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There’s very little risk to getting a testosterone blood test. The entire procedure (blood draw) for a testosterone test usually takes less than five minutes. Free testosterone is easier for your body to use. A testosterone level that’s too low or high can cause health problems regardless of your sex. Your body functions best when your testosterone is in a certain range. Levels of testosterone are naturally much higher in males. More specifically, the testicles in males and the ovaries in females make testosterone.
Part of this may be due to the difficulty defining "normal" testosterone levels and "normal" behavior. If a man has been prescribed TRT for low testosterone and wants to have children, that should be a part of the conversation with his healthcare provider, since TRT can affect fertility. "Get a baseline sperm count to know what his natural levels are and consider banking sperm in case his sperm count doesn’t return if he stops treatment." Hone’s at-home assessment measures testosterone levels.
ASRM has prepared resources to help you explain and advocate for reproductive rights and the continuation of in vitro fertilization and other fertility treatments. ASRM 2025 reveals support for IVF access, wildfire smoke's fertility risks, and how insurance mandates improve outcomes in reproductive health care. About 20% of infertility cases are due to a male factor alone. Fertility specialists for males will prescribe these drugs, because sometimes they can act to lower sperm counts if they are used incorrectly. There are some medications that can lower estrogen levels in your body. Testosterone can be measured by a simple blood test and are usually measured in the morning, since that is when levels are highest in men.
FSH levels decreased by 52% in the testosterone gel group, and by 27% in the 2 mg and 37% in the 4 mg progestin groups . Another study showed that 6 months of 0.5–5.0 g of testosterone gel (1%) for 28. Compared with initial values, LH (from about 3 to 1 IU/L) and FSH (from about 5 to 2 IU/L) levels significantly and chronically decreased for the duration of the intervention without additional improvements after 6 months.|After 6–12 months of treatment, all patients could ejaculate, and spermatogenesis was recovered in 71% of the patients . The mean first sperm density was 22.6 million/mL, with average FSH levels of 4.04 mIU (an increase of 191% vs. baseline), average LH levels of 3.12 mIU (an increase of 267% vs. baseline), and average testosterone levels of 475.8 ng/dL (a decrease of 17.0% vs. baseline) . The mean baseline FSH, LH, and testosterone levels before termination of testosterone therapy were 1.39 mIU, 0.85 mIU, and 573.5 ng/dL, respectively. In this case, it is crucial to understand which drugs can restore endogenous testosterone and sperm production. The testosterone levels did not show significant changes from pre- (616 ng/dL) to post-treatment (596 ng/dL) .|This hormonal shift can also lower sperm count and affect fertility. Extra body fat, especially around the stomach, is linked to lower testosterone. This includes semen analysis, hormone levels, imaging, and possibly genetic tests.|General fatigue and malaise has so many other causes, and when most men get a blood test, the result is a normal testosterone level. Just being tired isn't enough to seek testosterone replacement therapy. To help you learn more about testosterone, we sat down with Irene Cheung, MSN, APRN, FNP-C, a family nurse practitioner and clinical lead at Labcorp, who answered your top questions about this important hormone. It is recommended to consult with a healthcare provider if you have any questions about your results or symptoms. If you were assigned female at birth (AFAB) and are seeking testosterone testing, consider the Total Testosterone Test for Women. This comprehensive testosterone panel includes measurements of albumin, sex hormone-binding globulin (SHBG), and total and free testosterone.|Regular meals and balanced nutrition help keep insulin and blood sugar steady, which also supports hormone health. Even a 5% to 10% weight loss can improve testosterone levels. Another test called Y chromosome microdeletion testing can find missing parts of DNA that are needed for sperm production. Some chronic medical conditions can lower testosterone levels as well.|This hormone signals the pituitary gland to secrete luteinizing hormone (LH) and follicle-stimulating hormone (FSH). The hypothalamus, a small region at the base of the brain, releases gonadotropin-releasing hormone (GnRH). Whether you're planning a family now or want to keep your options open for the future, understanding this hormone could be a game-changer. Testosterone isn't just the hormone that fuels muscle growth, deepens voices, and powers sex drive. Studies show sperm counts have dropped by 50-60% in the last 40 years.|Although this new information is somewhat reassuring, men and their doctors should still weigh these issues before committing to long term testosterone therapy. For men who clearly have testosterone deficiency, there is no apparent increased risk of heart attack or stroke or greater chance of developing a new prostate cancer from testosterone replacement therapy. If a man's testosterone is below the normal range, it's best to repeat it once more to be sure before starting testosterone therapy - often staying on it indefinitely.|Chronic anxiety or tension can diminish sperm count and sexual function. Antioxidants fight oxidative stress in the testes, protecting sperm DNA and quality. A balanced diet rich in testosterone-supportive nutrients is key.|These medications are taken once or twice a week and are often used together with other fertility treatments. Some men with low testosterone have higher estrogen levels, especially if they are overweight. Aromatase inhibitors, such as anastrozole and letrozole, are pills that stop the body from converting testosterone into estrogen. This tricks the brain into thinking the body has low estrogen, which leads to increased production of LH and FSH. Gonadotropin therapy is often used in men with low sperm counts or azoospermia (no sperm).}
About two-thirds of formerly azoospermic men regain measurable sperm within a year; the rest need longer or do not return to their old baseline. Stopping therapy lets GnRH, LH, and FSH wake up, but recovery is not instant. LH triggers the Leydig cells in the testes to make testosterone. The brain’s hypothalamus releases gonadotropin-releasing hormone (GnRH).
