RATNADEEP BANERJI says Indian males are increasingly becoming less virile.
Falling male fertility poses threat to the male bastion. The hustle and bustle of fast life has cast its insidious imprint. It is estimated that about 15% of couples in active unprotected sexual relationship for one year have infertility. Male infertility alone or in combination is responsible in about 40% of cases. Andropause is seizing men in their early forties. A whole gamut of reasons is responsible.
Bursting stress is scuttling libido out of our macho men sometimes despite maintaining normal levels of testosterone, the male hormone. Smoking and alcohol is dwindling sperm count. Lifestyle diseases like diabetes and obesity is wreaking havoc. Psychosocial morbidity of a moribund society freezes sexual prowess. Thyroid and pituitary problems add to the woes of fertility. And yes, beefcake kneading bodybuilders popping steroids ameliorate testosterone to abysmal levels. Less hours of sleep also desiccates fertility. Falling testosterone is harbinger of frail bones with low density.
The sperm count is dwindling in a precarious manner. In a meta-analysis of 61 publications between 1938 and 1990 on the sperm characteristics of 14,947 healthy men from various regions of the world, there was reduction in the mean volume of ejaculate (3.4ml in 1940 vs. 2.7ml in 1990) and mean sperm concentration (113 million/ml vs. 60 million/ml). In a study assessing the temporal trends in semen characteristics in 1351 French men from 1973 to 1992, there was an annual decrease of 2.6% in sperm concentration, 0.3% in the percentage of motile sperms and of 0.7% in the percentage of morphologically normal sperms. In a recent study from South India, 30% decline in sperm counts was observed between 1995 and 2005. Fertile semen contains more than 15 million sperms per milliliter.
Myth busters
Does high levels of male hormone testosterone imply more virility? Testosterone varies in healthy males between 300 -1200 ng /dL in males and 8 – 60 ng /dL in females, the morning hours ticking the maximum.
Dr Amit Bhargava, Consultant with Fortis C-Doc puts it squarely, ‘Often high level of foreign testosterone leads to decrease of spermatogenesis that is sperm production. A man with testosterone levels of 400 ng/dL may be at par with someone with testosterone level of 800 ng/dL. Many things have to be diagnosed for instance, functioning of pituitary and narrowing of artery leading to erectile dysfunction. Chronic lifestyle diseases like high blood pressure, sugar and cholesterol all decrease libido. Diabetes sounds the death knell.’
Administering testosterone can inflict potential harm. Dr Bhargava warns, ‘Medicines administered for prostate cancer brings down testosterone production. And so if prostate cancer patients are administered testosterone then their condition will worsen. Over treatment with testosterone can lead to vascular problems as well.’
Sleep auto-regulates the interplay of hormones. Higher cortisol levels have been detected among late night workers. Higher level of cortisol implies impinged production of testosterone. Dr Bhargava says, ‘Obstructive sleep apnea (OSA) has tongue falling back during sleep cutting down oxygen supply, can also lead to decreased levels of testosterone and decreased sex drive. So snoring population remain at the receiving end. Mostly people
with OSA are obese.’
In case of excess body fat, testosterone is normally broken down in the body’s fat cells into estrogen, the female hormone. Abdominal or belly fat has a greater tendency to break down testosterone. A recent French study found that obese men were 42% more likely to have low sperm count than their non-obese counterparts.
Alcohol affects your liver function, which in turn, causes a dramatic spike in estrogen levels. Even males do have estrogen. Even two-drinks a day will have long-term effects on sperm production. Cigarette smokers also have lower sperm counts and the sperms become less motile, moving much slower.
Exercise releases testosterone into the body keeping with sperm production. But too much of exercise causes the release of adrenal steroid hormones that actually cause testosterone deficiency. Anabolic steroids may help in muscle building but they shrink your testicles causing infertility.
Stress hormones block the Leydig Cells present in male testes to produce testosterone. When your body experiences too much stress, it can actually stop producing sperm altogether.
Potent Threats
Dr Ritesh Gupta, Head of Clinical Operations at Fortis C-Doc points out some unnatural causes, ‘Radiation especially after radiotherapy for cancers in childhood or adult life can permanently affect the ability of testes to produce sperms. Similarly many drugs used in cancer chemotherapy also cause permanent infertility. Cryopreservation of sperms before starting chemotherapy is often employed, the preserved sperms can be used at a later date.’
Exposure to electromagnetic fields has also been shown to cause reduction in sperm counts and morphology. This was initially suggested by an American study on military radar operators. More recently, there have been concerns about the effects of cellophane use on male fertility. There are studies linking cellphone usage with unfavorable sperm characteristics, however the evidence is far from conclusive.
There are several chemical substances which have been implicated to cause endocrine disruption in testis, meaning that they have estrogenic effect. Insecticides like DDT, Lindane and substances in plastics like Bisphenol A have been shown to have anti-androgenic effect and contribute to infertility especially in high concentrations in laboratory animals. However, the evidence is again inconclusive and it is not known whether low levels of exposure would cause significant change in sperm characteristics in men.
Environmental pollution especially the agricultural and industrial pollutants have been shown to lead to decline in sperm concentration and morphology. In 1977, use of dibromochloropropane (DBCP), a nematocide employed on various tropical crops, including bananas in particular, was found to have rendered thousands of agricultural workers sterile in many countries worldwide. Several other pesticides, industrial solvents and heavy metals have also been implicated in causing male infertility. Correction for libido may involve medication, hormone replacement therapy, psychic counseling and also physical aids. All mammals except humans and some species of monkeys have penile bones serving as natural implants to hold their penis erect. Animals like a walrus has a two-feet long penile bone. However only the humans and some monkeys have haemodynamic penis that is penile erection is achieved by blood pressure. So men can claim their macho index over animals like dogs, horses and even tigers and lions.
The writer is a senior journalist with
varied interests, reachable
at ratnaub@gmail.com
