Male Health

I gave a radio interview to Outside the Loop Radio discussing some of the topics that I recently discussed on this blog. For those interested, you can hear the interview here.

An article in press in Fertility and Sterility is getting a lot of media attention. The study connected men seeking infertility care to a cancer registry in the State where the clinic was located. The researchers found that men with infertility had almost twice the chance of getting cancer and almost three times the chance if the man had no sperm in his ejaculate.

The authors of the study have a few theories about why cancer and male infertility may be connected. Cells need to divide just right to make sperm in the testes, and problems with division could lead to both problems with making sperm and the kind of bad division that makes cancer. It could also be that toxic substances in the environment may lead to both infertility and cancer.

Whatever the reason, we’re beginning to understand that problems with male fertility are just a tip of a much bigger iceberg that involves health in general. It’s more than just about the testicles.

I was quoted in Time Magazine in an article on “Frontiers of Fertility“. For those interested, it’s a nice read.

Are cell phones bad for sperm? They emit electromagnetic radiation, and some have questioned whether that may be harmful for sperm.

Researchers exposed sperm in a test tube to the typical 850 and 900 MHz frequencies of cell phone transmitters and found that its movement worsened, its inner cell life decayed, and bad reactive oxygen molecules that are thought to damage sperm increased.

But a man doesn’t commonly hold his sperm up against his cell phone’s transmitter, and there’s a lot of distance and stuff between his cell phone and his sperm. So what’s the information about cell phones and sperm in real life?

In a study of sailors in the Norwegian navy, men who were exposed to high power military equipment transmitting radiofrequency electromagnetic radiation had problems with infertility. The higher the exposure, the worse the infertility, which argues that the electromagnetic radiation was the factor damaging a man’s reproductive chances. (An interesting observation in the study was that higher exposure resulted in less boys and more girls at birth.) But the high power electromagnetic radiation in that study is still not quite real life use of a cell phone for a typical man.

In another study of men going to a fertility clinic, researchers divided them into four groups based on how much time they spent talking on a cell phone each day: none; less than two hours per day; two to four hours per day; and greater than four hours per day. As talk time went up, sperm count, motility, inner sperm cell life, and the number of normally shaped sperm went down.

Should men stay away from using cell phones to protect their sperm? The pieces of the puzzle aren’t enough to make a blanket recommendation like that yet. But in the meantime, it’s probably a good idea not to go wild on the cell phone if a man is trying to impregnate his partner.

As I’ve written in earlier posts, clomiphene is a medication that a doctor can use to increase a man’s production of testosterone in his own body. (I’ve also written about how doctors can prescribe it. If you think that you’d benefit from this medication, you should see a doctor. I can’t answer personal questions about a man’s health on this blog. Medical care is always done best in person.) But clomiphene is “off-label” for use by men and didn’t go through the rigorous series of studies that the FDA mandates for a drug for a particular use.

One good question is whether clomiphene is safe for long term use by men. John Mulhall, a great doctor in New York, recently published a report in the British Journal of Urology studying the use of clomiphene for up to three years in 46 men diagnosed with low testosterone. Blood testosterone, bone scans, and symptom scores all improved, and men did not report problems with the medication.

There are limitations to this study. It wasn’t controlled, meaning that there wasn’t a group of men treated with a placebo, or sugar pill. 46 isn’t a lot of men, and three years isn’t really a very long time. But this kind of study is what needs to be done with more men and for a longer time to really determine the safety of clomiphene for long term use in men.

Clomid surely has its advantages compared to testosterone for use in men with low testosterone. It’s a pill, and other treatments are either shots or cumbersome skin applications. It also saves sperm, as testosterone itself reduces sperm production. But information about its use is less than that of testosterone, which puts men and their doctors in a kind of Catch-22. Mulhall and colleagues are to be commended for expanding what we know of the safety of this medication.