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Does low testosterone mean low sperm count: Low Testosterone & Male Infertility

Low Testosterone & Male Infertility

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

First, 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.

Does Low Testosterone Cause Infertility? – Cleveland Clinic

Deciding to start or grow your family is an exciting time. If the test keeps coming back negative, though, you may start to worry — “What if it’s never going to happen for us?” 

It’s a question many people face. The National Institutes of Health estimates 9% of men and people assigned male at birth (AMAB) experience fertility issues.  

In men and people AMAB, decreased fertility is commonly associated with low testosterone levels, commonly referred to as “low T.” Low T = low sperm count = lower likelihood of reproducing. 

The key here, though, is the lower likelihood. Living with low T doesn’t mean you and your partner won’t be able to conceive a child. There are ways to increase your chances. 

We talked with endocrinologist Kevin Pantalone, DO, about how low testosterone affects fertility and how you can increase your chances.      

Testosterone’s role in fertility 

In people whose testosterone levels are in the normal range, a single ejaculation can contain more than 15 million sperm per milliliter. If your testosterone levels are low, your sperm count may also be low, which decreases your chances of conception. 

Let’s get micro for a minute, though. This is the short story of how sperm is created: 

  1. Your pituitary gland (a part of your brain that controls hormone release) produces two hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). 
  2. LH tells your testes to make testosterone. 
  3. Testosterone then works with FSH to produce sperm. 

Dr. Pantalone says a lot of testosterone is needed within your testes to create sperm. So, if you’re experiencing low testosterone, you can get stuck at step 2, which means you ultimately create less sperm.

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“This is the primary issue we see in men related to low testosterone and infertility. Low testosterone means a lower sperm count. That doesn’t mean you can’t conceive, but it does decrease the chances,” Dr. Pantalone notes.  

Additionally, living with low testosterone can impact your sexual function, Dr. Pantalone says. Low libido and erectile dysfunction are common symptoms of low T, which can further lower your odds for conception. 

Testosterone therapy and fertility 

OK, so low T means you need more T, which means you need testosterone therapy, right?

Actually, no. It might sound counterintuitive, but testosterone therapy can actually keep you from producing sperm.

“Testosterone therapy will increase your circulating testosterone in your blood, but it will not increase testosterone in the testicles, which is where it’s needed for sperm production,” Dr. Pantalone explains. “In fact, testosterone therapy can reduce your sperm counter further, so it is not recommended for people who want to start a family.” 

Think of it like supply and demand. When you increase your testosterone through patches, pills, injections or creams, your body thinks it has an ample supply of testosterone and so doesn’t produce more in your testicles. That means the levels of testosterone in your testicles — where it matters for sperm production — will remain low. 

Ways to increase your sperm count

If hormone therapy won’t increase your sperm count, what will?  

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There are a lot of myths about male fertility (no, you don’t have to ditch the tighty-whities if that’s your thing). The truth is that taking care of your overall health can be your best bet to increasing your testosterone levels.  

Proven strategies to increase testosterone and boost sperm production include: 

  • Managing chronic illnesses through diet, exercise and other lifestyle changes. 
  • Injections of human chorionic gonadotropin (HCG) — a hormone therapy that can help your testes increase testosterone levels within your testicles and improve sperm production.  
  • Not smoking. 
  • Not using illegal drugs. 
  • Limiting alcohol use. 

When to see a fertility specialist    

If you know you have low testosterone, or if you and your partner have been trying to conceive for six months to a year without success, a visit to a fertility specialist should be your next step, Dr. Pantalone says.

A fertility specialist can test you and your partner for any fertility issues and recommend options to increase your chances of starting or growing your family. They can also discuss options like intrauterine insemination (IUI) and in vitro fertilization (IVF) with you. Dr. Pantalone says it’s extremely important both you and your partner are evaluated when undergoing an investigation for causes of infertility. 

Living with decreased fertility can be emotionally painful and isolating. People living with fertility issues often report feeling depressed, grief-stricken or inadequate. Supporting your partner, talking with a licensed mental health professional and finding community with others who share your experience can help. Ask your healthcare provider about mental health support, such as therapy and support groups, for people who are experiencing infertility — you’re not alone, and there is hope. 

