In this article:
- The importance of a healthy microbiome
- What are probiotics?
- Understanding male fertility
- The connection between gut health and male fertility
- What foods are high in probiotics & prebiotics?
- Why implement probiotic supplementation?
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October 18, 2021 11 min read
As if you needed yet another reason to mind your gut health and make friends with probiotic bacteria! Everyone's health is positively affected by having a healthy microbiome, but recent studies have shown that the health benefit of friendly microbiota extends to men's health as well, specifically sperm quality.
The microorganisms in our bodies make up what's called the "microbiome." There are literally trillions upon trillions of these microbiotas in our bodies, especially our gastrointestinal tract. This vast army of microbes keeps us alive and protects us against pathogens, breaks down food to release energy, and produces many of the vitamins we need. Everyone’s microbiome is unique to them. In fact, no two people have the same exact microbial cells, even identical twins are different!
For years, a lot of attention has been paid to using probiotics as an alternative for alleviating the symptoms of and/or treating several diseases including gastrointestinal tract diseases, colorectal cancers, cardiovascular diseases, high cholesterol, and blood pressure issues. However, men's reproductive health is affected by the microbiome and the possible role of probiotics in addressing male infertility is only now starting to get any serious attention.
The "Father of Probiotics," Elie Metchnikoff, noticed that Bulgarian peasants lived a long time and also ate a lot of yogurt. This led him to study lactobacillus and drink sour milk every day. In 1906 Metchnikoff published "The Prolongation of Life: Optimistic Studies" which postulated that lactobacillus was the agent responsible for preventing intestinal putrefaction and aging in the peasants he studied. Basically, he and his contemporaries discovered that there are beneficial bacteria and microbes living in our intestinal tracts. These "good" microorganisms contribute to the health of one's immune system by either warding off pathogens directly or by displacing them, by out-reproducing them.
Probiotics are part of a larger picture concerning beneficial bacteria and your microbiome. For a microbe to be called probiotic bacteria, it must have several characteristics, including:
Four of the most common probiotics are:
Lactobacillus Acidophilus: This bacterial friend is one of the most common types of probiotics and can be found in fermented foods, yogurt, and dietary supplements. It is perhaps the most well studied of all the probiotic strains. According to a Healthline.com article, it produces lactic acid, which may prevent harmful bacteria from colonizing the intestines. It also ensures the lining of the intestines stay intact. And clinical trials have found that taking it as a supplement increases the expression of genes in the intestines that greatly boost one's immune system. It can also help:
Lactobacillus Plantarum:This probiotic lactobacillus aggressively binds to one's intestinal mucosa, the innermost layer of the intestinal tract. This displaces pathogens and, in turn, increases the intestinal population of beneficial bacteria. It is also an antioxidant with very potent anti-inflammatory properties. A Pubmed article (DOI: 10.3748/wjg.v18.i30.4012) relates that in clinical trials, a four-week treatment with Lactobacillus plantarum provided irritable bowel syndrome (IBS) sufferers effective relief from abdominal pain and bloating as opposed to placebo.
According to an article on Verywellhealth.com, other benefits include:
Lactobacillus Reuteri:The article Role of Lactobacillus reuteri in Human Health and Diseases" (doi: 10.3389/fmicb.2018.00757) states that this probiotic strain of lactobacillus inhibits the colonization of pathogenic microbes and alters the microbiota composition in the gut by excreting antimicrobial molecules. It also has strong anti-inflammatory properties and strengthens the intestinal barrier, preventing leakage of intestinal microbiota into other parts of the body.
Lactobacillus rhamnosus: This probiotic strain produces the enzyme lactase. This enzyme breaks down lactose, which is the sugar found in dairy, into lactic acid. According to a Healthline.com article, it also helps:
Bifidobacterium bifidum, Bifidobacterium infantis, and Bifidobacterium longum are other probiotic strains of beneficial bacteria. They also have anti-inflammatory properties and protect the lining of the intestinal tract. They have been strongly linked to reducing the symptoms of leaky gut syndrome as well as helping to alleviate constipation, ulcerative colitis, and celiac disease. The family of Bifidobacteria, in general, generates vitamins such as K and B-12, which may also influence mood and help reduce the symptoms of depression and anxiety. Similar to lactobacillus, they can help ward off pathogens and displace them by out-producing them.
