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  • Dr. Singh, ND

Declining Testosterone Levels and its Implications for Fertility

testosterone, fertility, naturopath, ottawa

Testosterone is an androgen hormone in the body that serves many physiological processes. From supporting cognition and mental functioning, building lean muscle mass, supporting bone health, increasing the basal metabolic rate (BMR), to developing healthy amounts of sperm cells.

As one ages, however, it has been observed that the levels of testosterone tend to decline. The Hypogonadism in Males (HIM) study had estimated that about 39% of males above the age of 45 have hypogonadism (defined as a decrease in circulating testosterone levels in the blood accompanied by symptoms of low Testosterone). However, only 5-35% of males with hypogonadism are actually treated. Hypogonadism is also commonly referred to as andropause, male menopause, androgen deficiency syndrome, or testosterone deficiency syndrome.

Types of Hypogonadism:

  • Primary Hypogonadism: a decrease in the production of Testosterone from the testes, leading to an increase in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These are hormones from the pituitary gland in the brain, that try to signal the testes to increase their function. This type of hypogonadism can be a result of a history of mumps causing inflammation of the testes, physical trauma to the tissue, history of undescended testicle(s), certain auto-immune disorders, radiation/chemotherapy, and genetic disorders.

  • Secondary Hypogonadism: this results from a decrease in the levels of the FSH and LH hormones from the pituitary gland, which leads to a decreased signal to the testes to produce testosterone and sperm cells. This can be a result of trauma to the brain, certain genetic disorders, pituitary tumors, and increases in the levels of prolactin.

  • Mixed Hypogonadism: the third form of hypogonadism is called "mixed" because it can exhibit signs of both primary and secondary hypogonadism. It can be a result of alcohol abuse, ageing, certain medications, hemochromatosis (elevated levels of iron in the blood), or systemic diseases/infections (i.e. liver failure, sickle cell disease, HIV infection, etc.).

Symptoms of Hypogonadism:

The most common symptoms associated with low testosterone are:

  • Decreased libido

  • Erectile dysfunction

  • Reduced muscle mass and strength

  • Increased fatigue

  • Depressed mood

  • A decrease in work capacity

  • Increased adiposity

  • Other symptoms can also include menopause-like hot flashes, anaemia, and decreased body hair (axillary and pubic)

  • Hypogonadism can also lead to an increased risk of diabetes, osteoporosis, cardiovascular disease, and obesity/metabolic syndrome.

Impact on Fertility:

Hypogonadism is accompanied by a dramatic decrease in sperm count (number of sperm cells per mL of a sample). This may then make it more difficult to conceive.


Various formulations of testosterone exist, from gels and creams to tablets and intramuscular injections, however, it is unclear if these therapies will increase the risk of benign-prostate-hyperplasia (BPH) or prostate cancer. Naturopathic therapies can also be helpful in supporting normal testosterone levels.


1. Dandona, P., & Rosenberg, M. T. (2010). A practical guide to male hypogonadism in the primary care setting. International Journal of Clinical Practice, 64(6), 682-696.

2. Seftel, A. D. (2005). Male hypogonadism. Part I: Epidemiology of hypogonadism. International Journal of Impotence Research, 18(2), 115-120.

This article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor or Primary Care Provider.

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