Strictly speaking, it should be andropause, the male equivalent of menopause. Often referred as ‘mid-life crisis’.

It is claimed that andropause is hormone-related, just like female menopause. However, comparing with female menopause which is triggered by a dramatic fall in the levels of female hormones, male menopause witnesses the levels of the male hormone testosterone fall far more gradually over many years. Many 70-year-old men have similar testosterone levels to those of a 20-year-old.

Along with the decline of testosterone, men may see symptoms such as poor sex drive, tiredness, fatigue, hot flashes, night sweats, muscle and joint aches, forgetfulness, mood swings, irritability, depression, and listlessness, etc. Those may occur as early as 45 to 50.

Male menopause can occur naturally in some men, however, more often than not, it is triggered by diseases. Though claimed as hormone-related, some believe it has a psychological basis rather than a hormonal one.

Even if testosterone levels are low, there is still discuss about whether testosterone as hormone replacement therapy (HRT) should be offered, as it has some potential risks and side effects.

Male menopause & Chinese medicine

There is no such disease recorded in Chinese classics, but similar symptoms can be found in ‘yu zheng’, ‘zang zao‘, ‘yang wei’, ‘xu lao‘. From Chinese medicine’s perspective, its Ben lies in kidney (kidney deficiency), and Biao liver (liver qi stagnation). It also relates to heart and spleen.

In practice, we find three patterns are often seen.

Blood deficiency and qi stagnation

Therapeutic principle: nourishing blood and soothe liver

Herb prescription: Cai Zhi Su Gan San and Si Wu Tang modified

Acupuncture prescription: zu san li (ST36), san yin jiao (SP6), xing jian (LV2), nei guan (PC6), si shen cong (EX)

Kidney yin deficiency

Therapeutic principle: tonifying kidney yin

Herb prescription: Zuo Gui Wan and Er Zhi Wan modified

Acupuncture prescription: shen shu (BL23), tai xi (KD3), zhong ji (CV3/RN3), san yin jiao (SP6), shen men (HT7), si shen cong (EX)

Kidney yang deficiency

Therapeutic principle: tonifying kidney yang

Herb prescription: You Gui Wan and Er Xian Tang modified

Acupuncture prescription: shen shu (BL23), pi shu (BL20), ming men (DU4/GV4), guan yuan (CV4/RN4), san yin jiao (SP6)

 They hadn’t heard anything about the benefit of traditional Chinese medicine for male infertility. They decided to give it go in spite of some hesitation.

 M’s Seminal fluid analysis (06/10/2008)

• Volume: 2.0ml
• Concentration: 26×10 PWR 6/ml
• Motility: 12% excellent; 5% sluggish; 19% non-progress; 64% immotile
• Morphology: 1% normal forms

He didn’t have many symptoms apart from generally feeling cold and preferring warmth. His pulse was deep and thready.

 The treatment plan was weekly acupuncture and daily herbal medicine. His partner was treated at the same time. Find more here. Thee months later, she was pregnant naturally.

 M did another sperm test to establish whether it had been a fluke, but found that his results were massively improved.

Seminal fluid analysis (01/05/2009)

• Volume: 2.4ml
• Concentration: 65×10 PWR 6/ml
• Motility: 31% excellent; 30% sluggish; 2% non-progress; 37% immotile
• Morphology: 11% normal forms

It is not common to see reports of male infertility treated with Chinese medicine, I mean in English versions. It is probably just because it has not been widely used and recognized in western countries. But it dated way back in China. The basic requirement for full reproductive potential, according to Chinese medicine, is strong Kidney Jing (essence) and a balance of Kidney Yin and Kidney Yang. Therefore, Kidney factor, more or less, will be mentioned in almost all cases. Complications with other factors, such as phlegm, damp, heat, Qi stagnation, blood stasis, make every case special.