what will be covered?
This article will throughly examine the essential aspects of how to improve male fertility with TCM using an evidence-based research. A wide range of topics will be explored, including key insights into male reproductive health and hormones, the alarming global decline in sperm quality, and a detailed overview of evidence-based strategies to boost sperm health and enhance male fertility outcomes. Specific Chinese Medicine concepts will also be explored, to provide a holistic perspective on male fertility, bridging both modern scientific research with Eastern philosophical insights. Given the depth and complexity of this subject, the article is divided into five sections, with the final section summarising key takeaways for practical application.
Part 1: Why assessing male fertility matters
- An overview of the global trends in declining sperm quality
- Why a semen analysis is essential for all couples wanting to conceive
- The key factors which make up healthy sperm
Part 2: How to assess & treat male fertility
- Specific blood and hormone tests to assess male reproductive health
- The role of testosterone
- Key nutrients and supplements backed by recent research
- Exercise, stress, sleep, alcohol and environmental toxins and their impacts on sperm health
Part 3: Chinese medicine & male fertility
- How TCM views male fertility & the concept of Jing essence
- Moderating sexual activity
- Yang sheng / nourishing life techniques for fertility
Part 4: How to improve male libido
- How Chinese medicine views male libido
- A specific Chinese herb for cardiovascular health and libido
- Some of the latest research
Part 5: A quick summary
- A summary of all the key take-home information on male fertility
Part 1: why assessing male fertility matters
the decline in sperm quality / a worrying trend
In recent years, a large growing body of evidence has highlighted a significant decline in male fertility, which covers nearly all sperm markers, including sperm count, motility, and morphology. A 2024 research paper, published in The Journal of Personalised Medicine, emphasised that these declines in sperm parameters is likely influenced by a combination of factors, such as rising obesity rates, poor lifestyle and dietary habits, and environmental toxins [1].
As lifestyle and environmental factors continue to affect male reproductive health, these studies highlight the urgent need to understand the causes behind declining sperm quality, and in turn, develop effective strategies to combat this issue. Infertility is estimated to affect 8-12% of couples globally, with the male factor being the primary or contributing cause in approximately 50% of cases [2]. Sadly, male fertility is often overlooked in fertility discussions. Yet understanding and optimising male fertility is not only essential for conception but also serves as a key factor for overall health and well-being.
but, isn’t it just about the ability to ‘perform’?
Although many men might equate fertility with their ability to perform in the bedroom, male fertility actually hinges on several key parameters, including sperm count, morphology, progressive motility, DNA fragmentation rate, the presence of sperm antibodies, and of course, physical libido. It’s important to stress that male fertility rates have been steadily declining in recent decades on a global scale. This isn’t just an isolated challenge faced by a few couples, but instead a widespread issue which calls for collective attention. For this reason, men should feel empowered, rather than embarrassed or ashamed, when seeking to improve their fertility markers.
semen analysis / a must on the fertility journey!
It is crucial for all couples or individuals trying to conceive to have a comprehensive semen analysis (CSA) performed for the male. Male fertility plays an equal role in the conception process, and semen analysis is one of the simplest yet most effective ways to assess a man’s reproductive health. A CSA provides valuable insights into sperm count, motility, morphology, and other markers which directly impact fertility. Identifying potential issues early on can help guide treatment options and improve the chances of conception, whether naturally or through IVF. Now, let’s break down some of these parts and explore their importance.
motility / progressive motility
Sperm motility refers to the ability of sperm to move progressively and efficiently, which is essential for reaching and fertilising the egg. Poor motility can be linked to several causes, including oxidative stress, nutrient deficiencies, exposure to toxins, and lifestyle factors such as smoking and alcohol consumption [3]. Based on current research, men with ejaculates showing less than 40% total motile or 32% progressive sperm motility, are considered to have asthenozoospermia, which is one of the predominant contributing factors in male infertility [4].
morphology
Morphology refers to the shape and structure of sperm. Abnormal sperm morphology, where sperm have irregular shapes or structural defects, can affect fertility by reducing the sperm’s ability to penetrate the egg. Earlier research on the strict criteria for morphology classified sperm as ‘normal’ if the morphology was greater than 14% [5]. Interestingly, over the past few decades, the World Health Organisation (WHO) has revised its classification, reducing the threshold of normal sperm morphology from 80.5% in its first edition to a mere 4% in its latest 5th edition.
