Testosterone–Restore-or-Replace-Question

Men who have low testosterone often take testosterone replacement therapy. These replacements consist of injections, topical gels, or pellets the size of a grain rice inserted under the skin the doctor’s office. However, testosterone replacement can reduce a man’s sperm count and thus impact his fertility potential. It is for that reason that men with low testosterone, focus on restoring testosterone production in men which may be as effective as replacing it, without compromising their fertility. There’s a drug that restores the body’s natural production of testosterone has no negative effect on a man’s sperm count while injections of testosterone, topical testosterone gels or the pellets of testosterone can cause a significant drop in the sperm count. The findings from the work of Dr. Ed Kim and his colleagues at the University of Tennessee could change the way men are treated for low testosterone.

While testosterone replacement therapy can boost men’s energy levels, sex drive, and mood, the treatment can fool the body into thinking that it is producing enough testosterone, so that it in turn starts making less of its own. This can result in a significant decrease in sperm count – leading to infertility – because the body needs its own testosterone to produce sperm.

An alternative approach to testosterone replacement is based on restoring the body’s natural production of testosterone with drugs similar to those used to help women ovulate. Edward Kim, MD, urologist at the University of Tennessee Medical Center and Professor at the University of Tennessee Graduate School of Medicine in Knoxville, and his colleagues compared such a drug, called Clomid (Enclomiphene citrate), with testosterone replacement therapy (Androgel) in overweight men with low testosterone, or hypogonadism. In the randomized studies, 44 men started on 12.5 mg of Clomid daily, with 25 men being up-titrated to 25 mg; 42 men received a topical 1.62 percent AndroGel; and 41 men received a placebo.

The investigators found that Clomid restored blood testosterone levels to normal after 16 weeks while maintaining sperm concentrations, whereas Androgel restored blood testosterone levels but caused marked reductions in sperm concentrations by suppressing the function of the testes.

This study has shown testosterone replacement therapy with Androgel can clearly decrease sperm production and potentially impact fertility. This study confirmed that Clomid can maintain the sperm count while restoring testosterone levels to normal.

If you have any questions about your testosterone and how to restore the testosterone level to normal, please give us a call.

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