July 12, 2013

Male Rejuvination: Perspective for the Fertility World

Male rejuvenation is the coined-term that refers to the use of androgens and alternate hormones to achieve a variety of health benefits. It implies the reversal or slowing of changes naturally associated with aging. This changes, often refer to as andropause, eventually result in the loss of muscle mass and strength, decreased sexual function, energy loss and impaired cognition.

Most protocols prescribed or supplements offered contain testosterone supplementation often at super-physiologic doses. As nutritional supplements need not be FDA approved, unknowingly, some med may received androgen replacement therapy in whopping doses without understanding the side-effects. These side-effects may be transient as well as long-lasting.

One of the most concerning side-effects of these supplements is the significant diminution in spermatogenesis. To some men, the occult androgen supplements may mitigate any spermatogenesis rendering the man without sperm (azoospermic). Anabolic, androgenic steroids lead to suppressed intratesticular testosterone levels which cause either severe oligospermia (little sperm) or frank azoospermia (sperm absence).

Continued use of these adjuvants will suppress sperm production. In general, sperm production returns within one year after cessation of testosterone supplementation in clinical trials. However, the consistency of spermatogenic return may not be as predictable as in the quoted studies. One of the more severe side-effects is testicular atrophy (shrinking); it is not reversible.

Any additional testosterone should be avoided in men desiring fertility now or in the future. Nutritional supplements and lifestyle changes can promote better health. However, one must be aware of its contents. Some may call it “male rejuvenation” but, it may just be a problematic Trojan horse and the buyer must beware.

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Danielle Vitiello, Ph.D., M.D.

Danielle Vitiello, Ph.D., M.D. Board-Certified in Obstetrics and Gynecology, Reproductive Endocrinology and Infertility