Sperm morphology either boarderline or below 4% is strongly associated with poorer fertility outcomes, both in natural conception and assisted reproductive (AR) technologies, such as IVF and intracytoplasmic sperm injection (ICSI). Conversely, sperm morphology above 4% is linked to a higher likelihood of successful fertilisation with AR technologies [6]. In the clinical setting, achieving sperm morphology levels as close to 14% or above is considered the optimal range for increasing the chances of natural conception or with AR technologies.
sperm count
Sperm count refers to the number of sperm present in a man’s ejaculate and is a crucial aspect in male fertility. Low sperm count, known as oligospermia, can significantly reduce the chances of natural conception and may require AR therapies, such as IVF to achieve pregnancy.
Recent research has revealed alarming trends in global sperm counts. A comprehensive study by Levine et al. (2023) found that sperm concentration have dropped globally by 51.6% from 1973 to 2018. What’s particularly concerning is that the rate of decline has accelerated since the year 2000, with a sharp decrease in sperm concentration at a rate of 2.64% per year from this time. This rapid decline suggests that environmental, lifestyle, and potentially other unknown factors are contributing to reduced sperm counts worldwide [7]. With such a rapid decline in sperm concentration each year, it is essential to perform a full semen analysis every 6 months if a couple are experiencing unexplained fertility.
anti-sperm antibodies (ASA)
Anti-sperm antibodies (ASA) are immune proteins (immunoglobulins) which mistakenly attack sperm cells. Normally, sperm are protected from the immune system by the blood-testis barrier, which keeps them separate from immune cells. However, if this barrier is damaged—due to injury, infection, or other health issues—sperm can come into contact with the immune system. When this happens, the immune system may recognise sperm as foreign and produce antibodies (ASA), which can interfere with normal sperm function and reduce fertility [8].
Previous research has shown that ASA’s were found in higher concentrations (approximately 9–12%) among infertile patients [9]. For males, risk factors associated with higher number of ASA formation, can include surgical trauma, various microbial infections and STI’s, prostate and testicular inflammation, testicular cancer, scrotal varicose veins (varicoceles), and vasectomy or vasectomy reversal [10]. If sperm antibodies are suspected or have been confirmed as a cause of male infertility, it is crucial to work with an AR therapy specialist.
DNA fragmentation rate
Sperm DNA integrity is crucial for fertilisation and development of healthy offspring. Increased sperm DNA fragmentation rate refers to the percentage of sperm in a sample that have damaged or broken DNA strands. The DNA fragmentation of sperm cells is largely thought to be caused by external influences e.g. heat exposure, smoking, environmental pollutants, and chemotherapeutics, as well as some internal factors, such as oxidative stress [11].
Recent research suggests that increased sperm DNA fragmentation has a negative impact on natural pregnancy and AR therapy outcomes. Sperm DNA fragmentation testing may be particularly important in the infertility evaluation of men with varicoceles, unexplained infertility, recurrent pregnancy loss, or previous AR therapy failure [12].
For the purposes of fertility, the following table outlines the lower reference limits for what the WHO considers normal sperm quality. It’s important to note that these values do not represent the optimal levels required for natural conception or successful AF therapy outcomes. Each individual’s fertility should be assessed on a case-by-case basis in a clinical setting, as optimal fertility markers may vary significantly depending on personal circumstances.
Table 1: World Health Organisation. WHO laboratory manual for the Examination and processing of human semen. 2010
Part 2: How to assess & improve male fertility
The following section explores evidence-based strategies for assessing and improving male fertility. It covers testing for male hormones, blood and nutritional markers, optimal testosterone levels and natural ways to boost them, along with specific dietary and nutritional recommendations to enhance sperm health. Key nutrients and supplements which support fertility are highlighted, as well as crucial lifestyle changes for better reproductive outcomes. The section also examines environmental pollutants to avoid in order to optimise male fertility outcomes.
check his blood pathology & nutritional markers
In male fertility assessments, several blood, hormone, and nutritional markers are commonly evaluated to assess the current fertility status, and to determine underlying causes effecting male reproductive health. Although this is not a complete list, it does provide some of the most common tests, which can provide critical insights into male fertility.
Hormonal panels:
Hormones like testosterone, follicle-stimulating hormone (FSH), luteinising hormone (LH), estradiol, and prolactin are critical for assessing the hormonal balance related to sperm production and overall male reproductive function. Low testosterone or imbalances in FSH and LH can directly impact sperm production and quality [13]. As testosterone is one of the most important androgenic (male) hormones, this will be discussed separately below.
