It is the month of November - Movember, to be specific. And it's not just about glorious (or less than glorious) moustaches; it's that special month of the year when the main focus is on men's health issues. According to a University of the Western Cape male fertility and health research specialist, the health issues that will affect between 60% and 80 % of all males in their lifetime, will be ‘aging male’ problems’ which would include prostate-problems.
Prof Ralf Henkel is a world-renowned Andrology specialist and university lecturer, internationally rated among the top professionals in the field of male fertility. His research team has made several findings which improve men's reproductive health as well as general well-being.
For example: between 14 and 20% of men will eventually have prostate cancer and up to 80% BPH (the swelling of the prostate), respectively. The prostate swelling develops very gradually from between the ages of 35 and 40. The patient eventually experiences difficulty urinating – and it could eventually mess up their kidneys permanently, says Henkel.
“The bladder just keeps filling up and you can't urinate, which later involves emergency treatment to help empty the bladder,” Henkel explains. “This condition is quite painful.”
With their research at UWC's Medical BioSciences Department, Henkel and his team are addressing several issues.
One major research topic is finding ways of making contraception the responsibility of both male and female. At the moment reproductive responsibility rests mainly with the female in terms of oral and other forms of contraception, while the only viable options available to men at the moment are testosterone applied to the skin or taken in tablet form, a vasectomy or a condom, according to Prof Henkel.
“Injections currently available to men today still have too many side effects, causing other anabolic diseases,” he notes. “Other not-so-popular methods include condoms, vasectomies, abstinence or coitus interruptus – where the sexual act is basically interrupted before ejaculation takes place.”
Growing older, and what that means for men's health
Research is still continuing in this field, but Henkel's main focus is on the symptoms of the ageing male. He explains the changes taking place as men age. “Generally, the levels of the male hormone, testosterone, drops after the age of 35 which has the same kind of effect that ageing women would commonly refer to as menopause. Men go through a similar set of ailments, but because not enough research has been done, and the male’s ego, they are basically still suffering in silence.
“Women are assisted by means of hormone replacement and it has become widely accepted, but there are not many such options for men at the moment,” he notes, “and what we are doing is trying to find those solutions for men.”
While aging the cells producing testosterone become less active and the actual testosterone production declines. Testosterone levels start declining from the age of 25 to 30.
“As a result, from this age onwards, belly fat is starting to grow,” Henkel says. “And the more belly fat around the tummy area, the more testosterone is converted by an enzyme into the female hormone estrogen, thus a vicious cycle is starting leading to even less testosterone.”
Also, the serum concentration of a protein, commonly known as the sex hormone binding globulin (SHBG), increases, taking more testosterone out of the system, thus the concentration of the biologically active free testosterone is declining in the body. More belly fat is the result – and fatigue, mental problems and prostate difficulties are added to the list of health risks for aging men.
But there is good news
Herbal medicine and men: Local solutions to global problems
“Through research we have discovered herbal products that can boost testosterone, and that is working really well. With this research we did clinical studies and the findings are significant – improved physical activity in spite of the ageing process and no weight gain.”
Henkel's team is aware of the properties of a Malaysian root extract (Tongkat Ali), which is widely used in Malaysia as a tonic to boost male well-being, but the exchange rate makes that too costly to import. So they looked at other South African alternatives: extracts from the “bull rush” or the “love reed”, Typha capensis.
“Sadly, further studies on its effects have been halted due to lack of funding, but both boost testosterone in vitro significantly,” says Henkel.
Using the love reed with animal experimentation on ageing rats showed that the rats were more physically active compared to the rats in the control group. Their body weight stayed low compared to the control group, whereas the ageing male rats' systems declined.
“We have also identified both, the Tongkat Ali root extract and the love reed,” he notes, “to have anti-prostate-cancer activity. Both plants extracts could also be used as boosters for infertility. An added value according to our studies is that there is no negative effect on the offspring. For the love reed, we chemically identified the bioactive compounds as well as the genes that are affected by them in terms of testosterone biosynthesis and prostate cancer development.”
Prof Ralf Henkel's top tips for health for aging men:
The best age to be starting to check your prostate regularly is from the age of 45. Problems only really start at the age of 50 – but if you have reason to suspect you might have a prostate problem and you're a bit younger, you should still get tested.
A Prostate-Specific Antigen (PSA) test is also standard procedure for cancer detection. PSA is a marker for cancer and this acts as a screening test. It doesn't replace the physical examination.