Dr. Rohit Gutgutia is the Medical Director at Nova IVF Fertility, Eastern India
What is testosterone?
Testosterone is a hormone that is produced primarily in the testicles for men. This hormone is essential to the development of male growth and masculine characteristics. Testosterone production increases about 30 times more during adolescence and early adulthood. As age advances, especially after 40 years, the levels fall by nearly 1% per year.
What testosterone does?
Testosterone plays an important role in men for:
- Building muscle mass
- Fat distribution
- Development of facial and pubic hair
- Voice change in males
- Sexual drive and libido
- Verbal memory and thinking ability
- Improved mood
- Bone strength
- Healthy heart functioning
- Maintain sperm production
What is testosterone supplementation?
When testosterone is pushed into the body in the form of either gels, skin patches or intramuscular injections, this is called as testosterone supplementation. This supplementation is prescribed for men who have symptoms of low testosterone levels, medically termed as “hypogonadism”and have documented low levels of serum testosterone. When replaced, many of the positive effects of testosterone are regained. There is a misconception among men that testosterone supplementation can make them feel younger and more vigorous. Millions of men worldwide take testosterone supplements to treat diminished libido and erectile dysfunction, and to improve strength and physical function.
What is the difference between testosterone supplementation and performance enhancing steroids?
While Testosterone supplementation only achieve physiologic (natural) levels of hormone in the blood, performance enhancing steroids used by athletes or body-builders contains much higher doses of testosterone and most of the times in combination with other steroids. These help them to achieve significant muscle mass in a short period of time.
Risks of testosterone supplementation:
There is a risk for prostate cancer and worsening symptoms of benign prostatic hypertrophy, liver toxicity and tumor, worsening symptoms of sleep apnea and congestive heart failure, gynecomastia, infertility and skin diseases.
How testosterone supplementation affects male fertility?
Testosterone replacement therapy is not appropriate for men who are interested in fathering a child. Testosterone treatment decreases sperm production by decreasing levels of another hormone called Follice Stimulating Hormone (FSH), which is important for stimulating sperm production in the testis. In most cases, the infertility caused by testosterone treatment is reversible. Men who have received testosterone for a shorter period of time probably recover more quickly. For a small percentage of men, the infertility is not reversible.
What are the options if someone on testosterone supplementation wants to father a child?
Consult with a fertility physician. He may ask you to stop taking testosterone and have hormone tests and semen analyses checked periodically as it could be months before the sperm count returns to baseline. Men of reproductive age should avoid testosterone treatment if they want to have biological children or consider freezing sperm for use later.