Blood pathologies:
Blood tests assessing full thyroid function (e.g., TSH, T3, T4), blood glucose levels (as high glucose is linked to oxidative stress), and lipid profiles, may provide insight into metabolic or endocrine disorders which could impair fertility. Additionally, screening for inflammatory markers like high-sensitivity C-reactive protein (CRP) can help identify systemic inflammation, which can affect cardiovascular and reproductive health. Often a full blood count (FBC), is also performed to gain a glimpse at the body’s electrolytes, immune, liver and kidney function, for overall health status.
Nutritional markers:
Deficiencies in key nutrients, such as zinc, vitamin D, folate, and omega-3 fatty acids, are often linked to poor semen quality. Recent systematic reviews have highlighted the importance of these nutrients in supporting sperm motility, morphology, and DNA integrity [14].
the role of testosterone
One of the most important hormones related to male fertility is testosterone. Testosterone plays a critical role in spermatogenesis (sperm production) and libido, as well as regulating several body functions in men, including metabolic and cardiovascular functions, bone and muscle growth, and mental health [15]. Evidence suggests that healthy lifestyle changes such as weight management, regular exercise, avoidance of alcohol and smoking, and adequate sleep can significantly improve testosterone levels, and therefore, have a positive impact sperm quality and male fertility outcomes [16]. A recent 2022 study found that in couples with unexplained infertility, low testosterone in the male partner was associated with abnormal sperm morphology and lower live birth rates, highlighting the need to maintain optimal testosterone levels [17].
Another recent 2022 study published in Best Practice & Research Clinical Endocrinology & Metabolism emphasised the importance of accurately measuring both total and free testosterone levels to diagnose male reproductive disorders in men. The study recommended measuring testosterone in the morning under fasting conditions for the most reliable results, and noted that the standard reference ranges for total testosterone in men is between 264-916 ng/dL (9.2-31.8 nmol/L in Australian units), while free testosterone is typically measured when total testosterone is low and symptoms of deficiency persist [18].
an important note
Testosterone levels should be tested if a male experiences persistent and unexplained fatigue, low libido, reduced muscle mass, mental health disorders which does not respond to conventional treatments, as well as if they have a history of anabolic steroid use, or suspected infertility.
nutrition for sperm health
Nutrition plays a pivotal role in sperm health and overall fertility. Deficiencies in key vitamins and minerals can impair sperm production, motility, and morphology. Previous research indicates that healthy diets rich in nutrients such as omega-3 fatty acids (found in fish), antioxidants (like vitamins E and C, β-carotene, selenium, zinc, and lycopene), vitamin D, and folate are associated with improved semen quality parameters. Studies have shown that foods like fish, shellfish, seafood, poultry, cereals, vegetables, fruits, and low-fat dairy products are linked to better sperm motility, morphology, and overall quality.
Conversely, diets high in processed meats and foods, dairy, sugary beverages, and sweets have been associated with poorer semen quality. Additionally, excessive consumption of alcohol, caffeine, and red or processed meats has been shown to negatively impact fecundability (natural conception), reducing the likelihood of pregnancy or fertilisation rates in partners. This highlights the critical role of dietary patterns in enhancing both sperm quality and broader male fertility outcomes [19, 20].
what are some of the key nutrients?
Vitamin D
Vitamin D plays a crucial role in male reproductive health, particularly in enhancing sperm motility, according to recent research. A 2022 review found that adequate levels of vitamin D was associated with improved sperm quality, especially in motility. Although more research is needed to investigate the link between vitamin D and hormone regulation in male fertility, the study suggests that vitamin D supplementation could be beneficial for men with fertility issues (both fertile and infertile men). Adequate sun exposure and supplementation during the winter months can help maintain optimal vitamin D levels for fertility [21].
Zinc
Zinc is one of the most important minerals for male fertility, as it plays a crucial role in sperm production, testosterone synthesis, and protecting sperm from oxidative damage. A study by Fallah et al. (2018) found that zinc, being highly concentrated in the testis and seminal plasma, significantly contributes to sperm cell production, quality, motility, and overall fertility.
It also provides antioxidant protection, helping prevent oxidative stress-related damage to sperm. Additionally, zinc is involved in testosterone production, stabilising sperm membranes, and supporting the acrosome reaction, which is essential for fertilisation. A deficiency in zinc is linked to poor sperm function, reduced fertility, and impaired hormonal balance [22]. Another recent 2023 study, showed that daily supplementation with zinc sulfate (40mg), was shown to increase sperm progressive motility, membrane integrity and viability, as well as increase glutathione (a powerful antioxidant) and testosterone levels [23]. Natural zinc-rich foods include oysters, pumpkin seeds, and legumes.
