Does going to gym affect male fertility? Andrologist explains why testosterone and steroids are the real concern

Building muscle fast with testosterone or steroids may come at a cost. Doctor explains how these hormones can affect sperm production and male fertility.

For many young men, going to the gym, lifting weights and building muscle are part of a healthy lifestyle. The concern arises when testosterone or anabolic steroids are used without medical supervision to speed up muscle growth. In an interview with HT Lifestyle, Dr Chirag Bhandari, an andrologist and male reproductive health specialist, explains why the concern is not weight training itself, but the unsupervised use of testosterone and anabolic steroids, particularly among young men who may want children in the future.

Taking testosterone can suppress sperm production

Testosterone and sperm production are controlled by a complex hormonal system involving the brain and testes. When testosterone is taken from outside the body, the brain can reduce the signals that stimulate the testes, particularly luteinising hormone (LH) and follicle-stimulating hormone (FSH).

“When testosterone is taken from outside, the brain senses that there is already enough testosterone and reduces LH and FSH production. These hormones are important for normal testicular function and sperm production. As a result, the testes may reduce their own testosterone production and sperm production,” explains Dr Bhandari.

High testosterone does not mean high fertility

A common misconception is that higher testosterone automatically means better fertility. However, blood testosterone levels and sperm production are not the same thing.

“A man can have very high testosterone levels in his blood while having a very low sperm count. In some cases, men taking external testosterone may have testosterone levels above 1,000, yet sperm production can be severely suppressed. Testosterone should therefore not be considered a fertility treatment,” says Dr Bhandari.

Anabolic steroids can similarly affect reproductive health. They may lower LH and FSH, reduce sperm concentration and motility, decrease testicular size and, in some cases, cause azoospermia, meaning no sperm is detected in the semen.

Low testosterone is not just a sexual problem. It is associated with reduced muscle mass, increased body fat and lower bone density. (Pixabay)

Recovery can take months

Stopping testosterone or steroids does not necessarily mean fertility returns immediately. Sperm production itself takes around 70 to 80 days, so recovery can take several months and varies between individuals.

“Sperm production does not recover overnight after stopping steroids or testosterone. Depending on the duration and extent of suppression, recovery may take three to six months, and in some men it can take a year or longer,” explains Dr Bhandari. In some cases, recovery may also be incomplete, particularly after prolonged use.

Hormone-related fertility problems can be difficult to notice because declining sperm production does not necessarily cause obvious symptoms. A young man may continue to gain muscle and feel physically healthy without knowing that his sperm count is being affected.

“Muscle gain is visible, but declining fertility is not. A man may only discover the problem years later when he starts trying to conceive,” says Dr Bhandari.

How can men protect their fertility

Going to the gym is not the issue. Resistance training, a balanced diet, adequate protein and appropriate supplements such as creatine can be part of a healthy muscle-building routine without using anabolic steroids or unsupervised testosterone.

“The gym itself is not the problem. The concern is the use of testosterone or anabolic steroids without proper medical supervision. Young men should understand the potential reproductive consequences before using these hormones,” says Dr Bhandari.

Men considering testosterone treatment, particularly those who may want children in the future, should discuss their fertility plans with a qualified doctor before starting therapy. Protecting reproductive health is something to consider alongside fitness goals, rather than only after fertility problems appear.

Dr Chirag Bhandari is a consultant andrologist and male reproductive and sexual health specialist with over 11 years of experience. He is the founder of the Institute of Andrology and Sexual Health (IASH) and has completed a fellowship in Andrology from University College London Hospital (UCLH), UK.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.