Is It Possible to Medically Increase Testosterone and Still Maintain Fertility? A look at Clomiphen
This is a review of a paper exploring conversion of hypogonadal (low testosterone) men from clomiphene to Natesto.
The debate between the influence of the environment versus genetics has been used to explain what happens to us, to our health and to our fertility. Supplements are a multibillion dollar industry, fueled by our desire to optimize what we put in our bodies. Greater attention is being paid to eating organic and non GMO products. Now, the idea that we may be susceptible to new environmental toxins has been gaining traction. Recently a renewed focus has been placed on Phtalates, a potential environmental toxin present in plastics as well as in some cosmetics.
Phthalates belong to a category of substances classified as “endocrine disruptors” because they interfere with the endocrine system, specifically the part of the endocrine system that influences reproduction.
In 2003, and article By Duty et al in Environmental Health Perspectives looked at the effect of Phthalates on DNA integrity. Findings revealed that exposure to certain phthalates correlated with a decrease in DNA integrity as measured by a test called the “comet assay”. However, the link between a change in global DNA integrity as measured by this assay and its correlation with difficulty conceiving remains somewhat controversial. Ref: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241569/
Recently, in a study by Buck Louis et al federal researchers spent four years tracking 501 couples as they tried to have children. Couples were monitored for urinary concentrations of BisPhenol A and 14 other phthalate metabolites. Men were apparently more susceptible to the fertility consequences of certain phthalates when compared to women. Specifically, Men’s urinary concentrations of monomethyl, mono-n-butyl, and monobenzyl phthalates were associated with a (statistically significant) longer time to pregnancy. Based on their findings, researchers stressed the importance of considering both men and women when assessing exposure to endocrine-disrupting chemicals as they relate to pregnancy outcomes.
References: http://www.fertstert.org/article/S0015-0282(14)00067-3/abstract
http://well.blogs.nytimes.com/2014/03/21/a-threat-to-male-fertility/?_php=true&_type=blogs&_r=0
So, is there anything to be done? Is it possible to control one’s phthalate intake? It turns out that one can lower phthalate exposure essentially by reducing exposure to plastics. Avoid cooking in plasticware. Use drinking glasses for your beverages and eat food off of china or paper plates rather than using plastic alternatives. Try to minimize the risk of plastics leaching into food: do not leave your plastic water bottle in the sun. Microwave food only in microwave safe containers. Taking the time to think about what we put in your body is likely not only good for your health, but also your reproductive health.