Omega-3 fatty acids
Omega-3s are essential for maintaining the structure and function of sperm cell membranes. Research published in The American Journal of Obstetrics and Gynecology (2022) found that men’s intake of total omega-3 fatty acids was positively related to sperm count and motility. Similar positive associations with sperm quality were seen when evaluating the primary food sources of omega-3 fatty acids, such as fish and nuts [24].
A large-scale systematic review and meta-analysis (2018), investigated the effects of omega-3 fatty acids (EPA and DHA) on male infertility. The findings revealed that omega-3 supplementation significantly improved sperm motility, concentration, and overall semen quality in men with infertility. These fatty acids were shown to enhance sperm membrane integrity, which is crucial for improving fertility outcomes [25]. Dietary sources rich in omega-3s, include fatty fish, flaxseeds, and walnuts.
Selenium
Selenium is essential for male fertility as it plays a key role in sperm production, motility, and quality. It also acts as an antioxidant, protecting sperm from oxidative damage, which can improve sperm DNA integrity and reduce the risk of infertility. The highest dietary sources of selenium include Brazil nuts, fish, eggs, sunflower seeds, and meats such as beef and chicken.
A small-scale study published in 2023 examined the effects of selenium supplementation on men with unexplained infertility, characterised by low sperm count, poor sperm movement, and abnormal sperm morphology. Over six months, the male subjects taking 200 µg/day of selenium showed significant improvements in sperm concentration, motility, and overall quality. Additionally, selenium was shown to boost the body’s antioxidant defences and reduce sperm DNA damage, both of which are critical for enhancing fertility [26].
antioxidants: CoQ10 / vitamin C / N-acetyl-cysteine
Co-enzyme Q10 (Coq10)
Antioxidants such as Coenzyme Q10 (CoQ10) help protect sperm cells from oxidative stress, which can damage DNA and impair sperm function. A 2021 systematic review on CoQ10 and male infertility found that CoQ10 supplementation significantly improved sperm concentration, motility, and overall seminal quality in men with unexplained infertility. It also reduced oxidative stress and sperm DNA damage, which are key factors for improving fertility outcomes. Although the systematic review emphasised the need for more large-scale randomised trials to confirm the therapeutic dose and efficacy, the authors concluded that “CoQ10 remains one of the most promising molecules for treating unexplained male infertility” [27].
Vitamin C & E
Vitamin C and E are two antioxidants which have shown promise in improving male fertility by enhancing sperm health markers such as motility, concentration, and morphology. These vitamins help protect sperm cells from oxidative stress, which can damage DNA, impairing sperm function. The highest dietary sources of vitamin C include citrus fruits, strawberries, bell peppers, and broccoli, while vitamin E can be found in foods like almonds, sunflower seeds, spinach, and avocados [28].
A 2022 meta-analysis, published in International Urology and Nephrology, assessed the impact of vitamin E and vitamin C supplementation on male infertility. The study analysed data from 11 randomised controlled trials (RCTs) involving 832 participants. The results showed that supplementation with vitamins E and C significantly improved several key semen parameters, including concentration, progressive motility, morphology, and total sperm count. Importantly, no adverse effects were reported during the trials, suggesting that these antioxidants may be a safe and effective option for improving fertility outcomes in men [29].
n-acetyl-cysteine (NAC): a powerful antioxidant agent
Lastly, N-acetyl-cysteine (NAC) is a supplemental antioxidant and precursor to glutathione, another powerful antioxidant in the body. NAC has come under the spotlight in recent years to investigate its ability to reduce oxidative stress, improve sperm quality, and support overall male reproductive health. A recent (2019) small-scale randomised controlled trial published in Reproductive Biology and Endocrinology investigated the effects of NAC supplementation on sperm quality, chromatin integrity, and oxidative stress in infertile men. In this study, 50 men with infertility (specifically asthenoteratozoospermia) received 600mg of NAC daily for three months.
