Episode 5: Testosterone and Azoospermia

Roadshow 5We all want to be that guy at the gym. You know, the guy with the tree trunk neck dead lifting weights the size of two modest Hyundai sedans. No one would ever accuse that guy of shooting blanks, not just because he looks like he could probably crush you without even setting down his protein shake, but because he looks like the model of testosterone. Testosterone can get you ripped, but it can also hit a guy right where it counts. We sat down with Dr. Werthman to find out exactly what testosterone does to your fertility. Trust us, you might not envy that guy at the gym anymore…

It Rubs The Lotion on Its Skin

So let’s get one thing out of the way: any kind of testosterone, when taken externally, can cause men to stop producing sperm. Testosterone lotions or gels contain chemicals whose side effects can cause azoospermia. They are just as bad for you as testosterone injections. If you have low testosterone and are trying to conceive, there are other medicines that can boost testosterone internally, without hurting your swimmers.

Who messed with the thermostat?

Here’s a bio lesson: your brain makes the hormones FSH and LH, which go in to the bloodstream and are taken up by the testicles. The testes’ job is to produce testosterone and make sperm. The LH causes the release of testosterone. The FSH causes and sustains sperm production. Once the testosterone is produced, a signal is carried to the brain. The brain gets the signal that testosterone is being produced, so it stops making FSH and LH. No FSH and LH means no testosterone or sperm. When the levels of testosterone start falling, the brain clicks on like a thermostat, producing those hormones again and starting the cycle over.

When you take external testosterone, either through a shot or a lotion/gel, you are flooded with testosterone that could last from 24 hours to 3 days. This causes the brain to shut off because your receptors are so saturated, meaning no FSH/LH gets sent to the testicles, so they stop making testosterone and sperm.

If you’re azoospermic (shooting blanks) because of external testosterone supplements, it’s fairly easy to treat. Your doctor will take you off of the testosterone and increase FSH and LH. 90% of men who are azoospermic because of external testosterone will make a full recovery, while 10% will remain sterile.

You aren’t the only one

If you’ve taken external testosterone and are suffering from azoospermia, you aren’t alone. Dr. Werthman has seen an increase in testosterone caused azoospermia. He says this is due to the increased advertising by drug companies, as well as a lack of information on behalf of the doctors who prescribed the testosterone.

What we learned

Juicing is really, really bad for babymaking. Seriously. Don’t do it. Just don’t. Also, long term use of testosterone can cause permanent damage to your testicles. If you are on external testosterone now, talk to your Doctor about natural alternative. Don’t be that guy at the gym.

Watch our full interview with Dr. Werthman on Testosterone and Azoospermia here.

Sara SDx

Sara SDx

Editor of Don't Cook your Balls, Co-Founder of TrakFertility.com, Health Coach and Men's Health Advocate. Passionate about sperm, men's health and helping people build their families.
Sara SDx

Author: Sara SDx

Editor of Don't Cook your Balls, Co-Founder of TrakFertility.com, Health Coach and Men's Health Advocate. Passionate about sperm, men's health and helping people build their families.

14 thoughts on “Episode 5: Testosterone and Azoospermia”

  1. Doctor,

    I am 33 Years old ,with 1ML Semen volume , Ph 7.3 , Viscous – Normal, Colour – Pale greyish white , Sperm – NIL (0)

    My recent reports shows Testosterone Total – 437.32 ng/dl , TeTestosterone free- 12.2 pg/ml . FSH = 2.73 mIU/ml

    I have no problem in doppler scrotl , this is good (Bilateral no obvious features of Varicocele )

    LH 4.27 mIU/ml, FSH : 2.73 mIU/ml, and testoteron total- 437.32 ng/dl
    testoteron Free- 12.2 pg/ml

    My doctor suggest me to take testosterone medicines ? As I know it will kill the sperm if it was existing on my testicle.

    Rejuspermin , Tamoxifen , Maxoza

    Thanks for the advise.

