Testosterone treatments are known to have a variety of effects on the body, including reducing sperm production and potentially leading to infertility. In most cases, this infertility is reversible, but there are cases where it can be permanent. While testosterone treatments don't normally cause permanent damage to fertility, it's not clear if they play a role in men's ongoing infertility. To understand the effects of testosterone supplements on fertility, it's important to understand how testosterone works in the body and how it can affect fertility. Testosterone is a hormone that has a variety of functions, and is commonly used in older men to treat symptoms of hypogonadism, such as decreased libido, decreased mood, and erectile dysfunction.
Despite its positive effects on sexual function, it has a negative effect on fertility. Exogenous testosterone therapy may adversely affect the hypothalamic-pituitary gonadal axis and inhibit follicle-stimulating hormone (FSH) and luteinizing hormone (LH) production. This inhibition of LH release by exogenous testosterone leads to the suppression of endogenous testosterone production by Leydig cells. The purpose of this review is to discuss the contraceptive properties of testosterone therapy and to discuss strategies for increasing testosterone in men with a desire to preserve fertility. With careful supervision by a healthcare provider, medications to naturally increase testosterone levels may be acceptable for fertility. The testosterone supplement in question is only sold by prescription and is not related to over-the-counter supplements marketed to increase testosterone production.
The Endocrine Society and the American Urological Association (AUA) recommend treating symptomatic men with documented low testosterone levels with serum total testosterone concentrations on an empty stomach. When a man is given exogenous testosterone (just like when a woman takes birth control pills), the hypothalamus and pituitary gland believe that the testicles are already working and that the secretion of FSH and LH is suppressed, leading to lower testosterone production in their own testicles and reduced production or sperm deficiency (a lot (for example, a woman doesn't release eggs while taking birth control pills). Katherine McKnight, a specialist in reproductive endocrinology and infertility at Houston Methodist and CCRM Houston, says she sees a large population of couples with male infertility solely due to the use of testosterone, as high doses of testosterone significantly lower a man's sperm count. Millions of men in the United States use testosterone replacement therapy (TRT) to treat low testosterone levels (low T). The pituitary gland uses testosterone levels in the blood to determine the amount of FSH and LH released for the production of testosterone and sperm. This can cause your brain to think it's producing enough testosterone and sends a signal to the brain to decrease the release of previous hormones (FSH and LH), which promote testosterone production within the testicles. While some of the testosterone altering effects of these medications can be reversed, experts warn that it's best to avoid anything that alters the body's testosterone levels, as it can develop a tolerance.
Options such as clomiphene citrate and hCG should be considered, along with referral to a reproductive urologist, to naturally increase testosterone levels in men with low testosterone levels who want to avoid TRT. When men take testosterone supplements, they increase the amount of testosterone in the blood, resulting in something called negative feedback. The Translational Andrology and Urology article explains that the external form of testosterone causes a negative feedback cycle in the body's natural hormone production, resulting in a decrease in overall testosterone levels in the testicles. To treat low testosterone levels without supplements, you can take an HCG supplement, which will increase your testosterone levels without adversely affecting FSH levels or sperm production. Jenkins says that when external testosterone is introduced into a man's body, the body's natural cycle is disrupted, causing the testicles to stop their natural testosterone production, resulting in testicular atrophy.