An enlarged prostate can sometimes lead to urinary issues, which might indirectly affect sexual health. Some men might find that their erections become stronger and more frequent as their testosterone levels rise. If you have any concerns about changes in your sexual health while on TRT, don’t hesitate to consult with your healthcare provider. While some men may experience an increase in volume, others may notice no change or even a slight decrease. So, you might be asking, does testosterone increase sperm volume? Although testing in some animal models has shown minimum testosterone levels are needed for spermatogenesis (3), a minimum level for human spermatogenesis is not well defined. In humans, low serum total testosterone (TT), a surrogate for intratesticular levels, has previously been linked sometimes inconsistently (5) to abnormal semen parameters such as lower sperm concentration and total sperm motility (6). While this can impact the ejaculate's volume and sperm count, it does not necessarily affect the act of ejaculation itself. It largely depends on the individual's baseline hormone levels and overall sexual health. However, it’s important to understand that not all men will experience a significant change in ejaculation volume. One of the changes that some men look for is an increase in the volume of ejaculation. In the first few weeks after starting TRT, some men may notice slight changes in their sexual health. With proper planning and medical guidance, you can take steps to preserve your fertility while benefiting from the positive effects of TRT on your overall health. Patient characteristics of male partners of couples with unexplained infertility Of the 900 couples enrolled, 781 men with both TT and a baseline semen analysis with at least 5 million total motile sperm were included in our present study, whereas 119 men were excluded due to missing TT. While fasting, male partners also provided blood samples, which were processed for TT levels at the University of Virginia Ligand Assay and Analysis Core (Charlottesville, VA). Male partners were required to have a baseline semen analysis with at least 5 million motile sperm, recorded within 1 year of study initiation (7). To address the relationship between TT, semen parameters and live birth rate in couples with unexplained infertility, we performed a secondary analysis of the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) trial. In humans, intratesticular testosterone concentrations are 30–100 times higher than serum levels (11–15), and this elevated testosterone concentration is necessary for spermatogenesis to occur. These data suggest that optimal spermatogenesis and fecundity may require a minimum level of testosterone and underscore the importance of identifying men with low TT in couples with unexplained infertility. No association between low TT and semen volume, sperm concentration or sperm motility was found. Baseline median (IQR) sperm parameters included semen volume 2.8 (2.0–3.7) mL, sperm concentration 49 (27–85) × 106/mL, motility 56 (49–65) %, and strict morphology 9 (5–18) %. Normal semen parameters were defined as semen volume ≥ 1.5 mL, sperm concentration ≥15 ×106/mL, total sperm motility ≥40%, and Kruger strict morphology ≥4%. This minimum required sperm count was considered sufficient for sperm washing and intrauterine insemination—which was performed in all AMIGOS treatment cycles. Low testosterone is found in approximately 15% of male infertility cases (2); however, the impact of low testosterone on a man’s fecundity is less known. Older men might need to manage these underlying conditions alongside TRT to see improvements in their sexual health. Younger men might see quicker and more pronounced improvements in ejaculation and overall sexual function with TRT than older men. Quality sleep helps your body recover and maintain healthy hormone levels, which can directly impact ejaculation. Eating a diet that lacks these nutrients might reduce the effectiveness of TRT on ejaculation and other aspects of sexual health. Testosterone Replacement Therapy (TRT) can have a significant impact on a man's sexual health, particularly on ejaculation. As testosterone levels rise, some men may notice that their orgasms become more intense. When testosterone levels are low, some men may find that their orgasms are less satisfying or less intense. Testosterone is a hormone that influences many aspects of male sexual function. Testosterone Replacement Therapy (TRT) is often used to help men who have low testosterone levels. There are ways to manage this side effect, such as using other medications alongside TRT to preserve sperm production.
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