2003;79(2):292-300

[xxviii] Zhou, X., Liu, F., and Zhai, S. Effect of L-carnitine and/or L-acetyl-carnitine in nutrition treatment for male infertility: a systematic review. Asia Pac.J Clin Nutr. 2007;16 Suppl 1:383-390

[xxix] Wang, Y. X., Yang, S. W., Qu, C. B., Huo, H. X., Li, W., Li, J. D., Chang, X. L., and Cai, G. Z. [L-carnitine: safe and effective for asthenozoospermia]. Zhonghua Nan.Ke.Xue. 2010;16(5):420-422

[xxx] Balercia G, Mosca F, Mantero F, et al. Coenzyme Q10 supplementation in infertile men with idiopathic asthenozoospermia: an open, uncontrolled pilot study. Fertil Steril 2004;81:93-8.

[xxxi] Safarinejad MR. Efficacy of coenzyme Q-10 on semen parameters, sperm function and reproductive hormones in infertile men. J Urol 2009;182:237-48

[xxxii] Engelhard YN, Gazer B, Paran E. Natural antioxidants from tomato extract reduce blood pressure in patients with grade-1 hypertension: a double-blind, placebo-controlled pilot study. Am Heart J 2006;151:100.

[xxxiii] Paran, E., Novack, V., Engelhard, Y. N., and Hazan-Halevy, I. The effects of natural antioxidants from tomato extract in treated but uncontrolled hypertensive patients. Cardiovasc.Drugs Ther. 2009;23(2):145-151

[xxxiv] Kohlmeier L, Kark JD, Gomez-Gracia E, et al. Lycopene and myocardial infarction risk in the EURAMIC Study. Am J Epidemiol 1997;146:618-26

[xxxv] Sesso HD, Buring JE, Norkus EP, Gaziano JM. Plasma lycopene, other carotenoids, and retinol and the risk of cardiovascular disease in women. Am J Clin Nutr 2004;79:47-53

[xxxvi] Silaste, M. L., Alfthan, G., Aro, A., Kesaniemi, Y. A., and Horkko, S. Tomato juice decreases LDL cholesterol levels and increases LDL resistance to oxidation. Br.J.Nutr. 2007;98(6):1251-1258

[xxxvii] Shen, Y. C., Chen, S. L., and Wang, C. K. Contribution of tomato phenolics to antioxidation and down-regulation of blood lipids. J.Agric.Food Chem. 8-8-2007;55(16):6475-6481