Texas Fertility Center San Antonio

Testosterone Use and Infertility

The link between testosterone use and infertility in men

Dealing with infertility is not easy. This is true for both men and women. Lots of men don’t realize that taking certain workout supplements, specifically (anabolic) steroids could be causing the problem. Testosterone and its derivatives, sometimes used to enhance strength and muscle mass, can lower sperm counts significantly, sometimes to zero.

High testosterone levels lower sperm production

When testosterone and similar substances are taken to promote muscle gain, the brain interprets the increase in testosterone as coming from the testicles. As a result, the brain reduces stimulation of the testicles, leading to lowered production of both testosterone and sperm. When testosterone is supplemented, the testicles can shrink and sperm counts can fall to zero. In a sense, giving a man testosterone is similar to giving a woman estrogen (i.e. a birth control pill). Similar to estrogen, which usually blocks ovulation, testosterone will reduce sperm production, reducing the chance of pregnancy significantly.

Once testosterone supplementation is stopped, it can take as long as three months to see an increase in sperm parameters. If a man has been taking testosterone supplementation for a long time, the return of sperm production can take many months. It is also possible that it may not return at all.

High levels of testosterone and similar steroids can cause many other issues, some of which may be irreversible:

  • Adult acne
  • Gynecomastia (male breast enlargement)
  • Liver disease
  • Heart attacks
  • Strokes

It is critical for men to understand the link between steroid use and male infertility, as well as the increase in short- and long-term health issues that can result from high testosterone levels.

When is testosterone use appropriate?

Testosterone is frequently prescribed to men who have low serum (blood) testosterone levels. Low testosterone can cause fatigue, irritability, low libido, low sperm counts, and even osteoporosis over time. As testosterone is necessary for normal sperm production, one might think that giving testosterone to men with low testosterone production would boost sperm production. To the contrary, however, due to a complicated hormonal feedback mechanism, even low dose testosterone supplementation can further suppress sperm production.

Fortunately, there are alternative medicines that can be prescribed that will improve the testosterone level and increase the sperm count at the same time.