The use of hormones for rejuvenation is increasing with the aging of the Baby Boomer population. Exogenous testosterone and anabolic androgenic steroids suppress intratesticular testosterone production, which may lead to decreased sperm production. Men desiring children at a later age may be unaware that treatment with testosterone and use of anabolic androgenic steroids has well-established detrimental effects on sperm production, but sperm production may recover after therapy is stopped.
When male fertility is a concern, the following approaches may be considered:
- Change in lifestyle to include strength training, a healthy diet, and decreased consumption of alcohol and nicotine
- Weight management
- Use of aromatase inhibitors such as anastrazole, chrysin, resveratrol and/or zinc to decrease aromatase activity and conversion of testosterone to estradiol, simultaneously affecting two potential causes of male infertility
- Use of 5-alpha-reductase inhibitors such as progesterone and/or saw palmetto to decrease 5-alpha reductase activity and conversion of testosterone to DHT
It is important to consider additional endocrine imbalances, including all hormones and cortisol, along with stress evaluation and reduction, to have a complete picture of factors contributing to sexual dysfunction.
Fertil Steril. 2013 Jun;99(7):1814-20.