They say that dental health is mental health. But as far as we know, no one says germ health is sperm health. However, it turns out to be true. As a Healthline.com article points out, the symptoms mentioned above, which the lactobacillus bacteria can help alleviate, may help with libido or "getting one in the mood." However, libido, in general, is very complicated and is impacted by many different things like hormones, lifestyle, and relational factors.
Determining if your libido is being torpedoed by "dysbiosis," which is an imbalance of pathogens versus beneficial bacteria, is tricky business. A gastroenterologist, the medical specialist that focuses on the gut, may be able to help you with any of these mood-killing symptoms:
However, male infertility goes way beyond not being in the mood. Semen quality can be directly affected by a microbiome that is out of whack. Infertile men may suffer from changes in the morphology of their spermatozoa, the physical structure of their sperm cells. Semen analysis can be conducted by a doctor who specializes in andrology, the branch of medicine that deals with the male reproductive function. One of the basic things that will be analyzed is sperm motility, which refers to the spermatozoa's ability to "swim." Abnormal morphology can severely limit sperm motility.
A Mayo Clinic article, Abnormal sperm morphology: What does it mean? says that while normal spermatozoa have an oval head with a long tail, abnormal sperm cells can have defects such as a large or misshapen head or a crooked tail. It's even possible for some to have double tails. Although these defects can lower sperm motility and egg-penetrating ability, they're not necessarily cause for alarm. Having a large percentage of spermatozoa with abnormal morphology isn't uncommon. In fact, these andrology researchers have found that only 4% to 10% of the sperm in a semen sample are "normal." They are clear on the point that since sperm morphology is so poorly understood, it's a poor predictor of male infertility unless nearly 100% of the sperm are abnormal.
Along with sperm morphology, a typical semen analysis also assesses:
According to an article found on PubMed entitled Impact of Inflammation on Male Reproductive Tract, the beneficial bacteria in your gut help to keep your digestive system functioning properly. They also work to maintain your intestinal walls, especially Lactobacillus reuteri, as mentioned above. When it's healthy and strong, your intestinal tract can absorb the nutrients your body needs to create healthy sperm, like zinc, vitamin C, phosphorus, folate, and magnesium. It also prevents toxins and stray nutrients from passing through the gut barrier and into your bloodstream. And since a permeable intestinal wall can put your immune system in a state of high alert, resources are diverted away from reproduction. This puts damaging oxidative stress on your sperm, altering their morphology and can lower your sperm count. Who knew that taking your daily antioxidant supplement could boost male fertility?!
Your gut microbiota is also responsible for the maintenance of many hormones. This includes the ones that are important for reproductive hormones, like estrogen and testosterone. According to another article found on PubMed, Glucocorticoids, Stress, and Fertility, too much estrogen lowers one's sperm count and increases oxidative stress on one's reproductive health. Also, low testosterone levels can cool the sex drive and lower sperm production. Cultivating a balanced gut microbiome can also keep the stress/anxiety hormone, cortisol, from being released in high levelsand negatively affecting your hypothalamus, pituitary, and testes. When these are out of whack, all reproductive hormones are affected leading to a decline in semen quality.
Excess weight also puts a damper on men's reproductive health. And since probiotic bacteria help regulate weight, there is a connection to male infertility. According to an article from the Harvard School of Public Health, Excess Weight May Affect Sperm Production, Reduce Fertility In Men, obesity is a big deal. They found that overweight men were 11 percent more likely to have a low sperm count and 39 percent more likely to have no sperm in their ejaculate. Obese men were 42 percent more likely to have a low sperm count than their normal-weight peers and 81 percent more likely to produce no sperm.
A Healthline.com article, How Probiotics Can Help You Lose Weight and Belly Fat Foods, details how probiotics affect weight. Probiotics release appetite-regulating hormones as well as metabolism-boosting hormones, a one-two punch to body fat. They also regulate energy usage by producing short-chain fatty acids such as acetate, propionate, and butyrate. These beneficial short-chain fatty acids are also produced by probiotic strains of bacteria when they break down otherwise non-digestible fiber. It’s also believed that certain probiotic lactobacillus may inhibit the absorption of dietary fat, increasing the amount of fat excreted with feces. Add to this already impressive list of health benefits the secretion of fat-regulating proteins that help decrease fat storage. Strong evidence also links obesity to inflammation throughout the body. In other words, the anti-inflammatory properties of probiotics mentioned above also helps reduce obesity.
