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Male Fertility and Testosterone Replacement Therapy (TRT)

Testosterone Replacement Therapy can be a game-changer for the millions of men living with low testosterone – or Low T. But are there risks involved for your future fertility? And how can we best protect our sperm health when taking the medication?


What is Testosterone Replacement Therapy?

Testosterone Replacement Therapy (TRT) is a type of medication taken to boost your natural levels of testosterone. It can be taken in many different forms – from pellets to patches, injections to gels.

Unlike anabolic steroids, TRT is approved by doctors for cases where men are suffering from low testosterone, and the much lower dose has fewer side effects – as the medication is regulated.

In some cases, you can get TRT on the NHS, but to avoid long waitlists you can also get tested and have medication prescribed through approved private specialists like Alphagenix.


Who Can Benefit From Testosterone Replacement Therapy?

TRT is mainly used to treat men who are struggling with low testosterone. Millions of men worldwide face this problem – and yet it is so often misunderstood and misdiagnosed. Let’s discuss some of the signs that you could be suffering from low T:

Symptoms of Low Testosterone

Low Libido

This is one of the most common symptoms associated with lower levels of testosterone, as testosterone is the hormone responsible for your sex drive.

Low Energy

Testosterone is a hormone that gives us our get up and go, so if you are constantly struggling with fatigue and low energy it could be a sign of Low T.


The lack of energy won’t be helped by another common symptom of Low T – insomnia. Hormonal imbalances can impact our sleep quality and circadian rhythm.

Reduced Muscle Mass or Weakness

Testosterone also plays a role in our strength and the growth of muscles. Many men with Low testosterone struggle to put on muscle mass.


Physical fitness is one area that can be heavily affected by low testosterone and this can lead to some men struggling with an unhealthy amount of body fat.


Low testosterone is very often misdiagnosed as depression in men because the symptoms of low energy and low mood are very similar.

Lack of Motivation

The combination of depression-like symptoms and low energy can lead to a lack of motivation, which can have a huge impact on your quality of life.

Lowered Self-Confidence

All of the above can put a huge dent in your self-esteem and mental well-being, especially as so many men living with low testosterone feel embarrassed, and suffer in silence.

Whilst the acute symptoms of low testosterone are already pretty devastating, it can have an even bigger impact in the long term. If left untreated, low testosterone levels can lead to a number of health conditions including an increased risk of osteoporosis, heart attacks and even early death.


Causes and Conditions Associated With Low Testosterone

But what causes low testosterone? Well, one factor is age. We talk a lot about the decrease in female fertility after a certain age – but men are not immune to the tick of the biological clock. On average, testosterone actually decreases by around 1% each year after thirty.

However, there are other things that can contribute to low T including injury, illness and hormonal imbalances. There are also conditions like Klinefelter Syndrome, where you are born with an extra X chromosome which can impact your testosterone levels.


Risks of Testosterone Replacement Therapy

For men living with low testosterone, TRT can be a game-changer and have far-reaching benefits for their overall health. But as with any medication, there are always some risks and side effects involved. One such potential risk of TRT is an impact on your fertility.

When we add synthetic testosterone into our bodies, your body may slow down your natural production of testosterone to balance things out. This can have a knock-on effect on your sperm production. As men with low testosterone can often already have issues with sperm health, it’s really important to be aware of the risks surrounding your fertility and do what you can to protect your swimmers whilst on TRT.

Before starting any treatment of TRT, always make sure to seek professional medical advice.


How To Support Your Sperm Health During TRT

Monitoring Your Sperm Health

Before embarking on TRT, it’s a great idea to test your sperm. Even if you aren’t planning on having children any time soon, understanding your base pre-TRT sperm count and motility is really important. You can then monitor your sperm health every few months whilst on TRT and if you notice a shift in your sperm health, you can talk to your health practitioner about either changing up your dosages, freezing your sperm, or considering other treatment options. Testing your sperm can be done without needing to go into a clinic through the ExSeed Completely At Home Sperm Test, a fast and easy way to test and track your sperm health from the comfort of your home.

Nutrition and Supplements

Your diet is one of the most important ways you can support your sperm health. Make sure that you are eating nutrient-dense sperm superfoods like dark, leafy greens full of iron and folate, Omega-3 Fatty Acids found in oily fish, diverse, colourful vegetables full of antioxidants and coenzyme Q10, found in liver, fatty fish, and whole grains. You can also supplement a healthy diet with a good men’s health supplement created specifically with sperm health in mind, like our ExSeed Multi.


Exercise is great for giving your testosterone levels a boost and it’s also helpful for protecting your sperm health. Your swimmers don’t love a sedentary lifestyle! However – too much exercise can also create a lot of oxidative stress in the body which can have a negative impact on sperm quality. It’s all about balance and finding something you enjoy. Aim to be active for at least 45 minutes every day and mix up low-impact exercises like yoga and walking with more high-intensity workouts like running or weight lifting.

Healthy Habits

Obviously, as well as keeping on top of your health habits, it’s a good time to drop some bad ones. Smoking is one of the worst things you can do for sperm health – and vaping is not great either – so definitely consider quitting. It’s also a good idea to reduce your alcohol and caffeine intake and also limit your stress levels.

Consider Freezing Your Sperm

If you are concerned about your future fertility, one option may be to freeze your sperm before starting TRT, to give yourself a safety net should you experience a decline in motile sperm count over time. Unlike for cancer patients, sperm freezing for men on TRT is not readily available on the NHS, but there are several good private options for sperm cryopreservation if this is a direction you wish to pursue.

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