A range of botanicals could be leveraged to address men’s health in midlife, according to one herbal expert who is calling for a shift in attitudes and more research to help serve what she describes as an “unmet need”.
Dr Vivien Rolfe, director at Curiosity Research, was pulling together data for a Vitafoods Europe presentation when she specifically looked at men's health in midlife – and was “really quite shocked” by her findings.
“When you look at the symptoms, when you look at what men experience from the age of 40, through the forties and fifties – probably with the exception of things like hot flushes, which are very female-specific – they are experiencing everything else,” she told Vitafoods Insights. “They get the weight gain too; they get hair loss and hair thinning... and stress, poor sleep.”
While she agreed that it was right that awareness of and research into women's health has grown in recent years, she argued that men are “an unmet need as well, in terms of their mid-years”.
Rolfe believes this is in part due to the fact that the so-called “andropause” constitutes a series of various and gradual changes, compared with menopause, defined by the sudden onset of symptoms due to “hormones dropping off a cliff”.
She said: “I think with men some of these changes are so gradual, it's like they just haven't got their eyes on it – whereas [with] women, we know some of the changes can be quite rapid because oestrogen drops quite quickly.”
However, this is not to say such changes do not have an impact on quality of life.
“I do think it's a problem,” she said. “[F]rom what I see in the research, a lot of what men [are] experiencing is quite similar [to women], which is really, really surprising. It's not what we perceive.”
Meanwhile, some botanicals suffer from associations with gender stereotypes. The marketing of products targeting the male consumer tends to focus on libido and hormonal health, for example, with a widespread emphasis on testosterone.
Rolfe drew attention to the “macho presentation” of some products, adding: “I think that there's some stereotyping there that probably needs to be looked at to make men's health products more accessible.”
Many are created “with the assumption that testosterone is the full problem here – and oestrogen is the full problem. We know that it's not, but it's just what gets produced and marketed”, she added.
Rolfe encouraged formulators to look beyond “stereotypical” associations.
Ashwagandha, for example, “feels quite a macho herb” and in Ayurveda is often given to men to boost sexual function, when “actually, it's a fantastic herb for stress and sleep... [and] it's equally good for men and women”, she said.
Other herbs characterised as being a female health tonic, such as shatavari (Asparagus racemosus), an adaptogenic herb long used in Ayurveda for its vitality and immune-boosting properties, also have a potential role in men’s health, Rolfe said.
Research shows shatavari can support the building of muscle tissue in older men as well as women, while other findings suggest an association with ergogenic (performance-enhancing) properties.
“I think some of these herbs become a bit stereotyped too, whereas I would say ashwagandha and shatavari would both be hugely useful midlife herbs for men and women – perhaps in combination to boost muscle strength,” she said.
Rolfe called for the expansion of research into botanicals that hold promise for men struggling in midlife, highlighting examples such as chamomile for relaxation and sleep, brahmi (Bacopa monnieri) and ginkgo for cognitive function, and spices such as cinnamon and ginger to help regulate blood glucose and metabolic function.
“We need to be able to separate and segregate the data so we know the specific benefits to men and women,” she said, adding: “Green teas are fantastic for cognitive function and alertness – that is probably an area where there would be enough research to separate out the data that would be interesting.”
Most clinical herbal research is done on mixed groups, she said, making it challenging to “tease out the data”, but she added: “There's data in there somewhere, I think.”
She also drew attention to a lack of population-level studies, citing SWAN, a large longitudinal cohort study carried out in the US that examined women’s health and the menopause transition.
“That is such an important study because it shows through your midlife, the decline in oestrogen is just a small start [to] that story; the changes to your other hormones to compensate for that, again, will be involved in all of these symptoms that we’re familiar with,” she explained.
There is a tendency to over-focus on oestrogen, she said, adding: “We tend not to [ask]: what's happening to your stress hormones? What's happening to your other sex hormones?”
Rolfe added: “Maybe the main focus is still to understand women's health and support women's health, but to have a male cohort in there too, just to understand from that perspective.”
She cited a paper that outlined a concept called “couplepause”, wherein people in partnerships who were experiencing these midlife hormonal shifts were approached as a pair.
“People going through these midlife changes or any health thing – it immediately affects your partner,” she said, giving mood and sexual health as particularly salient examples. “Actually, we should be researching couples together.”
She added: “This was the only paper I'd seen that tried to consider a couple's approach to understanding midlife health... It was a really unusual approach, but something that would be... really interesting.”
Asked about the cultural aspect of men’s attitudes towards their health, Rolfe said: “I think some of it has improved, particularly around men's mental health.
“There [are] some amazing sportspeople that [have] come forward or celebrities – I think that is becoming such a better space for men... We've got a younger generation of people that are far more health-conscious, which is great.”
However, she said that she was less sure about attitudes to physical health, adding: “We almost need something equivalent to happen to make it more acceptable for men not just to talk about their health, but take care of it.”
She used anecdotal examples of attending yoga classes and a health coaching course, where all of the attendees were women.
“Where are the men engaged in their health?” she asked. “I don't think they do it in the same way... Mental health is something that is a bit more talked about and less stigmatised now, isn't it? But we need the same for the physical side.”