Personal care: Self-care: Lenta.ru

It is difficult to overestimate the influence of sex hormones on mood, endocrine processes and sexual desire. At the same time, many believe that testosterone is an exclusively male hormone. However, it is also produced in women, albeit in smaller quantities. Lenta.ru tried to answer why both sexes need testosterone and why its deficiency and excess are dangerous.

What is testosterone

Testosterone is the main male sex hormone. It plays a key role in the development and maintenance of sexual function in both sexes, and in men is directly related to reproductive function.

In the male body, this hormone is produced by the testicles and adrenal glands; in the female body, by the ovaries and adrenal glands. In both those and others, it is formed from cholesterol, and its production is regulated by the pituitary gland.

Testosterone in men

In men, testosterone is involved in the development of secondary sexual characteristics and reproductive organs. It is because of him that during puberty, the voice changes in boys, the growth of hair on the body begins. Also, this hormone contributes to an increase in muscle mass, affects the amount of fat and bone density.

Mood, vitality, intelligence, good sleep are associated with testosterone. Sexual desire, erection – also the effect of testosterone

Alexander Lubennikovurologist, andrologist, doctor of medical sciences

Testosterone in women

In women, this hormone is synthesized in a smaller amount, but it is also very important. It is involved in the processes of maturation of the egg, is responsible for the formation of the skeleton and regeneration of bone tissue, and regulates the functioning of the sebaceous glands. In addition, testosterone helps control stress and has a beneficial effect on mood.

In women, testosterone ensures the normal functioning of physiological processes occurring in the central nervous system, mammary glands and ovaries

Tamara Nuraeva obstetrician-gynecologist at the L7 Breast Center

Photo: Taisiia Shestopal / Unsplash

Testosterone affects potency 90 005

Precisely testosterone largely determines the level of male libido. A significant deficiency of this hormone (up to 80 percent of the norm) can lead to erectile dysfunction.

With low testosterone levels, sexual activity decreases, the number of erections decreases

At the same time, this is not the only factor that determines sexual desire. It can be affected, for example, by stress or depression, which can completely discourage interest in sex even with a normal level of male hormones in the body.

Libido also depends on testosterone in women

Testosterone is involved in the regulation of sexual desire in women along with estradiol, the main female sex hormone from the estrogen group.

Sexual activity, as well as the frequency and severity of orgasms in women depends on testosterone

At the same time, the results of scientific studies related to the study of the relationship between testosterone and women’s interest in intimacy are ambiguous. Some experts believe that the exacerbation of sexual desires during the period of ovulation is due to the highest level of testosterone in the body, others are sure that this effect is caused by estrogen, which prevails in the body until the middle of the menstrual cycle.

Testosterone causes aggression

Testosterone also affects behavior. It is widely believed that an increased level of this hormone makes a man more aggressive and risk-averse. Experts have different opinions about whether this is true. According to andrologist Georgy Mskhalay, a man with a high level of testosterone has more needs, more self-confidence, he is more striving for success.

I have a patient who, after normalizing testosterone levels, defended a doctoral dissertation that he could not defend before, and was still wondering if he needed it

Georgiy Mskhalaya andrologist, endocrinologist of the European Medical Center

Testosterone in bodybuilding

Testosterone accelerates the growth of muscle mass, so preparations based on it are often taken by bodybuilders. However, experts believe that this can lead to serious health problems. Unpleasant side effects are possible even after stopping the use of such drugs.

According to the therapist Elena Tikhomirova, testosterone abuse significantly increases the risk of heart attack, stroke and other cardiovascular diseases. And after the rejection of drugs with testosterone, a withdrawal syndrome occurs, against which depression can begin. Infertility is also possible.

