Improving Fertility in Men with Poor Sperm Count | UCLA Urology
How Low Testosterone Affects Fertility
You may already know that low testosterone can cause you to lose interest in having sex and to have weaker and fewer erections. But it can also affect your fertility.
“Low testosterone can cause infertility, but it also may represent a testicular problem that results in infertility,”says Harris M. Nagler, MD, chair emeritus of the Sol and Margaret Berger Department of Urology and professor of urology at the Icahn School of Medicine at Mount Sinai in New York.
One treatment for low testosterone is testosterone replacement therapy. But taking testosterone can hurt your fertility, Dr. Nagler says. Here’s why:
A part of the brain (the hypothalamus) and the pituitary gland, which sits just below it, help control male fertility. The hypothalamus produces a chemical, gonadotropin-releasing hormone (GnRH) that sends a message to the pituitary gland to tell it to produce two important fertility hormones: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). FSH triggers the creation of sperm cells. LH tells the testes to produce testosterone, which is needed for sperm production.
When you take testosterone, your brain thinks it's done its job and slows down the production of GnRH. Because it’s not getting the message, your pituitary gland no longer produces normal levels of the other hormones, FSH and LH, needed to make sperm. As a result, your sperm production decreases. The lower your sperm count, the less chance you have of fathering a child.
Men who have low testosterone and are struggling with infertility should see a urologist or an endocrinologist who specializes in male reproduction. After diagnosis, you and your doctor can determine the best treatment for your low testosterone based on your goals, which may be sexual function or reproductive function.
“The treatments are different and need to be tailored to your goals," Nagler says. If fertility is an issue, your doctor may suggest gonadotropin injections to stimulate the testicles to make more testosterone and sperm.
Steps to Boost Fertility
If you have low testosterone, certain lifestyle factors may help boost your fertility. Consider these tactics:
Keep your private parts cool.“Anything that heats up the genital area for excessive amounts of time can lower sperm counts,” says Suzanne Kavic, MD, a reproductive endocrinologist at Loyola Medicine in Chicago. “Sperm don’t like warm temperatures. That’s why the testes are outside the body.” So avoid saunas, hot tubs, and hot baths. Keep your laptop (which can get warm) off of your lap.
Lose weight.Being overweight can change your hormone levels and adversely affect your sperm production. “Men who are obese may have lower testosterone levels because their belly fat converts their testosterone to estrogen,” says Jay Simhan, MD, a urologist at the Einstein Healthcare Network in Philadelphia. “Shedding those extra pounds may have a positive effect on your testosterone and on your fertility.” Even if weight loss doesn’t increase your sperm count, Nagler says, it can make you feel better about yourself and improve your outlook.
Don’t smoke.One study of Saudi Arabian men who visited infertility clinics found that those who smoked had lower reproductive hormone levels than nonsmokers. The study was published in the January-March 2015 issue of the journal Urology Annals. If you smoke, quit.
Be careful with drugs.Some drugs — like steroids and narcotics — can affect sperm production, the Endocrine Society reports. If you need these medications to treat other health concerns, talk with your doctor, Dr. Kavic says. Recreational drugs, including marijuana, also have been linked to low testosterone, according to an article published in the September/October 2014 issue of the journal Trends in Urology & Men's Health.
Limit alcohol.Excessive alcohol consumption can decrease the amount of testosterone in a man’s body, according to the National Institute on Alcohol Abuse and Alcoholism. Alcohol impairs the secretion of the hormones LH and FSH, according to the article in the journal Trends in Urology & Men's Health. “Everyone is encouraged to drink alcohol in moderation for their general health,” Kavic says.
Get enough vitamin D.Chinese men who had lower levels of vitamin D also had lower levels of testosterone, according to a study published in July 2015 in the journal Reproductive Biology and Endocrinology. Good sources of vitamin D include fatty fish, mushrooms, and fortified foods such as cereal. Sunlight also is a source of vitamin D, but limit your sun exposure because of the risk of cancer.
Exercise regularly.Exercise not only helps you lose weight and reduce stress, but it can also help build testosterone, Nagler says. A regular routine of aerobic exercise and strength training is considered the most effective.
Video: Low Testosterone Effects On Sex Drive - Manipal Hospitals
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