The results showed significant improvements in several key sperm parameters, including sperm motility, concentration, and morphology. Additionally, NAC reduced sperm DNA fragmentation and improved protamine deficiency, both of which are crucial for healthy sperm function and successful fertilisation. NAC also enhanced the antioxidant capacity of semen and led to a significant increase in testosterone levels, alongside a reduction in FSH and LH, suggesting that NAC can also have a positive impact on hormonal balance in men with infertility. These findings suggest that NAC supplementation can be an effective treatment option for improving sperm quality and reducing oxidative stress in men with idiopathic infertility [30].
essential lifestyle adjustments – yes, these matter
Beyond nutrition, lifestyle choices significantly influence male fertility. Adopting healthier habits can have a profound impact on sperm quality and overall reproductive health. It’s often best to start with aspects of your immediate environment that you can control and gradually incorporate changes that support your goals. By prioritising small, sustainable adjustments, you can build a foundation for lasting improvements in fertility and well-being.
exercise
Regular moderate exercise improves hormone regulation and helps maintain a healthy weight—both of which contribute to better sperm health. A 2023 study published in the World Journal of Men’s Health reviewed the relationship between physical exercise and male fertility outcomes. The research found that low-to-moderate intensity exercise was associated with improved sperm quality and male fertility compared to high-intensity activities such as endurance sports, cycling, and heavy weightlifting, which may have detrimental effects due to increases in oxidative stress [31]. The study emphasised that while exercise supports male fertility, moderation is key—a sentiment aligned with Chinese Medicine thinking.
sleep & stress reduction
From earlier research, chronic stress has been linked to lower testosterone levels and higher FSH and LH levels, which negatively impact sperm quality markers [32]. Disturbances to normal sleeping patterns has been shown to further impact male fertility, with research showing that poor sleep quality, short sleep duration, and exposure to artificial lights at night (phone screens, tv’s and laptops) negatively affect sperm motility, volume, and testosterone levels in male subjects [33, 34].
A small-scale study from 2021 investigating male night shift workers attending an infertility clinic, were found to have reduced sperm counts and morphology, as well as poor sleep quality, compared to non-shift workers. The study linked poor sleep with decreased sperm quality, suggesting that disrupted circadian rhythms from shift work negatively impacted male fertility. Additionally, shift work combined with poor sleep quality significantly raised the risk of low sperm count, even when accounting for other factors like age, stress levels, and testosterone levels [35].
To counteract the negative effects of stress and poor sleep on male fertility, practicing stress-reducing techniques such as meditation, regular moderate exercise, and improving sleep hygiene is recommended. This includes avoiding screen time at least 1-2 hour before bed and instead focus on relaxation with music or an audiobook.
alcohol: reduce your consumption, or better yet, abstain completely
A meta-analysis published in Heliyon in 2023 reviewed the effects of alcohol intake on male reproductive health, analysing data from 40 studies with 23,258 men across five continents. The study examined how different levels of alcohol consumption affected semen parameters, antioxidant levels in semen, sperm DNA fragmentation, and sex hormone levels. The participants were divided into subgroups: non-drinkers, moderate drinkers (1-7 units per week), and heavy drinkers (more than 7 units per week).
The results indicated that heavy alcohol consumption (over 7 units per week) was linked to a decrease in semen volume, reduced antioxidant enzyme levels, and altered testosterone, FSH, and LH levels. Heavy drinkers also showed an increase in estradiol levels, which could further disrupt hormonal balance and negatively impact fertility. By contrast, moderate alcohol intake (less than 7 units per week) did not significantly affect semen parameters, including sperm count, motility, morphology, or sex hormones, suggesting that moderate alcohol consumption might not be as detrimental to male fertility as heavy drinking [36].
environmental toxins / endocrine disrupting chemicals
Endocrine-disrupting chemicals (EDCs) are external substances or compounds commonly found in certain foods, the environment, and consumer products, which disrupt the endocrine (hormone) system in both men and women. EDCs can impact male fertility by interfering with hormone receptors, often exhibiting oestrogen-like or anti-androgen (male hormone) effects, significantly altering normal male physiology and reproductive function. Several examples of EDCs include, Bisphenol A (BPA), parabens, phthalates, polychlorinated biphenyls (PCBs), and certain pesticides.
Exposure to EDCs can happen both in the womb or through environmental exposure in adulthood. Prenatal exposure may influence the development of the testis and the reproductive tract, resulting in subnormal testicular function, impairing normal testosterone production. Postnatal EDC exposure can affect the hypothalamic-pituitary-gonadal (HPA) axis resulting in decreased testosterone production and impaired spermatogenesis (sperm cell production) [37].
some common examples of EDCs
Plasticisers (e.g., BPA and phthalates): are widely used in plastic material production and is detected in food and beverage containers, kitchen utensils, microwave-cooking plastic containers, and packaged food. To avoid exposure to these common EDCs, opt for glass or stainless steel containers and BPA-free products for food storage, and avoid re-heating and eating from plastic containers (including ready made meals).