There are men who inject themselves with extra injections, use illicit drugs and raise their testosterone levels to five, ten times the norm. Of course, their aggression is higher

Georgy Mskhalaya andrologist, endocrinologist of the European Medical Center

Photo: Steven Erixon / Unsplash

Blood testosterone level

Testosterone level depends on sex, age, time of day, physical activity and many other factors. After the age of 30, the level of this hormone in the blood in men drops by one to two percent per year. By the age of 50, testosterone deficiency reaches 25-30 percent, and this begins to affect health and cognitive abilities.

Experts recommend taking blood tests to determine testosterone levels between 7 am and 11 am, on an empty stomach, since sex hormone secretion is highest in the morning.

Testosterone begins to be produced at night, during the phase of non-REM sleep, and the longer the rest, the stronger its production. Under normal sleep and wakefulness, the concentration of the hormone reaches its maximum by 5-6 o’clock in the morning

Vera BarinovaHead of the NACFF Clinical Diagnostic Laboratory

Men’s testosterone levels

Men’s testosterone levels are 20 times higher than those of women and children, ranging from 12.15 to 37.48 nanomoles/liter.

Age Testosterone level (nanomoles/liter)
after 18 years 12.15 – 37.48
20-39 years old 13. 88 – 37.48
40-59 years 12.15 – 30.88
over 60 years 12.15 – 24.98

A drop in total testosterone below 12.1 nanomoles/liter is cause for concern. In such cases, an additional analysis for free testosterone should be taken.

Testosterone levels in women

Testosterone levels in women are significantly lower. Between the ages of 18 and 49, values ​​from 0.31 to 3.78 nanomoles / liter are considered normal. During pregnancy, this figure may increase several times, but then falls again.

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Age Testosterone levels (nanomoles/litre)
before menopause 0.347 – 1.873
after menopause 0.243 – 1.388

What happens when there is a lack of testosterone in childhood

In boys, low testosterone levels are associated with some congenital disorders, underdevelopment or undescended testicles. As you grow older, its deficiency is manifested by a number of characteristic symptoms: eunuchoid proportions of the body (long limbs, shortened torso), poorly developed muscles, and pale skin.

According to andrologist Alexander Lubennikov, boys with low testosterone also have breast enlargement, no pubic hair, a high pitched voice, a penis less than five centimeters long, and very small testicles.

What are the signs of a lack of testosterone

With a lack of testosterone in men, sexual desire decreases, erection problems begin, and muscle mass decreases. Up to 90 percent of men who have this problem suffer from baldness.

Here are some typical signs of testosterone deficiency:

  • reduced libido,
  • reduced sperm count,
  • erection problems,
  • body hair reduction,
  • breast augmentation,
  • decrease in muscle mass,
  • increased risk of fractures,
  • frequent mood swings,
  • high fatigue,
  • irritability,
  • sleep disorders,
  • cognitive decline,
  • alopecia.

If the testosterone level goes below normal, irritability, nervousness, and internal tension begin to rise. A man becomes more capricious, irritated more easily

Georgy Mskhalayaandrologist, endocrinologist of the European Medical Center

Why testosterone levels fall

In addition to age, in adult men, testosterone levels are reduced by:

  • obesity,
  • testicular injury or inflammation,
  • diabetes,
  • chronic diseases of the cardiovascular and respiratory systems,
  • chronic kidney pathologies,
  • diseases or injuries of the hypothalamus and pituitary gland,
  • taking steroids,
  • alcoholism and drug use.

Low testosterone can be seen in testicular and pituitary disorders such as Klinefelter’s syndrome, Kallman’s syndrome, and in men with idiopathic, metabolic, or iatrogenic disorders leading to androgen deficiency

Alexander Sysoevdoctor urologist-andrologist of the highest category “SM-Clinic”

Lack of testosterone in women

Testosterone levels in women can fall during menopause, with diseases of the ovaries, pituitary and adrenal glands, various pathologies of the thyroid gland, with bulimia and anorexia, when switching to a low-fat diet or taking certain medications, such as glucocorticoids.

Women with low testosterone may experience:

  • insomnia,
  • fatigue,
  • pain in bones and muscles,
  • abdominal obesity,
  • decreased libido,
  • menstrual disorders,
  • cognitive decline,
  • depression.