    Could you please suggest : I will get sperm more than 0 in 3 months

    Would you suggest if its curable with medicines or what precations we need to take for this ?

    Please advise


    1. This looks like a potential obstructive azoo.
      Testosterone normal
      LH / FSH = normal

      I would totally NOT take testosterone. These medications seem ok to me, based on what I can learn about them. 2 of them are nutritional supplements and 1 is similar to clomid which is a safe way to try to boost T.

      I am not sure they will be effective… I’d recommend finding a urologist for a second opinion or requesting additional testing. My suspicion is that there may be a blockage somewhere.

  2. Doctor, I was diagnosed azoospermia with LH 4 mIU/ml, FSH 12 mIU/ml, and testoteron 6.7 nmol/L

    My doctor suggest me to take testosterone therapy. Is that good idea? As I know it will kill the sperm if it was existing on my testicle.

    Thanks for the advise.

  3. Hello Dr,

    My first semen analysis was done in Dec 2016 and I was diagnosed with azoospermia. Without taking any treatment, second semen analysis was done in March 2018 and it showed sperm count 4.6 million. Seeing this report, urologist advised me for a hormonal analysis – LH was 6.52, FSH was 2.6, serum prolactin was 7. 45 and total testosterone was 266. Seeing this, they advised me testosterone supplements. After taking supplements for approx 45 days, i went through semen analysis again and it came Zero. After this I came across many articles which said testosterone supplements can cause sperm count to drop. Scrotum sonography did not showed any abnormality. I am 33 years old. Doctor has suggested testicular biopsy and then IVF. My question is, can my sperm count become normal again so as my wife can conceive naturally?

  4. A nutritionist had my husband on the TRT “Aveed” as his testosterone levels were low on blood work. Unknowingly we thought the Aveed shots would boost his libido and sperm production as we were ready to conceive. As a result of the shots, my husband has Azoospermia. He has been off of the shot for 95 days with two tests that have confirmed zero sperm count. The fertility doctor immediately suggested sperm removal and IVF as opposed to recommending alternatives and said that he was very pessimistic that we would be able to conceive naturally. There was no recommendation to start treatments such as Clomid, etc. I am on the hunt for more knowledge/research as the world of IVF is a money maker and I don’t want to trust the first and only opinion we have received.

  5. Hi, my age is 29 years. My wife period cycle is 25 days. we are trying for a child for last 6 month but not successful so i went for Semen analysis on 24/12/2015 and 16/01/2016. Both time i was not feeling comfortable. i was not feeling hardness in my penis like i feel at home. i think i was afraid with the taste. i tried for 30 min. then came out and told to lab assistant that give me some time. after 30 to 40 min. i went again for test but that time also my penis was not fully erected. very little semen came out .5 ml, pH was 9.00 and with zero sperm. but at home i am not facing such type of problem. Please tell me it is real or due to my nervousness result come like that. one more thing when i reached to hospital and waiting for my number. i was often feeling to go to toilet for urinate both the time of giving taste please guide me i am very tensed.

    1. I think it would be a good idea to repeat the test if you can relax a little. It is important to find a way to try to be comfortable to get better feedback. Do you think you could do it ok next time now that you’ve been through it once?

  6. Doctor I was diagnosed with azoospermia and d Doctor suggested Hormonal Steroids(Testosterone).Please is it of more advantage to my testicles or of more disadvantage.I await your response.Thanks.

    1. I think you should consider getting a different opinion from a urologist that specializes in male fertility. Testosterone supplementation often causes azoospermia and definitely will not help improve sperm production.

      If you have azoospermia, you should recieve a complete evaluation to understand the cause. Typically, this involves a blood test to check your FSH level and Testosterone. Additionally, you should be screened for genetic causes of azoospermia including Y deletion, XXY syndrome and CF mutations. Finally, you should complete a medical history (you could complete this online and print to take to your doctor) and have the urologist do a physical exam to check for various structural issues that could prevent sperm from reaching the ejaculate.

      Have you had any of these tests done?

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