Restoring testosterone production in men better than replacing it

Testosterone restoration increases the hormone in men's bodies while not effecting sperm counts.

By Stephen Feller

KNOXVILLE, Tenn., Oct. 27 (UPI) -- Testosterone is important for red blood cells, bone growth, sexual function and mood in men. Men are generally treated for low levels of the hormone, called hypogonadism, with testosterone replacement therapy using topical treatments that often lower sperm counts.

Restoring testosterone production in the body was found by researchers to prevent declines in fertility, while solving the symptoms of hypogonadism. The researchers used a drug called enclomiphene citrate, which is similar to a type of drug used to help women ovulate.


While testosterone replacement effectively improves the symptoms of hypogonadism, it causes the body to produce even less of its own testosterone. Sperm counts decrease because the body needs its own testosterone to produce sperm.

"One of the basic tenets in medicine is to do no harm. As this study has shown in a randomized, double-blind, double-dummy, placebo-controlled manner, exogenous testosterone therapy with Androgel can clearly decrease sperm production and potentially impact fertility," said Dr. Edward Kim, a urologist at the University of Tennessee Medical Center, in a press release. "This study confirmed that Enclomiphene can maintain spermatogenesis while restoring testosterone levels to normal."

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The researchers recruited overweight men between the ages of 18 and 60 with hypogonadism. In the study, 44 were started on 12.5 mg of oral enclomiphene citrate daily, 25 of whom were increased to 25 mg, another 42 men were given a 1.62 percent topical AndroGel, and 41 men got a placebo. The men provided two semen samples at the beginning of the study and two more at the end.


After 16 weeks of treatment, testosterone levels rose in men who received either enclomiphene citrate or AndroGel, however patients treated with the AndroGel were seen to have "a marked reduction" in sperm count.

The study is published in BJU International.

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