Is more testosterone better? Does it make the sperm super?
Actually, the contrary occurs. Testosterone is very important for men as it is responsible for normal libido, muscle tone and sperm health. But, if a man takes these hormone in the form of an injection or gel/cream, it can cause infertility by impairing or eliminating sperm production.
The reason for this is that testosterone supplementation can cause supra-physiologic levels of this hormone’s in the blood stream. These can shut down the production of some important hormones by the brain that stimulate the production of sperm. Men on these supplements often end up with no sperm in the ejaculate.
It can take months or even years for the sperm production to return to normal even after stopping supplements
It makes us cringe when a couple comes in for an infertility evaluation and the male partner tells us that he has been on testosterone because of fatigue and “low-T“ levels. This is probably one of the worst things to do for a man if he wants fertility and a family.
Body builders who intentionally take anabolic steroids to build muscle are especially prone to azoospermia (no sperm in the ejaculate). So, never start testosterone supplements without a very good reason and talking to an infertility specialist.
Primary care doctors are unfortunately not all aware of this effect of this hormone pertaining to fertility. If supplementation has to be initiated for whatever reason, then it may be worth considering freezing some semen specimens prior to starting therapy.
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