Thinking about testosterone for the gym, wellbeing or your health? There’s something important you might not have considered: your sperm.
Testosterone has become a hot topic. From gym and fitness culture to conversations about men’s health, energy, mood and wellbeing, more men are considering testosterone treatments or using testosterone and anabolic steroids to change how they look or feel.
But there’s one part of the conversation that often gets overlooked: fertility.
At NUH Life, we’re seeing men come to our fertility clinic with severely reduced or even absent sperm production after taking testosterone. In some cases, they had no idea their testosterone use could have such a significant impact on their fertility.
So how does this happen?
More testosterone doesn’t mean more sperm.
It might seem logical that having more testosterone in your body would be good for sperm production. After all, testosterone is an important male sex hormone.
But sperm production is more complicated than that.
Your brain, pituitary gland and testes work together as a carefully balanced system. The brain sends hormonal signals to the testes, helping them produce the very high levels of testosterone inside the testes that are needed for sperm production.
When you take testosterone from outside the body, your brain detects that there is already plenty of testosterone around. It responds by reducing the signals that tell your testes to make their own testosterone. That can dramatically reduce the testosterone available inside the testes – and, as a result, sperm production can fall significantly or stop altogether. In some men, this can lead to azoospermia, meaning no sperm can be found in the semen.
“But I’m only taking it for the gym…”
That’s one of the reasons this is important information. Testosterone and anabolic steroids aren’t only being discussed in fertility clinics. They’re increasingly visible in fitness and social media spaces, where conversations often focus on muscle growth, performance, appearance, energy and wellbeing.
Fertility isn’t always part of that conversation.
But whether testosterone is being taken under medical supervision or used for performance or physique purposes, exogenous testosterone can suppress your body’s natural sperm production. The effect can be particularly important for younger men who aren’t thinking about starting a family for many years.
You might not want children now, but you may want the option in the future.
What if I’m taking testosterone and want children?
Don’t panic, but don’t ignore it either. Suppression of sperm production caused by testosterone can be reversible after stopping treatment, and sperm production can recover in many men. However, recovery isn’t necessarily immediate and the timeframe varies from person to person. Some men may need several months or longer before sperm production returns.
If you’re taking prescribed testosterone, don’t stop your medication without speaking to the clinician who prescribed it. If you’re planning to have children, or want to preserve your future fertility, tell your doctor or fertility specialist about any testosterone or anabolic steroid use. There may be alternative approaches depending on why testosterone was prescribed and what your fertility goals are.
What does this mean if you’re thinking about becoming a sperm donor?
This is particularly important if you’re considering donating sperm. Before you can donate, you’ll go through health and fertility screening to make sure you’re suitable to donate. If you’re currently taking testosterone or anabolic steroids, it’s important to tell the clinical team.
You may need to stop using testosterone and allow time for your natural sperm production to recover before you can be assessed as a donor.
Don’t assume you’re not eligible – and don’t stop prescribed medication without medical advice. Our team can talk you through what your individual circumstances mean for donation.
The takeaway
Testosterone might be marketed as a way to build muscle, improve performance or support wellbeing, but more testosterone doesn’t mean more sperm.
In fact, taking testosterone from outside the body can send the opposite message to your reproductive system and switch down the signals responsible for sperm production.
If you’re thinking about testosterone treatment, already taking it, trying for a baby, or considering sperm donation, make fertility part of the conversation. It’s much easier to make an informed decision about your fertility when you know the facts.
Thinking about becoming a sperm donor?
If you’re a healthy man aged 18-45, find out more about donating with NUH Life. Our team can answer your questions, explain the screening process and help you understand whether you’re eligible to donate.
