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Men's Health

Joe Rogan, young men rave about testosterone supplements. But do they reduce sperm count?

America's birth rate has been on a steady decline since 2007, and pronatalists − both in the White House and out − are determined to raise it. But an underdiscussed obstacle might be standing in the way. 

A growing number of men are using testosterone supplements in the hopes of enhancing their physical performance, unaware of the drug’s impact on their fertility, and more public figures — from Joe Rogan to Dax Shepard — are making their use of supplements known. From 2016 to 2019, prescriptions for testosterone replacement therapy (TRT, or “T”) have increased by 20%. Dr. Masaya Jimbo, a urologist and male infertility specialist at Reproductive Medicine Associates Philadelphia, says more college students are coming into his practice seeking — or already taking — testosterone.

However, research shows up to 25% of men do not have their testosterone levels checked before starting therapy, and up to a third do not meet the criteria for testosterone deficiency. Jimbo warns that the desired benefits of TRT — such as increased sex drive and enhanced fitness — do not unequivocally outweigh the damage TRT can have on men’s fertility. 

“There’s a lot of men who are out there taking testosterone thinking that it's making them more virile, but in fact, the testosterone is telling their testicles to shut off,” says Dr. Neel Shah, the Chief Medical Officer at Maven Clinic, a virtual clinic for women’s and family health. “Within three to six months, they can go from producing normal amounts of sperm to producing none at all.” 

What is testosterone? Risks and benefits of testosterone replacement therapy

Testosterone is a hormone produced primarily in the testicles that helps maintain men’s bone density, fat distribution, muscle strength and mass, facial and body hair, red blood cell production, sex drive and sperm production. 

Testosterone levels generally peak during adolescence and young adulthood, and begin declining by approximately 1% per year after age 30 or 40. A blood test is used to diagnose a low testosterone level, and a doctor may recommend testosterone replacement therapy in the form of injections, pill, patches or gels, for men with conditions like hypogonadism (when low testosterone levels are due to a disease rather than normal aging). 

Studies show that patients not meeting the diagnostic criteria for testosterone deficiency are still being prescribed testosterone therapy, often based on vague symptoms. Jimbo says that among his college-aged patients, some report getting testosterone supplements from their friends.

“There’s a big community that thinks of testosterone as an important or beneficial, purely enhancing kind of treatment to do,” he says. He often sees patients that tell him, “All my friends do it too.”

In 2018, Joe Rogan said on his podcast that he started TRT when he turned 40 to "feel way better" and make his body “work way better."

Still, he cautioned against going overboard with testosterone.

"Get to a point where you have the hormone levels of a healthy young man," Rogan said. "You don't want to be higher than that. That's when you run into problems."

The risks of TRT can include worsening sleep apnea, acne or other skin reactions, stimulating the growth of existing prostate cancer, englarging breasts, limiting sperm production and causing the testicles to shrink, and stimulating too much red blood cell production, which contributes to the increased risk of forming a blood clot. 

And, testosterone supplements aren’t always delivering their advertised results. A 2019 study evaluated 50 “T booster” supplements for composition and product claims. 90% percent of supplements claimed to “boost T,” 50% “improve libido,” and 48% “feel stronger.” However, only 24.8% of supplements had data to support these claims, and 10.1% contained active ingredients with data suggesting a negative effect on T levels. 

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Testosterone therapy may lower men’s sperm count

The pituitary gland (a part of your brain that controls hormone release) produces two hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). LH tells the testicles to make testosterone, and that testosterone works with FSH to produce sperm.

Testosterone supplements can have a “quick and dramatic” impact on fertility, Jimbo says. 

Once a person starts taking exogenous testosterone, the pituitary gland recognizes that it no longer needs to produce it on its own, which causes the testicles to shrink over time and can halt sperm production. 

It typically takes 3-6 months for sperm production to resume, but individuals who have been on high-dose testosterone for longer periods will require longer to return to normal sperm production. It can take up to three years for sperm to recover, but in a small number of patients, sperm production never fully recovers. 

Research shows that for heterosexual couples trying to conceive, when the cause of infertility can be attributed to a known factor, it's a roughly 50-50 split between male and female factors. The male partner was found to be solely responsible in about 20% of infertility cases, and a contributing factor in another 30-40% of all cases.

“Usually when people want to start having kids, they really want to start having kids,” Shah says. “The difference of having to wait six months or 12 months can be really meaningful.” 

Biohacking, masculinity misperceptions can harm fertility

Biohacking, which is the pursuit of accomplishing the "best possible results" from your body, even if it requires extreme measures, has exploded in the wellness industry. 

“2025 is just a very different era in terms of being able to push a button and get a drug in general,” Shah says. Telehealth providers have streamlined the process of testosterone therapy prescriptions (among many other medications, like GLP-1s), and expanded the market for testosterone supplements. 

“I think that there's a lot of testosterone use that's not measured, and it shows up again in the fertility clinic,” Shah says. 

A 2025 report by Maven Clinic that surveyed over 500 men aged 25–49 found that among men currently trying to conceive, or planning to conceive in the future, over half (55%) would be motivated to make lifestyle changes if they felt confident the changes would help conceive a child.

“Anecdotally, the majority of people, once they see the line between testosterone and being able to have children, are very willing to make the changes they need to make to have a family,” Shah says. 

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