Traditional Asian Herbs: Potential Use for Late-Onset Hypogonadism?

Abstract

Sexual herbs throughout the ages have been eagerly consumed no matter how unappetizing or bizarre. In our never-ending search for better sex, humans have ingested such diverse items as elephant tusks, lion blood, bull testicles, rhino horn, ram penis, pig genitals, and the dried remains of the Mediterranean Cantharis beetle, otherwise known as “Spanish fly.” The motivation to use these herbs has been largely to improve sexual function. Can they be used to treat hypogonadism? The Bomos (village doctors) in Malaysia and Indonesia and Chinese Traditional Medical Practitioners (in China and elsewhere) have been using these herbs for centuries. Some of these work purportedly by apparently restoring testosterone levels directly, by releasing it from testosterone-binding globulin, or by enhancing their action at the receptor sites. If these claims can be proven then surely the aging male suffering from andropause may derive benefit from their consumption. Generations of Asians taking them have either really improved physically or at least psychologically from a placebo effect. These herbals can be found throughout Asia and range from Tongkat Ali, Ginseng, to Tribulus, etc. I will discuss only those herbs that claim to increase testosterone levels by increasing its actual level or its free fraction or cause existing testosterone to be more effective by blocking its aromatization (see Fig. 11.1).