Part of healthy ageing in men includes maintaining healthy testosterone levels throughout life. Age-related testosterone decline has also been referred to as andropause, male menopause, partial androgen deficiency of the ageing male, testosterone deficiency syndrome, and late-onset hypogonadism.¹ Signs and symptoms of androgen deficiency include reduced libido and erectile dysfunction, decreased energy and physical strength, low mood and motivation, reduced cognitive function, decreased body and facial hair, increased body fat, decreased muscle mass, insomnia, hot flushes, gynaecomastia, and osteoporosis.² Erectile dysfunction can be a particularly distressing symptom for men. It is classified as “the inability to achieve or maintain an erection that is sufficient for satisfactory sexual performance”. It affects many men, particularly older men, at least occasionally.³ Erectile dysfunction can have a significant negative effect on a man’s quality of life, with many sufferers experiencing depression and anxiety related to sexual performance.³ It is often comorbid with hypertension, low testosterone, obesity, diabetes and prostate enlargement.

Initial Presentation

A male patient, aged 46 years, presented with erectile dysfunction. His overall health was good, however his blood pressure was mildly elevated at 125/95. He had no other signs of cardiovascular or circulatory dysfunction. He had tried pharmaceutical medication for the erectile dysfunction, in the form of a PDE-5 inhibitor; however, he did not like using it and was looking for an alternative. Close examination of his diet and lifestyle revealed sedentary habits, and regular intake of a Licorice and Fennel herbal tea.

Prescription

Significantly reduce the Licorice and Fennel tea; swap for Green Tea

Include regular daily exercise into his routine

Liquid herbal blend: 5 mL twice daily; containing Withania somnifera (Withania) 2:1 20 mL, Turnera diffusa (Damiana) 1:2 30 mL, Ginkgo biloba (Ginkgo) 2:1 30 mL, Passiflora incarnata (Passionflower) 1:2 30 mL

Vitality and Stamina tablets: 2 tablets twice daily; containing Rhodiola rosea (Rhodiola) dry root 720 mg, and Panax ginseng (Korean Ginseng) dry root 500 mg

Follow Up – 3 Months

After three months of treatment, the patient reported that he had significantly reduced his consumption of the Licorice and Fennel tea and was exercising as advised. His blood pressure was now normal, and his energy had significantly improved. To his great delight, he also reported that the herbs were “working” and he was able to enjoy normal sexual function.

References

Golan R et al. Age-related testosterone decline is due to waning of both testicular and hypothalamic-pituitary function. Aging Male. 2015; 18(3): 201-204. doi: 10.3109/13685538.2015.1052392

Huhtaniemi IT et al. Ageing male (part I): Pathophysiology and diagnosis of functional hypogonadism. Best Pract Res Clin Endocrinol Metab. 2022 Feb 11: 101622. doi: 10.1016/j.beem.2022.101622

Yafi FA et al. Erectile dysfunction. Nat Rev Dis Primers. 2016 Feb 4; 2: 16003. doi: 10.1038/nrdp.2016.3