The three treasures of happiness for elderly men: libido, family affection, and activity.

**The First Relationship: The Relationship Between Sexual Desire and Abstinence**

Many people believe that men over 60 should stop having sex, arguing that it's harmful to their health and longevity, and also that it's indecent. This is actually a misconception stemming from outdated ideas. Maintaining a sex life is beneficial for the health of older adults. It can help them maintain a cheerful mood, feel confident and enjoy life, and boost their immunity, increasing their resistance to disease. However, the methods of sexual activity for older adults can be adjusted according to their physical condition. Some older adults can achieve sexual communication through physical intimacy, conversation, and other means. Therefore, we encourage older adults to have companionship.

**The second relationship: The relationship between loneliness and filial piety**

As people enter old age, they still have 40 long years to live happily beyond 100. How to spend these 40 years happily is a significant matter worthy of study. I have a great-grandmother in my family who lived to be 105 years old, enjoying five generations under one roof and living out her natural lifespan. One of the reasons for her good health was that her sons and grandsons took turns accompanying her, preventing her from being lonely. Having people to talk and laugh with year-round ensured her a happy life beyond 100.

**The third relationship: The relationship between activity and stillness**

Life lies in movement. As people age, their feet age first; to stay young, they need to keep their legs moving. As people age, their brains age first; to avoid becoming forgetful, they need to keep their minds active. Many Chinese people, upon entering old age, want to stay home and avoid going out and being active. This is highly undesirable; it is essential to maintain both mental and physical activity. First, one must insist on walking every day; as the saying goes, "A hundred steps a day keeps the doctor away." Second, one must insist on keeping the mind active every day. In reality, only about 30% of human brain cells are utilized; 70% remain unused and undeveloped. Therefore, regular mental activity every day, such as reading newspapers, novels, or writing in a diary, keeps the elderly's minds busy, ensuring a rich blood supply, adequate nutrition and oxygen, and maintaining youthful vitality.

**Cao Kaiyong's Mailbox**

Why do children sometimes experience incomplete sexual development?

**Dr. Cao:**

I have a son who is 18 years old this year, but his sexual development is somewhat abnormal: his Adam's apple is not prominent, he speaks in a effeminate voice, and his testicles are also very small. Why is he sexually underdeveloped? Can this condition be cured?

Qian XX

Mr. Qian:

Normally, boys reach puberty maturity between the ages of 18 and 24. Signs of maturity include: enlarged testes and penis, a prominent Adam's apple, a deepening voice, the occurrence of nocturnal emissions, and the production of sperm by the testes. Changes in the Adam's apple, body hair, and skeletal structure are medically termed secondary sexual characteristics. If a young man has not yet exhibited these developmental phenomena by age 20, it indicates an impairment in his growth and development; this condition is called male sexual dysplasia.

The most direct cause of male hypogonadism is low testosterone levels in the blood, which fail to stimulate the development of body tissues, thus preventing the appearance of male secondary sexual characteristics. Diseases that can cause this condition can be broadly classified into two categories:

The first type is caused by a lesion in the hypothalamus-pituitary gland in the brain, resulting in the inability to secrete gonadotropins or only in small amounts. This hormone deficiency subsequently leads to testicular hypofunction, preventing the secretion of sufficient testosterone. Many factors, including brain tumor growth and destruction, intracranial infections, head trauma, pituitary surgery and radiation therapy, as well as currently unknown causes, can cause this type of hypothalamic-pituitary lesion. In addition to the absence of secondary sexual characteristics during and after puberty, these patients may also exhibit other distinctive features such as obesity, short stature, and congenital malformations.

The second category is caused by primary diseases of the male gonads-the testes themselves-leading to insufficient testosterone secretion. This change can be seen in primary seminiferous tubule dysplasia, a disease caused by abnormalities in genes that control sex differentiation, and also in orchitis complicated by mumps.

Other causes, such as severe varicocele, frostbite of the testicles, radiation damage, mechanical injury, surgical removal, testicular tumors, or some unknown causes, can all lead to decreased or lost testicular function. Additionally, when the testicles fail to descend into the scrotum as the body grows and develops, a condition known as cryptorchidism, testicular tissue may also be underdeveloped, resulting in decreased sexual function.

Traditional Chinese medicine (TCM) offers effective treatments for male sexual dysfunction. TCM believes that the kidneys govern reproduction. TCM herbal remedies for kidney deficiency can help restore and enhance male reproductive function. Western medicine primarily uses oral medications like methyltestosterone or intramuscular injections like testosterone propionate as supplemental therapy to replenish insufficient testosterone levels, promote physical maturation, and induce the development of secondary sexual characteristics. However, testosterone use requires a doctor's examination and diagnosis, and should only be used under the guidance of a professional physician.

**Cao Kaiyong**