The main manifestations of testosterone deficiency in women are a general deterioration in well-being and a decrease in sexual desire. Vaginal dryness may also appear, the menstrual cycle is disturbed. Due to the lack of a male hormone, a woman becomes less resilient, her cognitive abilities decrease, and depression may develop

Tamara Nuraeva obstetrician-gynecologist at L7 Breast Center

Photo: Klara Kulikova / Unsplash

How to increase testosterone

If the deviation from the norm is insignificant, testosterone levels can be increased simply by changing lifestyle. According to andrologist Alexander Sysoev, there are several simple means to eliminate the lack of this hormone in one to three months.

  • Regular sleep for at least seven hours a day, and it is important to learn to go to bed and wake up at the same time
  • Moderate and regular exercise. It is better to do gymnastics or run for half an hour every day than to do four hours of strength training once a week
  • Stop smoking and alcohol, stop taking steroid supplements
  • Refusal of fatty, smoked and fried foods. Also, do not get carried away with sweet desserts
  • Eating fresh marine fish, seaweed or other seafood containing zinc

An increase in physical activity can lead to an increase in androgen levels in both men and women, which has been proven by numerous studies. At the same time, strength training is considered the most effective. Treatment of concomitant diseases, weight loss and dietary review will also help to adjust the level of androgens

Tamara Nuraeva obstetrician-gynecologist of the L7 Breast Center

It should be understood that such methods work only in cases where testosterone deficiency is caused by temporary problems – for example, a sharp change in the daily routine and lifestyle, stress, strong feelings. If this is not the case, then a specialist should deal with the normalization of testosterone levels. If necessary, the doctor will conduct additional examinations and select an effective therapy.

Excess testosterone is also dangerous

Increased testosterone levels in men lead to cardiovascular diseases – hypertension, stroke, heart attack and thrombosis. In addition, it interferes with the formation and maturation of spermatozoa, increases the likelihood of developing prostate and breast cancer, and can lead to impaired urination. Excess testosterone in men may indicate a tumor of the testicles or adrenal glands, hyperthyroidism.

Baldness is one of the most common consequences of high testosterone in women

In women, androgen imbalance provokes the activity of the sebaceous glands, which exacerbates acne and worsens skin condition. Coarse hair begins to grow on the chin, cheekbones and upper lip, the voice becomes deeper and rougher, the clitoris increases in size, and the risk of breast cancer increases. A similar picture can be observed with diseases of the ovaries and adrenal glands or taking certain medications that include this hormone.

Male hormonal infertility | Useful from the clinic “Genome” in Rostov-on-Don


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/Male hormonal infertility

Disruptions in the endocrine system lead to changes in hormonal status. In men, against this background, there is a violation of the process of spermatogenesis. As a result, the quality of sperm decreases and there are problems with conception. In such cases, they talk about male hormonal infertility. Usually, it is caused by a lack of androgens or an excess of prolactin.

Androgens are mainly produced by the testicles – about 95-98% of the total volume. The rest of them are produced by the adrenal cortex. The main androgen is testosterone. He is responsible for the production and maturation of sperm – spermatogenesis. If the sex hormones are not produced enough, then hypogonadism occurs.

Primary or testicular hypogonadism occurs due to damage to the testicular tissue. As a result, the function of the testicles as the main organ responsible for the production of male sex hormones is disrupted. At the same time, FSH and LH levels are high, and testosterone levels are low.

Secondary hypogonadism appears as a result of hypothalamic-pituitary disorders. Insufficiency of the hypothalamus or pituitary gland responsible for producing enough FSH and LH leads to a decrease in both FSH and LH levels and total testosterone.

From about the age of 30, testosterone levels in men decrease by 2-3% annually. In this regard, allocate age-related hypogonadism. It is found in 40% of men over 50 years of age.

With hypogonadism (lack of testosterone) in men, a drop in fertility occurs, that is, a man becomes incapable of becoming a father.

Lack of testosterone also leads to the following phenomena:
– depressive states;
– decrease in muscle volume;
– overdrying of the dermis;
– anemia;
– impotence;
– Accumulation of fatty deposits in the abdomen.