Pesticides: Found in non-organic produce and agricultural chemicals.
Chemical-laden personal care products: Choose phthalate-free cosmetics, lotions, and shampoos.
Processed foods and canned goods: Often contain BPA in linings and additives.
Part 3: Chinese medicine & male fertility
In Traditional Chinese Medicine (TCM), male fertility is intricately linked to the cultivation and preservation of Kidney Jing (essence), the essential life force which underpins male (and female) reproductive health. TCM approaches this by integrating ‘Yang Sheng’, health-supporting practices, to strengthen and preserve Jing, as well as addressing any internal imbalances which are disrupting normal reproductive function.
a closer look at jing / the reproductive essence
At the core of male reproductive health lies Jing, the constitutional essence which is passed down from one’s parents at birth, akin to our DNA, and serves as the foundation of the physical body, reproductive strength, vitality, and longevity. In men, Jing plays a crucial role in the production and quality of sperm, directly impacting fertility. However, Jing naturally declines with age, and this depletion can be accelerated by modern lifestyle factors such as chronic stress, poor diet, overexertion, and excessive sexual activity (in particular too frequent ejaculation).
As Jing diminishes, men may experience reduced sperm quality, decreased libido, and symptoms such as fatigue, poor memory and cognitive decline, chronic lower back pain, and signs of premature aging. In TCM, preserving and nourishing Jing is essential not only for maintaining male fertility but also for promoting general well-being throughout life, which brings us to one of the fundamental ancient daoist practices to preserve Jing essence.
moderate sexual activity & ejaculation / ancient daoist practice
TCM emphasises the regulation of ejaculation to prevent the depletion of Jing. While some might interpret this as abstaining from ejaculation completely (common in advocates of semen retention), TCM instead promotes balance, ensuring that ejaculation occurs in a healthy, regulated manner. According to both Chinese medicine and ancient daoist texts, the frequency of ejaculation should be moderate and attuned to individual constitution and age.
One example comes from the classical Chinese medicine text Huangdi Neijing (Yellow Emperor’s Classic), which suggests that younger men may have more frequent sexual activity and ejaculation without adverse effects, while men over the age of forty should moderate the frequency to conserve their Jing. Daoist teachings also offer more advice, suggesting that seasonal changes and personal health status should determine sexual activity, with ejaculation being limited particularly during the colder months, when kidney energy needs greater preservation, as well as during times of illness, injury or recovery.
It is important to note that moderation is key, rather than complete abstinence or extreme practices, Interestingly, modern research has found a link between regular-moderate ejaculation and prostate health. A 2016 study published in European Urology suggests that moderate ejaculation throughout adulthood is linked to a lower risk of developing prostate cancer, which is an important consideration for all men as they age, hence reinforcing the idea of moderation and balance in line with TCM thinking [38].
yang sheng / nurturing life
Yang Sheng (养生), often translated as “nourishing life,” encompasses a sophisticated array of practices within TCM aimed at preserving health and increasing longevity. Far beyond general lifestyle advice, Yang Sheng involves a nuanced understanding of the intricate relationship between an individual and their environment, emphasising both preventive and proactive measures to enhance health.
In practice, Yang Sheng draws from ancient TCM theories, primarily focusing on seasonal living, dietary considerations, specific exercise regimens like Tai Chi and Qi Gong, and mental-emotional cultivation such as meditation. Central to Yang Sheng is the belief that health is not merely the absence of illness but an ongoing state of dynamic equilibrium, requiring mindful attention to daily habits, emotional states, and alignment with the seasons and natural environment.
In the context of male fertility, Yang Sheng principles emphasise cultivating a lifestyle which nourishes Kidney Jing and supports the balance of Yin and Yang within the body. Dietary practices play a crucial role, focusing on foods that support both the Kidney and the Spleen-Stomach systems, which are foundational for Qi and blood production. Men are encouraged to consume warming, easily digestible foods like broths, soups, stews, and steamed or wok-fried vegetables, along with quality proteins such as lamb, chicken, and beef, all of which bolster blood circulation and increase energy levels.