Mood swings, low libido, and erectile dysfunction are symptoms that can seriously impact your relationship. Read real-life stories from patients who have faced reproductive medicine challenges and come out stronger on the other side. One way that ASRM works to improve access to fertility care is by advocating for insurance coverage for reproductive medicine care..|Many men may not realize that these symptoms are linked to low testosterone. Testosterone helps make sperm, the male reproductive cells needed for fertilization. There are a lot of myths about male fertility (no, you don’t have to ditch the tighty-whities if that’s your thing). OK, so low T means you need more T, which means you need testosterone therapy, right? "This is the primary issue we see in men related to low testosterone and infertility.|Testosterone plays a key role in sperm production, so low levels can affect the ability to have children. A full medical evaluation can help find the exact cause and guide the best treatment to protect both hormone health and fertility. Stress causes the body to release cortisol, a hormone that blocks testosterone production. This causes their testicles to be smaller and work less effectively, often leading to both low testosterone and poor sperm production. If a man is responding well, testosterone levels rise and sperm counts improve. Like clomiphene, they are safe for fertility and do not block sperm production. The brain responds by making more LH and FSH, which then boost testosterone and sperm production.|After 12 months post-cessation, more than 98% of the participants recovered normal sperm production . Therefore, not only TRT patients but also AAS users might face similar side effects related to male infertility. Therefore, if testosterone is administered exogenously, the hypothalamus will sense this and downregulate GnRH release, leading to impaired endogenous testosterone and sperm production in the testes. When serum testosterone levels rise, a signal to suppress the production of GnRH from the hypothalamus is sent, leading to an inhibited release of LH and FSH by the pituitary gland.|Restorative reproductive medicine overlooks IVF, male-factor care, and the need for full-spectrum fertility treatment using modern technologies. All men have estrogen in them but lowering it may help with sperm production. Sperm production is stimulated by hormones other than testosterone. However, it is important to know that testosterone treatment usually leads to either low sperm counts, or no sperm seen whatsoever in the semen. Older men or men who have been taking testosterone for long periods of time may not achieve sperm quality recovery after treatment has stopped.|Sperm production takes approximately 74 days — meaning heat-related effects on fertility are temporary but require weeks to fully reverse after stopping exposure. Spermatogenesis — the production of sperm — requires temperatures 2-4°C below core body temperature. Podstawski et al. 2021 ('Endocrine Effects of Repeated Hot Thermal Stress') documented that short-term sauna exposure can acutely increase testosterone and growth hormone levels. A 35-year-old man today often has the testosterone levels of a 50-year-old man from decades past. Men today have approximately 15–25% lower testosterone levels than men of the same age just one generation ago. Not everyone with low testosterone has symptoms (like low sex drive, fertility problems or erectile dysfunction).|One study looked at the outcomes of short-acting testosterone (a 4.5% nasal gel; Natesto®) on testosterone, gonadotropins, and sperm parameters for a period of 6 months . LH and FSH concentrations steadily decreased after injection until day 10 and then recovered to basal levels, while testosterone levels were still below initial levels . Serum testosterone levels continued to decrease below basal levels on days 12 and 14 and then returned to basal levels. Serum testosterone levels increased sharply, peaking on days 1 and 2 after injection, following a gradual decrease to basal levels on day 10 (from ~3–4 mIU/mL to ~0.2 mIU/mL).}
One meta-analysis about testosterone as a short-term hormonal contraceptive in eugonadal men showed that the mean probability of sperm recovery to 20 million sperm/mL was 67% within 6 months, 90% within 12 months, 96% within 16 months, and 100% within 24 months . One study examined the impact of anastrozole in men with elevated E2 levels due to testosterone therapy . Increased estradiol levels enhance the feedback in the hypothalamic–pituitary axis, triggering decreases in LH, FSH, and testosterone production. Aromatase inhibitors have been prescribed to treat male infertility for a long time, but there is no consensus about the efficacy and safety of AIs in the treatment of male infertility to this day. Serum testosterone levels should be closely monitored since the addition of a SERM can increase testosterone even more. However, HCG alone probably triggers similar increases in serum testosterone levels. During the 9 months of TRT and 6 months of additional HCG treatment, serum FSH was inhibited from about 120 ng/mL to undetectable levels of 50.