Men's Health

Alternative Medicine Practitioners Discuss Men's Health Issues

Yarnell leads a discussion with Geo Espinosa and Mark W. McClure, two holistic practitioners with extensive experience in urology and men’s health in general. The first question, “Why do so many men avoid going to see a doctor?”, is vital. Men often do not seek medical care until symptoms are intense, rather than acting to stay healthy.

Espinosa sees a change in younger men, perhaps not reared to believe that boys do not cry, or who see their elders suffer from preventable health crises. Yarnell adds that in the past, medicine simply did not have many answers, making it pointless to seek treatment. McClure says some men still refuse diagnostic tests because “they don’t want to know” if anything is wrong. Educating boys about health issues they may face as adults is needed to change the paradigm. Teaching healthy lifestyles, fighting obesity and diabetes in children and teens, and including parents, so that healthy behaviors are practiced at home, can all have benefits. Yarnell reaches out to midwives in Seattle, who often are pediatricians for boys they have delivered, to let them know he is available if older boys have concerns they – or the midwife – are uncomfortable addressing together. Testicular self-examination should definitely be taught to grade school boys.

Prostatitis, a common men’s health issue, is discussed. Antibiotics are often used for this condition, even when no bacterial infection is present. Causes may include leaky gut, chronic stress, and muscle tension. An elimination-challenge diet is a good diagnostic tool, if time-consuming, as some prostatitis is caused by food allergies. Lifestyle and diet changes, such as limiting caffeine and reducing stress, can offer rapid improvement. Espinosa says that when men finally see him for prostatitis, they are anxious, in pain, and willing to try suggested lifestyle changes.

He has also had success with acupuncture and with some Chinese herbal decoctions and teas, using Cordyalis yanhusuo syn. C. turtschaninovii for pain. Pelvic muscular issues may require physical therapy. If Espinosa thinks that prostatitis is caused by muscle issues, he adds magnesium citrate malate to prescribed supplements and anti-inflammatories, e.g. proteolytic enzymes, bromelain, quercetin, curcumin (Curcuma longa), and fish oil. McClure uses Prostanex™ (Graminex® LLC; Saginaw, Michigan), a mixture of rye (Secale cereale) pollen and saw palmetto (Serenoa repens), for the same sort of pelvic muscle pain.

Watchful waiting is the treatment now advocated for men with less aggressive forms of prostate cancer (PC). A recent US study found no reduction in mortality from prostate-specific antigen (PSA) screening, long thought an indicator of the presence or absence of PC. A European study found a 20% decrease in mortality from PC with screening, but no overall mortality decrease. McClure stresses guiding patients to think about their options before having a PSA test. If high levels are found, will the patient have a biopsy? If not, there is little point in having the screening. If a biopsy shows abnormal cells, will the patient have surgery? If not, there’s little reason for a biopsy. Still, for men who would be interested in pursuing treatment, he recommends PSA screening at age 40, first to get an idea of the patient’s possible risk for developing PC in the next 20 years, and second as a baseline reading to compare to later screens. Recent evidence suggests that velocity of change in PSA levels, rather than absolute levels, is more indicative of risk. He adds that PSA screening began in the 1980s, and is a survival advantage for men whose PC is found by screening and treated when it would have taken 10-15 years to be evident. This advantage, he says, is especially evident in preventing metastasis that can severely decrease both quality of life and life expectancy.

Espinosa points to new tests being developed. One, the PCA-3 (Prostate Cancer Gene 3) urine test, is already used by some urologists, although it is not completely accurate and not yet approved by the Food and Drug Administration. He uses this test as well as PSA screening, stating the latter should be called “patient-stimulated anxiety” screening for its ability to cause anxiety in patients. Like McClure, he considers rate of change in PSA levels more important than absolute levels, but even this measure cannot determine with certainty whether a patient has a more or less aggressive form of PC.

Yarnell adds that the use of the PCA-3 tool can be used before biopsy to rule out prostatitis and benign prostatic hyperplasia (BPH) as causes of high PSA. He says early stage PC may be treated in most cases by lifestyle changes, such as a vegan diet, exercise, and meditation. Cardiovascular disease is the leading cause of death for men, and anything that is healthy for the prostate protects against degenerative diseases in general. Education can also reduce the stress and anxiety of PSA screening, so that men know what information can be gained from the test, and what options they may need to consider. When seeing a patient who presents with an elevated PSA count, McClure first has the test re-done by the same laboratory; often levels return to normal on their own.

Finally, the practitioners discuss premature ejaculation (PE), a self-perpetuating condition related to performance anxiety and uncertainty about how to be intimate. While selective serotonin reuptake inhibitors (SSRIs) are the newest form of medication for PE, these practitioners prefer to refer patients to sex therapists. Espinosa has also had good results with acupuncture. Yarnell has recommended nervine herbs (kava [Piper methysticum]; valerian [Valeriana officinalis]) with good results.

Yarnell E. Roundtable discussion: focus on men’s health. Altern Complement Med. April 2010;16(2):77-82.

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