In short
Testosterone treatment lowers sperm production, often to zero. It usually recovers after stopping, but it can take a year or more. Tell your doctor if you want children.
On this page
Testosterone treatment lowers sperm production, often to zero. It works like a contraceptive, though not a reliable one. If you want children now or in the next few years, tell your doctor before you start, because it changes the plan.
Why it happens
The brain measures testosterone in the blood. When it sees plenty arriving from outside, it stops sending LH and FSH, the two signals that tell the testes to make testosterone and sperm. The testes go quiet and shrink a little. Blood testosterone looks normal, but inside the testes, where sperm are made, it falls.
How much it lowers sperm count
In studies of testosterone as a male contraceptive, most men’s sperm counts dropped to very low levels or zero within three to six months. It’s not dependable enough to rely on for contraception.
Does it come back?
Usually. After stopping, sperm production recovers in most men over six to twelve months, and it can take up to two years. Recovery is slower in older men and after long periods on treatment, and a small number don’t fully recover.
If you want children
- Say so at the first consult. It affects whether testosterone is the right treatment at all.
- Ask about a semen test and sperm storage before starting.
- Ask about alternatives. For men whose low testosterone comes from the pituitary gland, specialists can use medicines that stimulate the testes instead of replacing testosterone. That’s arranged through an endocrinologist or fertility specialist.
- Treat reversible causes first. Losing weight and treating sleep apnoea raise testosterone without affecting fertility.
If you’re already on treatment
Don’t stop suddenly on your own. Talk to your doctor about coming off and what to expect while your own production restarts. If you’re trying for a pregnancy, ask for a referral to a fertility specialist.
What about steroids used for bodybuilding?
The same thing happens, usually more severely, because the doses are higher and often combined. It’s a common reason for infertility in men who’ve used them.
Next step: talk to a GP
Request an appointment and we’ll be in touch to arrange a time. A consultation doesn’t guarantee a prescription.
References
- Healthy Male: Male infertility, and Testosterone replacement therapy
- Liu PY, et al. Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception. The Lancet. 2006.
- Yeap BB, et al. Endocrine Society of Australia position statement on male hypogonadism. Medical Journal of Australia. 2016.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.