World J Mens Health.  2019 Jan;37(1):45-54. 10.5534/wjmh.180036.

Testosterone Is a Contraceptive and Should Not Be Used in Men Who Desire Fertility

• Patel AS
• Leong JY
• Ramos L
• Ramasamy R

• KMID: 2429721
• DOI: http://doi.org/10.5534/wjmh.180036

Abstract

Testosterone has a variety of functions and is commonly used in older men to treat symptoms of hypogonadism, such as decreased libido, decreased mood and erectile dysfunction. Despite its positive effects on sexual function, it has a negative effect on fertility. Exogenous testosterone therapy can negatively affect the hypothalamic-pituitary gonadal axis and inhibit the production of follicle stimulating hormone and luteinizing hormone. The purpose of this review is to discuss the contraceptive properties of testosterone therapy and to discuss strategies to increase testosterone in men with the desire to preserve fertility.

Keyword

Contraception; Family planning services; Hypogonadism; Infertility; Testosterone; Testosterone replacement therapy

MeSH Terms

Contraception
Erectile Dysfunction
Family Planning Services
Fertility*
Follicle Stimulating Hormone
Gonads
Humans
Hypogonadism
Infertility
Libido
Luteinizing Hormone
Male
Testosterone*
Follicle Stimulating Hormone
Luteinizing Hormone
Testosterone

Figure

• 

  Fig. 1 Image explaining the contraceptive effect of exogenous testosterone. In summary, it works by 2 mechanisms, decreasing intra-testicular testosterone, and inhibiting spermatogenesis. Most of the intra-testicular testosterone is made by the Leydig Cells in the testis. When exogenous testosterone is present, it inhibits gonadotropin-releasing hormone (GnRH) production which in turn inhibits luteinizing hormone (LH) production and decreases endogenous testosterone production by the Leydig cells, decreasing the intra-testicular testosterone concentration. Inhibiting GnRH production also inhibits follicle stimulating hormone (FSH) release, which impairs spermatogenesis in the Sertoli cells.

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