Additionally, nutrient-dense foods like walnuts, goji berries, black sesame seeds, black fungus (mushrooms), and black beans are highly recommended for their ability to nourish Kidney Qi and fortify reproductive health. Avoiding cold foods and beverages—including ice cream, processed sugary foods, raw salads, and dairy—protects digestive fire, optimising nutrient absorption and sustaining overall vitality.
Part 4: improving male libido & erectile dysfunction
Maintaining a healthy libido is another key factor in male reproductive health and overall well-being. Libido and normal erectile function can be influenced by a variety of physical, psychological, and lifestyle factors, and declines in libido are often tied to aging, mental stress, poor lifestyle habits, and some underlying health issues. Fortunately, there are several lifestyle strategies, supplements, and potential herbs which can help preserve and enhance male libido and male reproductuve function.
cinnamon / the Chinese herb for healthy libido
According to Chinese medicine, multiple internal patterns of disharmony can contribute to low libido and erectile dysfunction. However, one of the most common TCM patterns is Heart / Kidney disharmony, characterised by weak Heart Yang (cardiac function) and insufficient Kidney essence (Jing). Cinnamon twig (Gui Zhi) is a key herb example in the Chinese pharmacopeia, and is frequently used in various Chinese herbal formulas to address the Heart / Kidney pattern. Gui Zhi strengths the Heart, tonifies Yang, and increases blood circulation—thereby, boosting libido through healthy blood flow.
what does the research say?
Although clinical research specifically investigating cinnamon’s effects on erectile dysfunction (ED) and male libido is limited, cinnamon has been widely studied and shown to improve various cardiovascular health markers due to its anti-cholesterol, anti-atherosclerotic, anti-inflammatory, anti-arrhythmic, blood pressure and blood glucose-lowering, and antioxidant properties [39].
This connection is particularly relevant to libido and ED because cardiovascular health is closely associated with normal erectile function, as the two are fundamentally linked to good vascular health and blood flow. Notably, recent research has established that ED in men over the age of forty can serve as an independent and reliable indicator of cardiovascular disease (CVD) risk—including heart attacks and strokes.
In fact, ED often precedes CVD symptoms, providing a critical opportunity for healthcare practitioners to identify high-risk patients early and implement preventive strategies to reduce cardiovascular events and mortality rates.[40]. The key takeaway for improving libido lies in supporting healthy blood circulation, and addressing the underlying cause, which leads us to consider the role of diet and lifestyle.
diet & lifestyle & male performance
The great news is that many of the diet and lifestyle concepts discussed in previous sections—such as incorporating essential nutrients like Zinc and Vitamin D, along with stress reduction, moderate exercise, weight management, and balanced sleep patterns—are pivotal for boosting libido. For men, experiencing the ability to achieve an erection at the beginning of sexual activity but losing it during intercourse can often signal stress, or performance-related anxiety. This is particularly common in couples trying to conceive, especially during IVF cycles, where heightened stress and the urgency to achieve pregnancy can exacerbate these mental stressors.
a general caution on libido supplements
Caution should be exercised when considering any herb and supplement which is marketed at boosting male libido, especially without a proper diagnosis and prescription from a trained TCM physician or other allied health practitioner. While certain herbs and supplements may offer benefit, their indiscriminate use can lead to imbalances in the body if they do not fit the specific pattern of the individual. In TCM, an accurate diagnosis is essential to determine the appropriate treatment to address the cause of erectile dysfunction or loss of libido.
Part 5: a summary of all the essential information
Decline in Male Fertility on a Global Scale:
Research indicates a significant global decline in sperm quality, including sperm count, motility, and morphology, which is largely influenced by lifestyle factors, environmental toxins, and poor dietary lifestyle habits. Addressing male fertility is crucial, as the male factor contribute to about 50% of infertility cases worldwide.
Importance of Semen Analysis:
A comprehensive semen analysis (CSA) is essential for all couples trying to conceive. It provides insights into critical sperm parameters like count, motility, and morphology, helping to identify any potential issues and guide treatment options early on in the fertility treatment process.
Testing for Hormonal and Nutritional Markers:
Evaluating bloods and hormones (testosterone, FSH, LH, estradiol, prolactin, full thyroid function, full blood count, fasting glucose, cholesterol, and high-sensitivity CRP) and key nutrients (like Zinc, Vitamin D, and Omega-3s) can reveal underlying causes affecting sperm health. Optimising these markers is often pivotal for enhancing fertility outcomes.
Key Nutrients/Supplements for male fertility:
- Vitamin D: Supports sperm motility and may improve overall fertility outcomes.
