We’re going to school you real quick on a condition you’ve probably never heard of but are likely to experience in your lifetime: Hypogonadism. The Mayo Clinic defines it as a disorder “in which the body doesn't produce enough testosterone—the hormone that plays a key role in masculine growth and development during puberty—or has an impaired ability to produce sperm or both.”
It’s exceedingly common—over 3 million new cases in the U.S. are reported each year—as you can be born with male hypogonadism or it can develop later in life from injury or infection.
Additionally, “Testosterone production declines with advancing age; 20 percent of men older than 60 years and 30 percent to 40 percent of men older than 80 years have serum testosterone levels that would be subnormal in their younger adult male counterparts," according to the Cleveland Clinic.
In some cases, male hypogonadism is treated with testosterone replacement therapy, according to a release about new research in the journal BJU International. While this can boost your energy levels, libido, and mood, there are some complications with testosterone replacement therapy; namely, it can trick your body into thinking it’s producing enough testosterone so it begins making less and less of its own. This, in turn, can severely decrease your sperm count and spiral into infertility since you need your own testosterone to produce sperm.
But this new research has found that restoring testosterone production in men is just as effective as replacing it—and it won't compromise your fertility.
In the study, this alternative approach to testosterone replacement focused on restoring the body’s natural testosterone production with a drug, similar to one used to help women ovulate, called Enclomiphene citrate. They compared this drug with Androgel, a topical testosterone gel, on overweight men with low testosterone (a.k.a. hypogonadism).
Over the five months during the randomized studies, 44 men started on 12.5mg of the oral Enclomiphene citrate daily; the researchers upped the dosage to 35mg for 25 of these men (though they didn't say at what point). An additional 42 men received a topical 1.62 percent Androgel and 41 percent received a placebo. All had 10 clinic visits with one overnight stay to monitor results.
The researchers found men who took Enclomiphene citrate restored their blood testosterone levels to normal after 16 weeks while maintaining their sperm concentrations. The Androgel, on the other hand, restored blood testosterone levels in the men but caused marked reductions in their sperm concentrations by subduing the function of the testes.
"One of the basic tenets in medicine is to do no harm,” said study author and urologist Edward Kim, MD in the release. Something to remember: When it comes to safeguarding your fertility, restore your testosterone, don't replace it.
So, talk to your doctor about all your treatment options, including this new one, if you're suffering from hypogonadism.