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Andrology – Male Health & Fertility
Andrology is the medical specialty focused on male reproductive and hormonal health, including fertility, sexual function, and disorders of the male reproductive system.
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Andrology is the medical specialty focused on male reproductive and hormonal health, including fertility, sexual function, and disorders of the male reproductive system.
What is Andrology?
Andrology is the branch of medicine dedicated to male reproductive and hormonal health. Derived from the Greek word andros (man), it covers the diagnosis and treatment of conditions affecting the male reproductive organs, fertility, and hormone balance. Andrology often overlaps with urology and endocrinology, and specialists in this field are known as andrologists.
Areas of Focus in Andrology
The specialty covers a wide range of medical topics, including:
- Male infertility: Evaluation and treatment of disorders affecting sperm production or quality.
- Erectile dysfunction: Assessment and management of the inability to achieve or maintain an erection.
- Hormonal disorders: Treatment of testosterone deficiency (hypogonadism) and other endocrine conditions in men.
- Sexually transmitted infections: Diagnosis and treatment of infections affecting male reproductive health.
- Male contraception: Counseling on methods such as vasectomy.
- Sexual medicine: Counseling and therapy for sexual dysfunction.
Diagnostic Methods
Andrologists use a variety of diagnostic tools to assess male health:
- Semen analysis (spermiogram): A laboratory test evaluating sperm count, motility, and morphology.
- Hormonal blood tests: Measurement of testosterone, FSH, LH, and other hormone levels.
- Ultrasound imaging: Imaging of the testes, epididymis, and prostate gland.
- Genetic testing: Chromosomal analysis when a genetic cause of infertility is suspected.
- Testicular biopsy: Tissue sampling to assess sperm production within the testicular tissue.
Common Conditions in Andrology
Male Infertility
Approximately 15% of couples trying to conceive experience involuntary childlessness. In around 50% of these cases, the cause lies with the male partner. Common causes include reduced sperm count (oligozoospermia), impaired motility (asthenozoospermia), and abnormal sperm morphology (teratozoospermia).
Hypogonadism
Hypogonadism occurs when the testes produce insufficient testosterone. This can lead to symptoms such as fatigue, reduced libido, loss of muscle mass, and decreased bone density. Treatment typically involves testosterone replacement therapy.
Erectile Dysfunction
Erectile dysfunction is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It may have physical or psychological causes and is often considered an early warning sign for cardiovascular disease.
Treatment Options
Treatment depends on the underlying diagnosis and may include:
- Medication: For example, phosphodiesterase-5 inhibitors for erectile dysfunction, or hormone preparations for testosterone deficiency.
- Assisted Reproductive Technology (ART): Techniques such as intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF) for infertility.
- Surgical procedures: Such as varicocele surgery to improve sperm quality.
- Psychological counseling: Support for psychogenic sexual dysfunction.
When to See an Andrologist
A consultation with an andrologist is recommended in the following situations:
- Unfulfilled desire to have children after more than 12 months of regular unprotected intercourse
- Erectile or ejaculatory problems
- Symptoms of testosterone deficiency (fatigue, loss of libido, mood changes)
- Pain or swelling in the testicular area
- Signs of late-onset hypogonadism, sometimes referred to as the male andropause
References
- Nieschlag E., Behre H.M., Nieschlag S. (Eds.) – Andrology: Male Reproductive Health and Dysfunction. Springer Verlag, 3rd Edition, 2010.
- World Health Organization (WHO) – WHO Laboratory Manual for the Examination and Processing of Human Semen, 6th Edition. Geneva: WHO Press, 2021.
- Krausz C., Riera-Escamilla A. – Genetics of male infertility. Nature Reviews Urology, 2018; 15(6): 369–384.
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