Dr. Puneet Masson
It seems logical: If a man is struggling with fertility because of low sperm count, then more testosterone should help, right?
After all, testosterone is the top dog of hormones for male sexuality and reproduction. It’s produced in the testicles and is needed to rev the sex drive, stimulate erections and produce sperm, according to the Endocrine Society.
So, wouldn’t taking a testosterone supplement help a guy who has a low sperm count?
“Absolutely not,” says Puneet Masson, MD, Director of the Male Fertility Program at Penn Medicine. “This is a blanket, bold-faced rule: Men have to avoid any supplements that have testosterone if they’re trying to achieve a pregnancy.”
Why Testosterone is off-limits
Below are three reasons why testosterone is off-limits for those struggling with male infertility.
More testosterone is not better
The pituitary gland in your brain tells your body how much testosterone to produce. Normal testosterone levels encourage an adequate sperm count. Too much testosterone, however, sends the wrong signal to the brain.
“Think of the testosterone like a garden. Immature sperm are seeds. Mature sperm are flowers,” Dr. Masson explains. “The amount of testosterone in your testicles is like fertilizer. There has to be enough fertilizer in the soil to make adequate, good sperm.”
“But if someone is taking external testosterone, it’s telling the brain, ‘Oh, there’s enough in the body. Chill down the sperm production,” Dr. Masson adds. “That can actually lead to a substantial decrease in testicular testosterone, which is what you really need for good sperm health.”
Some supplements are not reputable
When you go to your local health food store for a supplement, you’re actually picking up a substance that has no regulation from the US Food and Drug Administration (FDA).
Since 1994, the supplement industry has been self-regulated, according to the FDA. Unlike pharmaceutical drugs, the companies that make supplements don’t have to test for safety or efficacy, and they don’t need FDA approval before being sold.
“People have to be careful about what they’re taking,” warns Dr. Masson. “On any drug commercial, half of the vocals are devoted to warning about all the side effects. But with supplements, you don’t have that regulation.”
A testosterone supplement will not spell out how much testosterone it actually contains or how that may harm fertility. The package also may not clearly disclose that it contains testosterone, as with some bodybuilding supplements.
“When my patients have been taking supplements, many times I make them take pictures and send them to me or bring them during the next visit,” Dr. Masson says.
“I’ve been in this industry long enough, so I know what to look out for,” he adds. “If there is not enough information on the label about testosterone agents, I make them stop taking it—just to be on the safe side.”
Taking testosterone can prolong male infertility struggles
Let’s say you’ve been taking testosterone supplements for a while. The supplement could have boosted the testosterone level in your bloodstream, but likely minimized what you have in your testicles. After all, medical tests gauge how much testosterone is in your blood but do not accurately report the testosterone level in your testicles.
“Since testosterone is made in the testicles, the amount of testosterone in the testicles can be 50 to 100 times higher than what you have in your blood,” Dr. Masson explains. “Now, we have no way of measuring how much testosterone is in the testicles, so we use what’s in the blood as a surrogate.”
Just as testosterone filters into your bloodstream, it can take time to filter out.
“Depending on how long the guy has been on the supplement and what he’s taking, it could take anywhere from four to six months before his testosterone levels return to normal,” Dr. Masson explains. “If he’s taking supplements that he’s obtained illegally or on the black market, it could take a lot longer.”
That’s additional time of not achieving a pregnancy tacked on to the year or more that you’ve already been trying.
The good news: better options are available
Testosterone may be off-limits, but other supplements and lifestyle changes can boost sperm production and quality.
“I put all of my patients on antioxidants. Those are supplements that prevent sperm DNA damage”, explains Dr. Masson. “That leads to good quality sperm.”
Plus, don’t forget the tried-and-true methods of addressing any health condition.
“It’s important to make sure you just have a heart healthy diet, you exercise regularly and get enough sleep,” says Dr. Masson. “All those habits are important for your general health, but they can also lead to good reproductive health.”