- Zinc: Crucial for sperm production, testosterone synthesis, and antioxidant protection.
- Omega-3 Fatty-acids: Essential for sperm membrane integrity, improving motility and concentration.
- Selenium: Boosts sperm quality and acts as an antioxidant, protecting DNA integrity.
- Antioxidants (CoQ10, Vitamin E & C, NAC): Combat oxidative stress, improve sperm function, and protect DNA integrity.
Foods to focus on
Cooked, thermally warming, and easily digestible foods: Essential for supporting digestion and Spleen Qi according to TCM.
Broths, Soups, and Stews: Provide easy-to-absorb nutrients and sustained energy.
Steamed and Wok-Fried Vegetables: Optimal for nutrient absorption and improved digestive health.
Quality Proteins: Lamb, chicken, fish, eggs, and beef, support protein, vitamin and minerals uptake, and energy levels.
‘Kidney tonifying foods’: Walnuts, goji berries, black sesame seeds, and black beans, nourish Kidney Qi and bolster male reproductive health.
Foods to limit
Thermally cold and Raw-damp forming Foods: Ice-cream, excess raw salads, and dairy products, which can weaken digestive fire and impair Spleen Qi.
Sugary and Processed Foods: These can create dampness and heat, disturbing the body’s hormone balances and digestive health.
Thermally Cold Beverages: Including icy-cold water, which can impair the function of the Spleen and Stomach, essential organs in TCM for digestion and nutrient absorption.
Fried foods: Similar to sugary and processed foods, these can cause excess dampness and heat in the body, raising inflammation and effecting male reproductive health.
Alcohol consumption
Limit or Abstain from Alcohol: Heavy drinking (more than 7 units per week) is associated with reduced semen quality and hormone imbalances. Consume no more than 1 alcohol drink per night, or even better, abstain completely,
Environmental toxins & EDCs / avoid these if you can
- Bisphenol A (BPA): Commonly found in plastic containers and canned goods; use glass or stainless steel for storage and re-heating of food. Avoid eating from ready-made meals.
- Phthalates: Present in many plastics and personal care products; opt for phthalate-free cosmetics and hygiene items.
- Pesticides: Often found in non-organic produce; whenever possible, choose organic options or wash produce thoroughly.
- Parabens and PCBs (Polychlorinated Biphenyls): Found in processed foods, cosmetics, and industrial products. Choosing natural personal care items and minimizing processed food intake helps reduce exposure.
Other key lifestyle factors
Quality Sleep:
- Maintaining a regular sleep schedule is essential, as poor sleep quality and short sleep duration is linked to lower testosterone levels and reduced sperm quality.
- Minimising exposure to artificial light at least 1 hour before bed and maintaining a dark, cool sleep environment can help improve sleep hygiene and support reproductive health.
Stress Reduction:
- Chronic stress negatively impacts hormone levels, particularly testosterone, and can lead to increased levels of FSH and LH, which disrupt sperm quality.
- Techniques such as meditation, deep breathing exercises, and mindfulness can help manage stress. Practicing regular relaxation techniques may improve libido and fertility outcomes, especially in high-stress situations like IVF cycles.
Exercise:
- Regular, moderate physical activity can improve hormone regulation and support a healthy weight, both of which are beneficial for sperm health.
- Low- to moderate-intensity exercises such as walking, yoga, or light strength training are ideal, as they reduce oxidative stress without compromising sperm quality. High-intensity activities, particularly endurance sports and heavy weightlifting, may have negative effects if not properly balanced.
moderate sexual activity
TCM emphasises moderation and balance in sexual activity, particularly in regulating ejaculation based on several factors like age, health status, and the seasons. For men over 40, or during times of illness, injury, or recovery, TCM suggests conserving Kidney Jing by limiting the frequency of ejaculation, especially in colder months. Conversely, younger men in good health generally have more flexibility, as their Jing is less likely to be depleted through frequent activity.
closing thoughts
Enhancing male fertility involves a comprehensive approach which integrates both Traditional Chinese Medicine (TCM) principles and evidence-based medicine. At Ancient Waters Acupuncture in Nowra, Dr. Fraser Cobham (TCM) is a fully qualified Chinese medicine practitioner, experienced in supporting both male and female fertility. He offers personalised fertility acupuncture and herbal medicine treatments, targeting factors like sperm quality, libido, and reproductive health. Whether you’re seeking to improve male fertility or exploring IVF support, Dr. Cobham provides a tailored approach to help you achieve your fertility health goals.
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