Case study:  Sperm-challenged Nate*


Meet Nate, 37 years

 Nate recently underwent sperm testing as he and his partner were having no success after a year of trying for a baby.  All parameters from the testing needed correcting – number, shape, and motility (movement).

Nate was a firefighter.  His physique was impressive. He worked out at the gym several times a week and confided that he had been taking anabolic steroids for the past 18 months. He was surprised and shocked to learn of the potentially devastating effects it can have on fertility.

Anabolic steroids, a form of synthetic testosterone, are used to enhance physical performance and appearance. Globally, it’s estimated about one in 16 men (6.4%) use anabolic steroids sometime during their life. They contribute to muscle growth and fat loss, but they also affect sexual function by reducing the size of testicles, reducing or stopping sperm production, and causing impotence and infertility. In small doses for short amounts of time, anabolic steroids have lower risk of long-term or harmful side effects. They impact on women’s bodies too, altering hormone balance and impacting fertility if taken for too long.

 

·       Anabolic steroids can suppress the body's natural production of testosterone, leading to reduced libido and erectile dysfunction.

·       They can cause the testicles to shrink due to the suppression of natural testosterone production. This can lead to decreased sperm production and infertility.

·       Steroid use can lead to an imbalance in hormone levels, causing an increase in estrogen levels and leading to the development of breast tissue (gynecomastia), which can affect sexual confidence and performance.

·       Steroids can lead to prostate enlargement, causing urinary issues and potentially affecting sexual function.

 

Anabolic steroids affect fertility in men through several mechanisms, primarily by disrupting the body's natural hormonal balance.  

·       Suppression of the Hypothalamic-Pituitary-Gonadal (HPG) Axis The HPG axis regulates the production of testosterone and sperm in men. Anabolic steroids interfere with this axis in the following ways:

·       Negative Feedback Mechanism: Anabolic steroids provide exogenous androgens, leading the hypothalamus to detect high levels of testosterone. This triggers a negative feedback loop, causing the hypothalamus to reduce the secretion of Gonadotropin-Releasing Hormone (GnRH). Reduced GnRH leads to decreased production of Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) by the pituitary gland.

·       Decreased LH and FSH Levels: LH is responsible for stimulating the Leydig cells in the testes to produce testosterone. Lower LH levels result in decreased endogenous testosterone production. FSH is crucial for the stimulation of spermatogenesis (sperm production). Lower FSH levels directly impair the production and maturation of sperm.

·       Testicular Atrophy Shrinkage of Testicles: The suppression of LH and FSH reduces the activity of the testes, leading to atrophy or shrinkage. This reduction in testicular size is associated with a decrease in both testosterone and sperm production.

·       Altered Sperm Parameters Reduced Sperm Count (oligospermia): The suppression of FSH and LH results in a lower sperm count, a condition known as oligospermia. Abnormal sperm morphology and motlity.

·       Azoospermia: In severe cases, anabolic steroid use can lead to azoospermia, the complete absence of sperm in the ejaculate.

·       Hormonal Imbalances Increased Estrogen Levels: Some anabolic steroids can be aromatized into estrogen, leading to higher levels of estrogen in the body. This can exacerbate the suppression of the HPG axis.

Imbalance Between Androgens and Estrogens: An imbalance between androgens and estrogens can further disrupt the normal hormonal regulation required for sperm production.

·       Direct Toxic Effects on Testicular Tissue

Oxidative Stress: Anabolic steroids can increase oxidative stress in testicular tissue, leading to cellular damage and impaired spermatogenesis.

·       Direct Testicular Toxicity: Some anabolic steroids may have direct toxic effects on the seminiferous tubules where sperm is produced, further impairing fertility.

 

Long-term Consequences

While some effects on fertility can be reversible after discontinuation of steroids, long-term use can lead to persistent or permanent infertility due to chronic suppression and potential damage to testicular tissue. Fortunately, the sterility caused by misusing anabolic steroids can be reversed for most men. In general, it may take from 6-12 months to regain fertility after stopping steroid use. There are treatments available for the recovery of anabolic steroid-induced hypogonadism including gonadotropin replacement therapy to induce both spermatogenesis and intratesticular testosterone production. All therapies are enhanced by a naturopathic regime supporting all aspects of fertility.

Nate’s fertility journey

After 6 months following the Making Healthy Babies eCourse, Nate’s sperm began to improved with all parameters creeping closer to normal range. Fortunately, spermatogenesis is a 90-day process, and so improving all aspects of diet, supplementation and lifestyle supported a return to fertility.

         Diet and Nutrition:

  • Antioxidant-rich foods: Consuming a diet high in antioxidants can help combat oxidative stress, which is often increased by steroid use. Foods rich in antioxidants include berries, nuts, seeds, leafy greens, and other colourful vegetables.

  • Healthy fats: Include omega-3 fatty acids found in fish, flaxseeds, and walnuts, as these can help balance hormones.

  • Folate and Zinc: Foods rich in folate (leafy greens) and zinc (such as pumpkin seeds, chickpeas, and meat) are essential for reproductive health.

    Herbal Supplements:

  • Ashwagandha: An adaptogen is known to support hormonal balance and improve sperm quality.

  • Maca root: Known for enhancing libido and improving sperm count and motility.

  • Tribulus Terrestris: This herb is often used to improve sexual function and fertility in men.

    Exercise:

  • Regular, moderate exercise can help improve overall health and hormonal balance. However, avoid excessive or intense exercise, which can negatively impact hormone levels.

    Stress Management:

  • Practices such as yoga, meditation, and mindfulness can reduce stress, which in turn can positively impact hormonal health and fertility.

    Adequate Sleep:

  • Ensure you get 7-9 hours of quality sleep per night. Sleep is crucial for hormonal regulation and overall health.

    Avoiding Toxins:

  • Reduce exposure to environmental toxins, which can be endocrine disruptors. Use natural cleaning products, avoid plastics (especially for food storage), and opt for organic foods when possible.

    Hydration:

  • Stay well-hydrated, as dehydration can impact cellular function and overall health.

    Acupuncture:

  • Some studies suggest that acupuncture can help balance hormones and improve fertility.

    Supplements:

  • Coenzyme Q10 (CoQ10): Known for improving sperm motility.

  • L-Carnitine: Helps in improving sperm health and function.

  • Vitamin C and E: Both vitamins are antioxidants that can help improve sperm quality.

    Hormonal Support:

  • Natural supplements or herbs like chasteberry (Vitex) can help regulate hormones.

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