by Serena Ma, ND, MS, LAc
This past week, a health news headline declared that sperm counts have declined by more than half in the past 40 years in Western countries (North America, Europe, Australia and New Zealand), which brought up the possibility of human extinction!
This is based on a systematic review and meta-analysis published July 25, 2017 in the journal Human Reproduction Update, which reviewed 185 studies from 1973-2011. Of course there are flaws to some of the studies they used. Most of the men included in they study were recruited from fertility clinics (who might have sperm issues to begin with), but this is not something to be ignored. We are certainly seeing this trend in our practice, but unfortunately we still have more women who come in for help conceiving. I assume it's male-pride (or shame) that keeps men from addressing this growing issue. Come on guys, there's nothing to be ashamed of, plus we can reverse this trend!
Let's look at why this might be happening... The study did not examine the possible cause(s) but the list of possibilities include:
- smoking, particularly maternal smoking during male reproductive development prenatally
- endocrine-disrupting chemicals (pesticides, plastics, fire retardants)
- watching too much TV
As a naturopathic doctor and acupuncturist, I consider all the above factors, focusing on lifestyle, inflammation (oxidative stress), nutrition (antioxidants) and balance of Qi/blood/Yang in the body.
Here are my 8 tips to mate:
- Keep your CELL PHONE off your body (particularly your pant pockets), and NO laptop on your lap! A small study showed that sperm motility (movement) was lower and more DNA damage seen in the sperm exposed to cell phone radiation for 5 hours. A similar result was also seen after 4 hours of exposure to a WiFi connected laptop (lower motility and more DNA fragmentation). As a lady, I carry my cell phone in a bag (and off my body) and use a radiation blocking blanket when using my laptop on my lap. Men, consider radiation blocking underwear, put your phone elsewhere (nothing wrong with a murse), carry only in airplane mode, and never put a laptop on your lap.
- Reduce (or better yet, eliminate) the use of PLASTIC. Anyone who has worked with me has heard me rant about this for years. BPA (the most researched plastic chemical) is a known hormone disruptor and linked to infertility, cancer, obesity, and diabetes. Research showe that increasing urinary BPA levels are associated with decreased sperm concentration, decreased total sperm count, decreased sperm vitality, and decreased sperm motility. Just avoiding BPA is not the answer either. BPS is used now as a substitute and is even more disrupting than BPA. Personally I don't trust any of the chemicals in plastic, many of which have not been studied for safety. So how do you avoid plastic? Store your food in glass containers, don't buy water in plastic bottles (instead fill up your re-useable glass or stainless steel bottle with filtered water), and never heat plastic or put hot food in plastic. Here is a list of 100 steps to a Plastic-Free Life for some inspiration.
- Do regular moderate EXERCISE. In one study looking at exercise, all 3 types of exercise studied improved sperm motility, sperm morphology, and sperm concentration, but moderate-intensity continuous training was superior to high-intensity continuous training and high-intensity interval training, in terms of inflammatory markers (lowers overall oxidative stress and better antioxidant defense). Moderate-intensity continuous training consisted of: 12 weeks of walking or jogging on the treadmill for 25-30 min/day 3-4 days per week at 45-55% VO2 max and increased to 40-45 min/day for 4-6 days per week at 56-69% VO2 max for the remaining 12 weeks. All exercise included 10-15 minutes of warm-up and cool-down. So, unless you are super fancy with a treadmill that calculates that or a wearable (the best seems to be the Garmin Fenix 3 with chest strap), you can roughly estimate what your target heart rate should be to reach a certain % VO2 max with this calculator - Percent VO2max to Heart Rate Conversion Calculator - simply entering your age and what % VO2 max you want to achieve. Aim for 30 min of 45-55% VO2 max for 12 weeks 3-4x per week and increase to 45 min of 56-69% after 12 weeks.
- Get regular ACUPUNCTURE. Acupuncture and moxa have been shown to significantly improve morphology, increasing normal-form sperm, with improvements seen after 5 weeks of treatment (2x per week). My general recommendation is to start with at least weekly acupuncture treatments for male fertility; more specific recommendations are made case-by-case.
- Chinese HERBS improve sperm motility and quality. Various herbs and formulas have been studied for enhancing male fertility. To name a few, astragalus (huang qi) and prickly acanthopanax (ci wu jia) have been shown to improve sperm motility. Meanwhile Shao Fu Zhu Yu Tang, a classic formula to increase Qi and Blood circulation in the lower abdomen/pelvic region, increases motility and improves sperm quality due to its antioxidant effects. However one of my favorite formulas for male fertility is Wu Zi Yan Zong Wan (Five Ancestors Pill) to replenish the kidneys with essence; this formula improves the quality of sperm by improving spermatogenesis. Chinese Herbal Medicine works by working with a trained herbalist who can identify your condition, whether it be stagnation (thus more Qi/Blood circulation needed) or more nourishment of Qi/Blood/Yang energy.
- Get your ANTIOXIDANTS in. Antioxidants protect our cells from free radical damage - and this applies to sperm too. My two favorites are zinc and coQ10. Zinc has been shown to increase semen volume, sperm motility, and percentage of normal morphology - and serum levels of zinc are lower for men who are infertile. Further it was noticed that smokers tend to have lower zinc levels than non-smokers. coQ10 is an antioxidant present in all the mitochondria in our bodies (the powerhouse of the cell), so you can imagine how important the mitochondria/coQ10 is for sperm movement! And as expected, coQ10 does improve sperm motility with doses ranging from 60-300 mg per day. To note, there are studies showing the improvement of egg quality in infertile women with coQ10, so I suspect the same for men and sperm. There are also other antioxidants that improve sperm, like vitamin C, carnitine, and selenium. It is best to work with a naturopathic doctor to determine which supplements to take and their dosages.
- Speaking of antioxidants, a good DIET is essential. Hopefully after the blurb ion antioxidants, it's obvious that a diet full of antioxidants (colorful fruit and vegetables) is beneficial for male fertility. But that's not the whole picture; let's talk fats. Trans fats has been shown to reduce sperm count in healthy young men. Trans fats are processed (artificially derived) vegetable oils, to make them solid at room temperature. Make sure to read your food labels as trans fat may be disguised as 'partially hydrogenated fat'. In general, processed foods are best avoided for everyone. Further, saturated fats reduce sperm concentration in semen, and a diet high in omega-3 fats has the best sperm morphology. Another big one is alcohol consumption as alcohol changes testosterone levels. As little as 5 drinks per week has shown to reduce sperm concentration, reduce sperm count, and increase abnormal sperm morphology, with pronounced changes in men who drink 25 or more drinks per week. Bottom line? Take a fish oil supplement, avoid trans fats (forever), and have no more than 5 drinks per week.
- Address STRESS. Research is showing that stress and lifestyle factors cause DNA damage to sperm, particularly self-perceived stress and stressful life events and not work-related stress. One proposed mechanism is that increased stress increases cortisol which affects testosterone production and spermatogenesis. Stress may also create more reactive oxygen species (free radicals) via inflammation...which damages sperm. Some ideas to reduce stress are mediation, low to moderate intensity exercise, spend time in nature, acupuncture, and do something you enjoy and enjoy it.
It's no wonder that sperm quality and counts are decreasing. We have a combination of poor nutrition and food quality, added stressors with less time connecting/cooking/spending time in nature, and increasing chemical and electromagnetic pollution (toxin) exposure. Our planet and humankind are in danger, and we must consider for future generations.