Male fertility problems
What are male fertility problems?
If pregnancy is absent, the cause may be male, female or both. Male fertility problems may include a reduced number of sperm, a reduced motility of the sperm or an increased percentage of sperm with an abnormal shape. Problems with the fluid, the vas deferens or testicles can also play a role.
Sometimes a clear cause is found in research, such as varicocèle (spater around the sperm ball), hormonal disorder, infection or obstruction. In other cases, sperm values have been reduced without any obvious cause being found.
Within Chinese medicine, not only the results of sperm research are considered. Also include energy, digestion, stress, sleep, libido, warmth and coldness and any urogenital symptoms are included to determine the underlying TCM pattern.
Common characteristics
Male fertility problems may manifest themselves in various ways during sperm testing, including:
- a reduced number of sperm (oligozoospermia);
- decreased sperm motility (asthenozoospermia);
- an increased percentage of sperm with an abnormal form ( teratogenic zoospermia);
- decreased sperm volume ( hypospermia);
- very thick or poachy semen which does not become sufficiently liquid (delayed or incomplete excretion of the semen);
- a combination of reduced number, decreased motility and abnormal sperm form (oligoasthenoteratozoospermia, OAT).
Not every man also has noticeable physical symptoms. Sometimes an abnormal sperm test is the only indication that fertility has decreased.
Possible causes
The quality of sperm can be influenced by various factors. Examples include a varicocèle, problems with testicles or seed tubes, infections or inflammations, certain medicines, drugs, alcohol and smoking.
Long-term exposure of the testicles to heat may also be unfavourable. Examples are regular use of saunas and hot baths, long cycling, a lot of sitting with laptops on laps or tight and warm sitting clothes.
In addition, prolonged stress, inadequate sleep, overload, nutrition and age can play a role. In some men, despite extensive research, no obvious cause is found.
What can acupuncture do?
Acupuncture can be used in addition to male fertility problems. Treatment is tailored to sperm abnormalities and the overall symptoms.
Within Chinese medicine, for example, long-term stress and tension may require treatment other than fatigue and recovery problems. Other treatment principles are also used in case of heat or inflammatory symptoms, a varicocèle or obvious cold symptoms.
Depending on the TCM pattern, treatment may be directed at:
- Support the flow of Qi and Blood in the pelvic area;
- reduce stagnation;
- Dampness and Heat reduce when present;
- Support the Spleen at Dampness and Phlegm;
- Qi and Blood strengthen in case of deficiency;
- Support kidney-Yang or kidney-Yin;
- within TCM support the Kidney-Essence, which is linked to reproduction.
Acupuncture does not replace studies on possible medical causes of impaired fertility.
What can Chinese herbal medicine do?
Chinese herbs, like acupuncture, are chosen on the basis of the underlying pattern. As a result, two men with similar abnormalities can still get different herbal treatment in a sperm study.
For example, in one man the treatment can be mainly aimed at reducing Dampness-Heat, while in another the strengthening of kidney-Yang or kidney-Yin is central. In a varicocèle or other indications for reduced local circulation, improving blood flow may be more important.
Depending on the grievance picture, herbal medicine can be aimed at:
- Provider-Qi regulation for stress and tension;
- Reduce Dampness-Heat;
- Transforming Phlegm-Dampness;
- supporting blood circulation;
- Add Qi and Blood;
- Enhance kidney-yang or kidney-yin;
- Supporting Kidney-Essence.
Because sperm production takes time, herbal treatment aimed at sperm quality is usually applied for a longer period.
How does Chinese medicine view male fertility problems?
Western medicine evaluates male fertility, among other things, on the basis of the number of sperm, their motility and shape and the properties of the fluid. In addition, Chinese medicine looks at the underlying imbalance that may fit with the grievance image.
In male fertility, the TCM organ systems Kidney, Liver and Spleen are especially important.
Within TCM, the kidney has a much broader meaning than only the anatomical kidneys. The system is inter alia linked to reproduction, development and the so-called Essence (Jing). Kidney-Yang is associated with heat and functional activity, while Kidney-Yin is linked to the nourishing and moistening base of the body.
The Liver plays an important role in free flow of Qi and Blood. Long-term tension and stress can disrupt this flow according to TCM.
The Spleen is involved within TCM in the processing and distribution of nutrition and body fluids. When this function is weakened, according to Chinese medicine Dampness can occur. When Dampness is long present and further thickens, it is spoken of Phlegm .
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Most common TCM patterns
Liver-Qi-stagnation
Brief explanation
With Liver-Qi stagnation, the flow of Qi according to TCM is less free. This pattern is seen especially when prolonged stress, stress or frustration plays a clear role. Fertility problems can change with periods of more or less stress.
Common symptoms
- decreased sperm count without a clear medical explanation;
- variable decreased libido;
- erection problems that are worse during stress;
- irritability, frustration or gloom;
- chest or ribs tension;
- headache or tension in neck and upper back;
- fatigue that can improve by moving.
Examples of Western disorders: stress-related fertility problems, unexplained oligospermia and sometimes erectile dysfunction.
Dampness-Heat in the Onderste Warmer
Brief explanation
At Dampness-Heat there is a combination of accumulation of moisture and heat in the lower part of the body according to TCM. This pattern may occur in case of long-term inflammatory symptoms of the urogenital region.
