A Study on the Benefits and Drawbacks of Androgen Supplementation in Elderly Men, and its Clinical Manifestations and Dietary Therapy for Chronic Prostatitis

As men age, their testicular function gradually declines, leading to a decrease in androgen secretion and a decline in sexual function. So, can androgen supplementation improve sexual function? For men with normal endogenous testosterone secretion, exogenous androgen supplementation does not enhance libido or sexual performance. In fact, long-term use of high or moderate doses of androgens can suppress the hypothalamic-pituitary-testicular axis through negative feedback mechanisms, causing testicular atrophy and reduced or absent sperm production. For older men with decreased testosterone levels, exogenous testosterone supplementation, both theoretically and based on actual research results, seems to improve sexual function in some elderly men. However, in-depth double-blind studies have not confirmed that androgens definitively enhance sexual function in older men. The reason is that when these individuals are given a placebo dose with no pharmacological effect and are suggested to themselves that the medication is testosterone, they may also experience a certain degree of enhanced sexual function. Therefore, medical experts believe that the improved sexual function observed in some individuals is actually a result of their unwavering belief in testosterone, a deep psychological reliance on it. As men age, the decline in androgen levels is much slower than in women, and most men can adapt to this change. Furthermore, the vast majority of elderly men have had extensive sexual experience and can maintain a certain level of sexual function through long-term conditioned reflexes, unlike those with congenital testicular hypoplasia or low sexual function. Long-term use of androgens in elderly men is not only inconsistent in its effects but also poses health risks, potentially leading to benign prostatic hyperplasia or gynecomastia caused by the metabolism of exogenous androgens into estrogen. In general, the use of androgen preparations by elderly men carries more risks than benefits. Of course, there are a few men whose androgen levels decline too rapidly with age, reaching very low levels before old age. Some men over 50 experience a decline in physical strength and sexual function, along with symptoms of male menopause such as dizziness, mood swings, and other signs of hormonal imbalance. In such cases, appropriate use of testosterone to increase blood testosterone levels can alleviate menopausal symptoms like depression, anxiety, headaches, and insomnia, and may also enhance libido. For this type of man, testosterone supplementation is a viable option, but the dosage must be carefully controlled and used under the guidance and close monitoring of a doctor to avoid side effects. Currently, research on sex hormone supplementation in older men is still in its early stages. For example, questions remain unanswered regarding the appropriate indications, the objective indicators of efficacy, and the effective prevention of side effects. However, it is believed that with the advancement of medical science, these issues will eventually be properly addressed, leading to substantial progress.

The clinical manifestations of chronic prostatitis are complex, and diagnosis is relatively difficult. However, if a few key symptoms are identified, chronic prostatitis can be detected in time. The following symptoms should raise concern: (1) Urinary discomfort: frequent urination, urgency, and burning pain in the urethra during urination. (2) Genital discomfort: discomfort in the posterior urethra, perineum, and anus. (3) Pain or distending discomfort: pain and distending discomfort in the lower back, scrotum, testicles, groin, perineum, and rectum. (4) Sexual dysfunction: such as decreased libido, painful ejaculation, and premature ejaculation. (5) Others: such as insomnia, excessive dreaming, and general weakness. If you find that you have any of the above five symptoms through self-examination, you should go to the hospital as soon as possible to consult a specialist for diagnosis. The doctor will usually perform a prostate palpation to check whether the prostate surface is smooth, whether the gland is flexible, and whether there is tenderness. Then, a prostate fluid test will be performed for diagnosis.

