Low Testosterone & Fertility

Low testosterone & male fertility at a glance

  • Testosterone (T) is a key male hormone. Low testosterone occurs when a man’s testosterone drops below normal levels. It can directly affect fertility by causing decreased sperm production and indirectly affect fertility by reducing his sex drive and causing erectile dysfunction.
  • Men with low testosterone levels, called hypogonadism in medical terms and commonly known as low T, can still have enough of the hormone for sperm production.
  • Risk factors for low T include advancing age, obesity, testicular injury, excessive alcohol consumption, chronic narcotic use, marijuana abuse, diabetes and cancer treatments such as chemotherapy.
  • Lifestyle changes such as quitting smoking and losing weight may help balance testosterone levels naturally.
  • Testosterone replacement therapy, a popular way to treat low levels, may actually lower sperm count and should not be used by men trying to conceive.

What is low testosterone?

When an adult male’s testosterone level falls below the normal range of around 270 to 1,070 nanograms per deciliter (ng/dL) he is said to have low testosterone. However, what is a normal testosterone level can differ for individual men.

Low testosterone is also known as hypogonadism, which can be present during fetal development or become apparent in childhood. Hypogonadism can cause a variety of problems. In adults, it can alter physical characteristics, such as decreased hair growth, and hamper normal reproduction.

Testosterone is a male sex hormone (known as an androgen) produced in the male testicles that is required for sperm production. Testosterone also affects a man’s sense of virility and sexual function. Testosterone helps in the development of muscle, bones, the penis and testicles. Both men and women have testosterone, but males have higher amounts.

The primary cause of low testosterone is age, because as men age their testosterone levels will normally drop. This generally begins around middle age. Some physicians consider low testosterone a normal part of aging and recommend doing nothing about it.

But the number of men being treated for low testosterone has increased significantly in recent years. This is because companies now market medications for low testosterone directly to men. (See section below for treatments.)

NOTE: An important side effect of the low testosterone treatment known as testosterone replacement therapy (TRT) is infertility. TRT can decrease sperm production because it also lowers the level of the follicle-stimulating hormone (FSH), which is responsible for stimulating sperm production. In many cases, the infertility caused by testosterone treatment can be reversed.

Therefore, men seeking to conceive with their partner should not use medications to treat their low testosterone.

Low testosterone’s effect on male fertility

Low testosterone does not always directly cause infertility. Men with low testosterone can still produce healthy sperm because sperm production is mainly stimulated by other hormones. However, low levels of testosterone may result in decreased production of sperm. The levels of testosterone in the testicles, where sperm is produced, is much higher than testosterone levels in the blood.

Low testosterone’s indirect effect on fertility involves a reduced sex drive that can result in a lack of desire to even have sex. It can also cause erectile dysfunction by causing a man to have fewer erections or erections that aren’t as strong as they once were. This can make it difficult to reach climax or to have sex often enough for reproduction.

Causes of low testosterone

In addition to natural aging, stress, excessive alcohol consumption, marijuana use, chronic opioid use, soy intake and hormones present in food may all affect a man’s testosterone levels. Low testosterone may also be caused by testicular cancer, early or late delayed puberty and kidney disease.

Some other risk factors for low testosterone include:

  • Obesity
  • Diabetes
  • Injury to the testicles
  • Cancer treatments such as chemotherapy and radiation.

Men can get their testosterone levels tested by their doctor. Usually this test is performed in the morning when testosterone levels are usually at their highest. Blood is drawn and analyzed for testosterone levels. We recommend that men be tested at least twice before taking any action.

How is low testosterone treated?

Whether or not a man seeks treatment should depend on how low his testosterone is and if he is experiencing bothersome degrees of symptoms, including:

  • Reduced sex drive
  • Fewer erections and weaker erections
  • Loss of muscle mass
  • Fatigue
  • Mood swings

Before entering into testosterone replacement therapy (TRT), men should try lifestyle changes first.

Lifestyle changes

SaunaFirst, men should make sure they are taking proper care of their testicles. This includes keeping the testicles and scrotum cool. Men may need to avoid hot tubs and saunas and keep their laptop computers off of their laps.

Some other lifestyle changes that will balance testosterone levels:

  • Stop smoking. Men who smoke have lower levels of varying hormones including testosterone.
  • Losing weight. Overweight men can have diminished testosterone levels.
  • Complementing a nutritious diet with exercise should also help improve testosterone levels.

Testosterone replacement therapy

Clinical therapies are available for men who feel as though their quality of life (sex drive, energy levels, etc.) is affected by low testosterone levels. The popular testosterone replacement therapy (TRT), involves delivering testosterone to boost levels. This can be done in several ways:

  • Injections in the muscle
  • Gels
  • Patches
  • Oral tablets
  • Nasal sprays
  • Implants placed under the skin.

Remember: Men who want to conceive should not undergo TRT.

For more information about male factor infertility, speak with a fertility specialist at LLU today.