Common symptoms
- decreased sperm count;
- decreased motility or abnormal sperm form;
- thick, sticky or yellowish semen;
- semen which does not become sufficiently liquid;
- irritation, itching or heat around groin or scrotum;
- to urinate concentrated urine or slightly burning;
- lower body weight sensation;
- sometimes overweight or indigestion.
Examples of Western disorders: chronic prostatitis, urogenital inflammations, diabetes mellitus and abnormal ulceration of sperm.
Phlegm-Dampness
Brief explanation
Phlegm-Dampness occurs within TCM when the processing and distribution of body fluids is prolonged. This pattern is seen especially in men with a heavy or slow body image and may be associated with metabolic problems.
Common symptoms
- decreased sperm concentration;
- decreased sperm motility;
- overweight;
- heavy or lame feeling;
- fatigue and somnolence;
- bloated abdomen, belching or reflux;
- dizziness;
- sometimes benign swellings or cysts.
Examples of Western disorders: obesity, metabolic syndrome, diabetes mellitus, varicocèle and some benign swellings around the testicles.
Blood stasis
Brief explanation
Blood stasis means that blood flow is reduced locally or more generally within TCM. In male fertility this is particularly relevant when the circulation around the testicles has been disturbed, for example in a varicocèle, after trauma or after surgery.
Common symptoms
- decreased sperm count;
- reduced mobility or abnormal shape;
- varicocèle;
- pain or discomfort surrounding testicles, groin or perineum;
- complaints after trauma or surgery;
- visible vessels or discolorations;
- sometimes few other general complaints.
Examples of Western disorders: varicocèle, effects of testicular trauma or surgery and local circulation problems.
Qi- and Blood deficiency
Brief explanation
In this pattern, according to TCM, the body has insufficient Qi and Blood to optimally support reproductive function. It is especially seen in men who are long-term tired or weakened, for example after illness or a period of severe stress.
Common symptoms
- decreased sperm count;
- decreased sperm motility and survival;
- decreased libido;
- fatigue and low energy;
- look pale;
- dizziness;
- low appetite;
- bloated belly and loose stools.
Examples of Western disorders: reduced fertility after prolonged illness or physical exhaustion and sometimes nutritional shortages.
Kidney-Yang-deficiency
Brief explanation
Within TCM, kidney-Yang is linked to heat, activity and reproductive power. In the event of a deficiency, both sexual function and sperm production and mobility can be reduced.
Common symptoms
- low sperm count;
- poor sperm motility;
- thin or watery semen;
- decreased libido;
- erection or ejaculation problems;
- feeling cold and cold hands or feet;
- weak or painful lower back and knees;
- fatigue;
- frequent urination or night peeing.
Examples of Western disorders: oligospermia, asthenozoospermia and fertility problems associated with sexual dysfunction.
Kidney-Yin-deficiency
Brief explanation
Within TCM, kidney-Yin forms the nourishing and moistening basis of the reproductive function. In case of a deficiency, body fluids can be reduced and relative heat phenomena may occur. According to TCM this can affect the quantity and quality of sperm.
Common symptoms
- low sperm count;
- abnormal sperm form;
- decreased sperm volume;
- thick or viscous semen;
- dry mouth and throat;
- night sweats;
- feeling of warmth in palms and soles of the feet;
- restless sleep;
- weak or painful lower back and knees.
Examples of Western disorders: oligospermia, abnormal morphology, increased viscosity and insufficient carcinogenicity of sperm.
Kidney-Essence-deficiency
Brief explanation
Within TCM, the so-called "Kidney-Essence of Jing" is seen as a deeper basis for growth, development and reproduction. This pattern is less general and is considered especially in case of severe or prolonged fertility problems and when there is evidence of an innate or developmental component.
Common symptoms
- very low or absent sperm count;
- significantly reduced mobility and abnormal morphology;
- low libido;
- development problems of testicles or sexual organs;
- weak lower back and knees;
- early ageing events;
- sometimes problems with hearing, teeth or hair.
Examples of Western disorders: severe oligospermia or azoospermia, hypogonadism and congenital abnormalities of the male reproductive system.
Outlook
The course of treatment strongly depends on the cause and severity of fertility problems, sperm count, age, general health and any conditions such as varicocèle or hormonal disorder.
Because the development of new sperm cells takes time, a treatment aimed at sperm quality makes sense to think in periods of about three months. If there are obvious deficits or more complex problems, a longer journey may be required. A repeated sperm study can then help to objectively assess changes in number, motility, morphology and other parameters.
Acupuncture is often used once a week in the initial phase. Depending on the grievance picture, this can be deviated. Chinese herbs are usually used daily and adapted to changes in the pattern during the course of treatment.
In case of severe sperm abnormalities or if pregnancy remains out for a longer period of time, regular fertility studies are important in order not to miss treatable medical causes.
Contact
Do you have any questions about male fertility problems and do you want to know if acupuncture and/or Chinese herbal medicine can be appropriate in your situation? During a first appointment, we will discuss your complaints, possible results of sperm tests and other factors that may affect you. On the basis of this, we will consider which TCM pattern best suits your situation and what treatment fits it.