Chronic prostatitis can occur secondary to acute prostatitis, cystitis, or pyelonephritis, or it can be caused by non-infectious factors such as frequent intercourse, excessive masturbation, interrupted intercourse, excessive alcohol consumption, habitual constipation, and overwork, leading to chronic congestion and edema of the prostate and resulting in chronic inflammation. The main symptoms of chronic prostatitis include perineal discomfort, lower back pain, fatigue, dribbling after urination, urethral itching, and urethral discharge. Due to the presence of prostatitis, perineal pain and painful ejaculation are common, leading to sexual dysfunction such as dyspareunia, low libido, premature ejaculation, and impotence. It may also cause anejaculation or hematospermia. Therefore, men experiencing sexual dysfunction accompanied by perineal discomfort or pain, painful ejaculation, dribbling after urination, and urethral discharge should consider the possibility of chronic prostatitis. Patients with chronic prostatitis should minimize the frequency of intercourse to allow the prostate to rest fully, reduce congestion, and promote early healing of the inflammation. If one does not practice moderation in sexual activity, it's like adding fuel to the fire, creating a vicious cycle. Not only will prostatitis be difficult to cure, but it will also worsen the symptoms of sexual dysfunction. Dietary therapy for chronic prostatitis should focus on foods that nourish qi and kidneys and are rich in nutrients. Avoid stimulating foods such as alcohol, chili peppers, onions, garlic, ginger, and coffee, as these can cause prostate congestion and recurrence of the condition. Hot and greasy foods should also be avoided. While using diet, medication, and physical therapy, reducing congestion in the prostate area is crucial. Therefore, excessive sexual desire should be corrected, interrupted intercourse or masturbation should be avoided, prolonged cycling or sitting should be avoided, and plenty of water should be drunk to maintain regular bowel movements. Daily hot sitz baths and Kegel exercises can help promote prostate activity. Regular physical exercise to strengthen the body and prevent colds will also contribute to the recovery from chronic prostatitis. If chronic prostatitis has been diagnosed, dietary therapy can be used in conjunction with treatment: (1) 150g of water chestnuts (with skin), washed, stems removed, chopped and mashed, mixed with 250ml of warm water, filtered to remove residue and skin, and the juice is drunk twice a day. (2) 500g of sugarcane, peeled, cut into sections, juiced, and drunk twice a day. (3) 250g of fresh grapes, peeled and seeded, mashed, and mixed with an appropriate amount of warm water, and drunk once or twice a day. (4) An appropriate amount of royal jelly, added to an appropriate amount of warm water, taken orally twice a day, 20-30ml each time, for long-term use.

Chestnut Stewed Black Chicken Ingredients: 60g chestnut kernels, 1 pair of seahorses, 1 black chicken, salt and ginger to taste. Preparation: Remove the intestines and feathers from the black chicken, cut into pieces, and place in a pot with the chestnut kernels, seahorses, salt, and ginger. Add enough water to cover and steam until cooked. Dosage: Consume in 2-3 servings. Efficacy: Tonifies the spleen and kidneys. Suitable for prostatitis.

Orchid-Style Meatballs Ingredients: 15 fresh orchids, 400g lean pork, 5g fox nuts, 15g lotus seeds, 1 egg, appropriate amounts of salt, MSG, cooking wine, lard, egg white, cornstarch, white pepper powder, scallion and ginger water, and sesame oil. Preparation: Wash and drain the fresh orchids, then place them in a bowl. Grind the fox nuts and lotus seeds into powder. Remove the tendons and membranes from the pork, pound it into a fine paste with the back of a knife, place it in a bowl, and mix with chicken broth and scallion and ginger water to form a paste. Add the fox nut and lotus seed powder, salt, MSG, cooking wine, lard, egg white, and cornstarch, and mix well to form the filling. Pour water into a pot, squeeze the meat filling into meatballs, and place them in the pot of cold water. Then, bring the water to a boil and poach until cooked through, skimming off any foam. Remove from heat. In another pot, pour in clear broth, bring it to a boil, add salt, MSG, and white pepper powder, skimming off any foam. Add the poached meatballs to the broth, drizzle with sesame oil, and sprinkle with the orchids. Dosage: Take as desired. Efficacy: Tonifies the kidneys and strengthens yang. Suitable for impotence, spermatorrhea, premature ejaculation, and other symptoms caused by prostatitis.

