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Educational article

Planning to Have Children? What to Discuss Before Using Testosterone

Endomédicos

Endomédicos medical profile

Published 5 min read

Educational content. It does not replace an individual medical assessment and should not be used for self-medication.

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An endocrinologist reviews semen analysis results and testosterone treatment with a patient during a medical appointment in Bogotá.
Interpreting a semen analysis alongside a patient’s medical history can help guide a conversation about fertility and testosterone.

How are testosterone and fertility related?

Testosterone has important functions in the body, but testosterone given from outside the body—for example, as treatment for hypogonadism—can reduce the hormonal signals that stimulate sperm production in the testicles. In some people, the sperm count decreases considerably, or sperm may not be detected in the semen during treatment. The effect varies from person to person.

Fertility and sexual function are not the same

Fertility depends on various factors, including sperm production. Sexual function includes aspects such as sex drive, erections, and sexual activity. Although these aspects may be related, one does not determine the other: having a sex drive or erections does not confirm that sperm production is normal, and sexual difficulties alone do not establish a person’s fertility status.

When should you bring it up?

Wanting to have children now or in the future is reason enough to discuss fertility with your healthcare professional, even if you have no symptoms. It is also important to bring it up if you are already receiving testosterone and are thinking about trying to conceive with your partner, if you have had difficulty conceiving, or if you have concerns about your reproductive or testicular history. Sperm production cannot be determined just by how you feel.

Discussing it before you start may change the plan

Before starting testosterone, let your healthcare professional know whether you want to have children and your approximate timeframe. If you have already started, tell your healthcare team that reproductive planning is important to you before continuing or making any changes. This discussion allows you to review the diagnosis, your goals, and alternatives that may be relevant; there is no single option that is right for everyone.

What an evaluation may involve

Depending on your situation, your healthcare professional may review your medical history, symptoms, medications, and hormone tests. If sperm production needs to be assessed, they may consider a semen analysis and other evaluations. Your care may involve endocrinology, urology, or reproductive medicine. Your healthcare team will determine which tests are needed and how to interpret the results in your situation.

Options depend on the cause and your goals

When fertility is a priority, different clinical options may be considered. Their appropriateness depends on the cause of hypogonadism, the evaluation results, and when you want to have children. Talk with your specialist about the benefits, limitations, and possible effects of each alternative. No option can guarantee a reproductive outcome.

Do not stop or change treatment on your own

Do not stop, replace, or change testosterone without medical guidance. Recovery of sperm production after changing or stopping testosterone varies from person to person and is not necessarily immediate; an individual timeframe cannot be assured, nor can recovery be guaranteed. Testosterone should not be considered a contraceptive method either.

How to seek guidance in Colombia

You can ask your healthcare network which professional and care pathway are appropriate for your situation, such as endocrinology, urology, or reproductive medicine. Bring your reproductive plans and a list of the treatments you use to your appointment. Confirm availability and coverage with your healthcare network.

When to seek medical care

If symptoms persist, test results are abnormal, or you have questions about medication, arrange an individual assessment. Do not change treatment or doses without medical guidance.

Frequently asked questions

Does testosterone always cause infertility?

The effect cannot be said to be the same for everyone. Testosterone given from outside the body can reduce sperm production and affect fertility; its effects require an individual evaluation.

If I stop testosterone, when will my fertility recover?

Recovery and the timeframe vary from person to person and cannot be predicted by a general rule. Do not stop treatment on your own; consult a healthcare professional to review your goals and evaluation options.

Can I have a sex drive and still have low sperm production?

Yes. Sexual function and sperm production are distinct aspects. Assessing fertility may require a medical history, a clinical evaluation, and, when appropriate, a semen analysis.

Does this topic resonate with you?

Every case is different. Book a consultation to review your history, test results and goals with a personalized plan.

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