Although this topic within andrology is still in its infancy (HAR!), the microbiome of men's seminal tracts may affect male reproductive health. Another article found on PubMed (DOI: 10.1111/andr.12886) relates that the semen microbiome is rich and diverse in both fertile and infertile men. However, dysbiosis can exist here as well, with bad bacteria outnumbering beneficial bacteria.
Pathogens like Prevotella, Bacteriospermia, Ureaplasma urealyticum, Enterococcus faecalis, and Mycoplasma hominis appeared to exert a negative effect on sperm quality. Separately or together, they reduced sperm concentration, decreased sperm motility, increased DNA fragmentation, damaged sperm morphology, and decreased sperm concentration in semen.
On the other hand, the existence of probiotic strains of lactobacillus in the seminal tract appears to improve semen quality. Fertile men had far more probiotic strains versus pathogens when compared to infertile men. By out-producing and replacing the pathogens, the probiotic strains seem to be beneficial to male reproductive health. And since the existence of the above-mentioned bad guys are implicated in up to 50% of male infertility cases, it seems like a good idea to eat your yogurt!
Yogurt is the MVP of probiotic foods because it has a flavor and texture that's generally appealing to Western palates. The number and type of bacteria species can vary depending on the yogurt brand. The probiotic content of yogurt can range from 90 billion to 500 billion colony-forming units (CFU). The CFU indicates how many bacteria are able to divide and form colonies. Look for the words "live and active cultures" on the label.
All fermented foods have probiotic strains of beneficial bacteria. The most commonly fermented foods that naturally contain probiotics include yogurt, kefir, kombucha, sauerkraut, pickles, miso, tempeh, kimchi, sourdough bread and some soft cheeses.
When you start to add these foods to your diet, take it slowly. Every person’s microbiome is different and so it's difficult to predict the effect of probiotic foods on them. In other words, don’t eat them all at once! For example, you might try a half cup of kefir first and see how your body reacts before working your way up to a full serving, which is one cup. Later, after you're sure your body is responding positively, try adding a different probiotic food.
Prebiotics are special plant fibers that help healthy bacteria grow in your gut. Both prebiotics and probiotics are good for your gut, but they help in different ways. Prebiotics are a source of food for your gut’s probiotic bacteria. They’re carbs your body can’t digest, and pass through undigested to your lower digestive tract. There they become food for the beneficial bacteria living there.
You’ll find prebiotics in many fruits, vegetables, and whole grains like:
Probiotic supplements typically contain a combination of several beneficial bacteria species. The recommended daily dosage ranges from 1 billion to 10 billion colony forming units. Supplements also often contain a mixture of probiotic strains, but the brands will generally list which strains, or species, they contain. If taking a probiotic, it’s usually best to do so with a meal, ideally breakfast.
When beginning probiotic supplementation, start with a lower dose than recommended. Assuming your body responds well, slowly increase the CFUs, watching to see how your body reacts over time, and then working your way up to a full dose.
Also, many supplements contain prebiotics. As mentioned above, prebiotics help the probiotic bacteria thrive. Do some research or consult a nutritionist to see what combination of probiotics and prebiotics would be right for you.
Keep in mind that it may take a few weeks before you start to notice major improvements. In general, you'll start to notice improvements in your gastrointestinal health and comfort. After more time, you should start to notice having lower levels of anxiety and improvements in your mood. As always, consult your healthcare provider before making any major changes to your diet, like probiotic supplementation, especially if you are already being treated for a gastrointestinal disease such as irritable bowel syndrome. In addition to taking a daily probiotic, your doctor may also recommend a potent antioxidant such as glutathione, the body’s “master” antioxidant, or a collagen supplement to help strengthen the gut lining and prevent leaky gut syndrome.
A healthy gut-microbiome and semen-microbiome may contribute to men's reproductive health. Fermented foods and probiotic supplementation are strongly associated with the health of both of these microbiomes. These beneficial bacteria may just help improve semen quality by preventing morphology damage, increasing sperm count, and boosting sperm motility.
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