Ingredients for Elderly Urinary Retention Decoction: Codonopsis pilosula 24g, Astragalus membranaceus 30g, Poria cocos, Glycyrrhiza uralensis, Vaccaria segetalis 12g each, Nelumbo nucifera 20g, Plantago asiatica 15g, Cinnamomum cassia 6g, Ginkgo biloba, Glycyrrhiza uralensis 9g each, Evodia rutaecarpa 5g. Preparation: Wash all the above herbs, decoct in water, remove dregs and collect the juice. Dosage: Take on an empty stomach, one dose daily. Efficacy: Tonifies Qi and strengthens the spleen, warms and tonifies kidney Yang. Suitable for benign prostatic hyperplasia, with symptoms such as difficulty urinating or urinary retention, fatigue, shortness of breath, loose stools or constipation, and clear urine. This formula, through the combination of these herbs, works synergistically to tonify the middle Jiao and replenish Qi, promote the ascending of clear Qi and descending of turbid Qi, invigorate blood and remove blood stasis, warm the kidneys and promote diuresis.

Rush Pith and Persimmon Soup Ingredients: 6 grams of rush pith, 2 persimmons, and appropriate amount of white sugar. Preparation: Simmer the above two ingredients in an appropriate amount of water to make a soup. Dosage: Add white sugar to taste, drink the soup, and eat the persimmons. Efficacy: Clears lung heat and promotes urination. Suitable for lung heat and qi stagnation, with symptoms such as difficulty or dribbling urination, thirst, shortness of breath, or cough, yellow tongue coating, and rapid pulse.

Magnolia Flower and Pork Soup Ingredients: 30g fresh magnolia flowers (10g dried), 150-200g lean pork, a pinch of salt. Preparation: Wash the lean pork, cut into small pieces, and simmer with the magnolia flowers in water. Add a pinch of salt to taste. Dosage: Drink the soup and eat the meat. One serving per day. Efficacy: Nourishes the kidneys and yin, promotes qi circulation and eliminates turbidity. Suitable for men with prostatitis and women with excessive vaginal discharge.

Justicia and Jujube Soup Ingredients: 100g fresh Justicia (half the amount if dried), 30g jujubes. Preparation: Wash and chop the Justicia, add it to 1000ml of water along with the jujubes, and simmer until reduced to about 400g. Dosage: Take twice daily, drinking the decoction and eating the jujubes. Efficacy: Diuretic and detoxifying. Suitable for prostatitis.

Dandelion and Corn Silk Soup Ingredients: 60g fresh dandelion, 60g corn silk, appropriate amount of white sugar. Preparation: Wash the dandelion, put it in a pot with the corn silk, add water and simmer until concentrated. Remove the dregs and keep 1 bowl of juice. Add white sugar and simmer briefly. Dosage: 1 dose per day. Efficacy: Clears heat, promotes urination and relieves strangury. Suitable for various symptoms of strangury due to heat, frequent urination, painful and difficult urination, burning sensation during urination, red tongue, yellow and greasy tongue coating, and slippery and rapid pulse.

Malva verticillata soup ingredients: 200g malva verticillata leaves (also known as winter amaranth). Preparation: Wash and chop the malva verticillata leaves, then boil them in water to make a soup. Dosage: Once daily. Efficacy: Promotes urination and relieves strangury. Suitable for damp-heat strangury syndrome: symptoms include difficulty urinating, frequent and urgent urination, and painful dribbling.

Plantain, Mung Bean, and Sorghum Porridge Ingredients: 60g plantain seeds, 50g mung beans, 15g tangerine peel, 10g tetrapanax papyriferus, 100g sorghum rice. Preparation: Wrap the plantain seeds, tangerine peel, and tetrapanax papyriferus in gauze, boil to extract the juice, remove the residue, then add the mung beans and sorghum rice to cook into porridge. Dosage: Take on an empty stomach for several days. Efficacy: Suitable for prostatitis and painful urination in the elderly.

Yam and Dodder Seed Porridge Ingredients: 30-60g Chinese yam, 10-15g dodder seed, 100g glutinous rice, appropriate amount of white sugar. Preparation: First, decoct the dodder seed in water, remove the dregs and keep the juice; wash and slice the yam and cook it with the glutinous rice into porridge, add the decoction and cook together. After the porridge is cooked, add white sugar. Dosage: Take twice a day. Efficacy: Strengthens the spleen and warms the kidneys, nourishes yin and clears heat. Suitable for various symptoms of urinary tract infections: painful and difficult urination, dribbling, aggravated by exertion, fatigue and lower back pain. The combined effects of the herbs in this formula are to warm the kidneys and strengthen the spleen, so as to restore normal qi transformation and replenish the source of qi.