|These results suggest that male infertility occurs about 3 months into treatment with injectable testosterone undecanoate. Another study showed that 20 patients treated with TRT for erectile dysfunction and androgen deficiency for 4–12 months (with a median of 8 months) all recovered serum hormone levels and sperm concentrations (≥15 × 106/mL) after 2–11 months (with a median of 8 months) . Thereafter, he was treated with clomiphene citrate (CC) at 50 mg/day, 5 days a week for 3 months, and his testosterone levels recovered (12.25 nmol/L), but only one mature sperm with normal motility and morphology was found in his ejaculate. Cardiovascular, metabolic, and sexual functions, bone and muscle mass, and mental health can be impaired if testosterone levels are low, while testosterone replacement therapy has been shown to improve these parameters 1,2,3,4.|These are not all the possible side effects of Male Excel’s Testosterone Lipoderm Cream. Tell your healthcare provider if you have any side effect that bothers you or does not go away. Inform your healthcare provider of all medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Male Excel’s Testosterone Lipoderm Cream can transfer from your body to others, including children and women. Male Excel l’s Testosterone Lipoderm Cream is a controlled substance (CIII) because it contains testosterone that can be a target for people who abuse prescription medicines.|Be sure to talk to your doctor about fertility before starting treatment with any type of testosterone therapy. It is actually not uncommon for men who want to have children and need testosterone replacement therapy to have their sperm preserved before starting treatment. If you intend to have children and plan to take testosterone for any reason, it is important to discuss the effects of treatment on fertility with your doctor. Testosterone may be prescribed by a doctor for either male hypogonadism (low testosterone) or for masculinizing hormone therapy. With careful evaluation and personalized treatment, it’s possible to improve symptoms of low testosterone and protect fertility at the same time.|You’re a candidate when you have both consistent low levels and symptoms. This guide breaks down exactly when therapy helps, how it’s diagnosed, the safest treatments, and how to monitor results with confidence. Even with an abnormally low level that is replicated on a repeat test, the decision to begin testosterone replacement therapy and the proper dose requires a careful conversation with your doctor. However, the wisdom and effectiveness of testosterone treatment to improve sexual function or cognitive function among postmenopausal women is unclear. Although testosterone may make prostate cancer grow, it is not clear that testosterone treatment actually causes cancer. For example, problem with function of pituitary gland or adrenal glands may lead to reduced testosterone production. As surprising as it may be, women can also be bothered by symptoms of testosterone deficiency.|Moreover, patients on clomiphene treatment did not show increases in hemoglobin, PSA, or cholesterol levels . One meta-analysis showed that clomiphene citrate is a potent drug for treating both the biochemical as well as clinical symptoms of hypogonadal patients, with few reported side effects and good safety aspects . However, testosterone therapy seems to be superior in increasing testosterone and treating hypogonadal symptoms . Clomiphene has been shown to be effective in elevating testosterone levels in hypogonadal men. AI monotherapy in hypogonadal oligo-azoospermic patients is still not completely understood to this day, but the results look promising.|Some men who have a testosterone deficiency have symptoms or conditions related to their low testosterone that will improve when they take testosterone replacement. All of this reduces the active (free) form of testosterone in the body. In recent years, researchers (and pharmaceutical companies) have focused on the effects of testosterone deficiency, especially among men. In addition, what may seem like a symptom of testosterone excess (see below) may actually be unrelated to this hormone. Blood levels of testosterone vary dramatically over time and even during the course of a day.}
When men have more fat tissue, more of their testosterone gets turned into estrogen, leading to lower testosterone levels. Fat cells in the body turn testosterone into estrogen, a hormone usually found in higher amounts in women. If the brain does not send enough of these hormones, the testicles will not make testosterone, even if they are healthy.
Most healthy men on TRT become oligospermic or azoospermic within months. The result is a steep fall in sperm count that can reach complete absence of sperm (azoospermia) in three to six months of steady therapy. When TRT floods the bloodstream with testosterone, the hypothalamus senses "enough hormone" and slows GnRH. When this happens, sperm production may be affected more severely. Even if testosterone is low in the blood, the level inside the testicles must remain high for sperm to grow properly.

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