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Testosterone is commonly known as the men’s hormone, as it plays such a crucial role in energy production, muscle mass, bone health, mood and fertility (as it helps with sperm cell production).

Testosterone levels naturally start to drop slowly once a man reaches his 30s, but a rapid drop can indicate an issue that might be caused by an unhealthy diet, lifestyle, or underlying medical conditions, like reduced thyroid functioning. 

Let’s dive into how you can potentially tell if your testosterone levels are starting to drop, how this can affect your fertility, and how best to support your hormone production safely and naturally. 

Signs your testosterone levels may be dropping
Your body always gives subtle, sometimes significant, signs when it is struggling. However, a definite way of clinically diagnosing low testosterone (hypogonadism) is via a blood test, which your doctor can prescribe if you notice a combination of the symptoms below. Self-diagnosing is not enough.

Key signs of low testosterone levels

• Sexual function: Reduced sex drive (libido), fewer spontaneous erections (especially morning erections), or erectile dysfunction (ED).
• Physical changes: Decrease in muscle mass and strength, increase in body fat (especially around the abdomen), loss of body or facial hair, and breast tenderness or enlargement (gynecomastia).
• Emotional / mental health: Low mood, depression, increased irritability, difficulty concentrating, and general fatigue or low energy.
• Sleep: Sleep disturbances or increased insomnia.

Testosterone and fertility

Testosterone plays a crucial role in the testes, where sperm is produced. While some men with low overall testosterone levels can still make healthy sperm (since the concentration of testosterone in the testes is naturally much higher than in the blood), a significant deficiency can directly or indirectly affect fertility:

• Decreased sperm production: Low testosterone can lead to a reduced quantity of sperm.
• Indirect effects: The most common indirect effects are a reduced sex drive and erectile dysfunction, which obviously reduce the frequency of intercourse and the chance of conception. Additionally, these symptoms can take a toll on you mentally, increasing stress and further worsening the low testosterone production levels.

Crucial warning: If you are trying to conceive, you must be extremely cautious about testosterone replacement therapy (TRT). TRT, while effective for symptoms, often tells the body to stop producing its own testosterone, which can lead to a major decrease in follicle-stimulating hormone (FSH), and a resulting inhibition of sperm production and temporary infertility.

Supplementing and eating for hormone production

A healthy diet is always highly recommended, as well as getting seven to nine hours of sleep and managing stress. Exercise is also really important as it helps you to manage stress and supports hormone production.

Since testosterone is a hormone derived of cholesterol (yes, not all cholesterol is bad for you), a balanced diet is important to ensure you get all the nutrients required for healthy testosterone production.

Key nutrients for testosterone support

• Zinc: This mineral is essential for testosterone metabolism and sperm health. 
  ○ Food sources: prawns, red meat, chicken, turkey beans (especially if soaked for more than six hours, or canned), nuts and seeds (pumpkin and chia seeds).
• Vitamin D: As South African’s, we are fortunate enough to get this vitamin naturally from the sun, but if you do not get at least 5 to 15 minutes (for low- and non-melanated skin), 15 to 30 minutes (medium-melanated skin), and 30 minutes to 3 hours (for high-melanated skin), a vitamin D3 supplement is advised. Vitamin D should preferably be taken with vitamin K2, if you get a supplement with 1000IU / 25 micrograms or more, to avoid your kidneys, bones or heart drawing in too much calcium.
  ○ Food sources: Fatty fish such as sardines, pilchards and salmon.
• Magnesium: This mineral helps to support hormone regulation, and increases free and total testosterone, especially in active men (so again, exercise is really important).
  ○ Food sources: dark chocolate, leafy vegetables (especially steamed / boiled), nuts and seeds.
• Healthy fats: As mentioned, cholesterol is key for testosterone production so prioritise healthy fats. Unlike processed fats, healthy fats have anti-inflammatory properties, and inflammation (which is stress on the body) can reduce hormone production.
  ○ Food sources: avocados, nuts, seeds, fatty fish, olives, beef and chicken liver.

Dangers of unprescribed testosterone boosters
You’ve probably seen a few ‘testosterone booster’ pills, tonics, and/or powders on the shelves in grocery stores, pharmacies, and on social media. It is highly recommended to practice extreme caution with these supplements. Not everything readily available in a pharmacy, or any other store, has been reviewed by the necessary health product board in South Africa (the SAHPRA)

These types of supplements can be classified under two categories:

1. Herbal / nutritional boosters: These products contain vitamins, minerals, and/or herbs, which may support the natural production of hormones (e.g. ashwagandha, fenugreek, D-aspartic acid). Although some of the ingredients (e.g. vitamin D and zinc) are beneficial if you are deficient, the overall effects of these supplements are often mild, unproven or unreliable.
2. Unregulated / unsafe products: These are the riskiest products to consider taking. A lot of these products are not regulated by SAHPRA, or any health authority in the world. Some muscle-building supplements have also been found to be contaminated with actual anabolic steroids, which are not disclosed / listed on their label.

The major dangers of non-prescribed steroids or TRT:

• Liver and kidney damage: Oral, unprescribed hormone products are notorious for causing stress and potential damage to the liver and kidneys.
• Permanent hormonal imbalance: Introducing external testosterone can stop your body’s natural production, potentially leading to testicular atrophy (shrinkage) and permanent reliance on the drug.
• Cardiovascular risk: Non-prescribed use can increase red blood cell count, raising the risk of high blood pressure, blood clots, heart attack and stroke.
• Infertility: As mentioned, taking external testosterone shuts down the signals needed for natural sperm production, leading to infertility.

So, never take an anabolic steroid or any testosterone replacement product that has not been specifically prescribed and monitored by a healthcare professional, especially if you have fertility concerns or an existing medical condition.