Low testosterone is a common cause of male infertility and subfertility. Along with the semen analysis, lab work is an important part of assessing men’s health and the fertility picture. Labs that should be included are:


Total testosterone

Free testosterone

Sex Hormone Binding Globulin (SHBG)

Luteinizing Hormone (Lh)

Follicle stimulating hormone (FSH)



There is a very wide range of normal when it comes to test levels. A “normal” laboratory value is anywhere between 300-1,000 nanograms per deciliter. Yes, you read that right, the reference range is extremely wide. That is why a complete evaluation of male health should include a symptom assessment as well as test measurement. If you are on the low end of normal AND have any of the following symptoms, you should consider lifestyle changes.


Symptoms of low testosterone in men:


Low sex drive

Low energy

Lack of muscle tone or strength

Erectile dysfunction


Low sperm count


It is important to note that if your goal is to get pregnant, the appropriate treatment for this is not testosterone replacement.


Here are some impactful lifestyle modifications for low testosterone:


  1. Keep a consistent bedtime and wake up at the same time everyday. If sleep is difficult for you, this should be your primary focus until it improves. You must get 7-9 hours of good quality sleep every night. Here are some tips for improving sleep.
  2. Eat enough protein, vitamins and minerals. You need the raw materials for creating hormones. This comes for food. Use an app like Cronometer to track your food and micronutrients (vitamins and minerals).
  3. Test for and supplement vitamin D if needed. Your vitamin D levels should be 50-70ng/mL
  4. Have sex regularly, make it fun and treat sexual dysfunction with sex therapy, mediation and/or acupuncture.
  5. DO NOT OVERWORK. More rest = more test. Overworking, especially if it leads to lack of sleep will affect your hormone level, especially if done for a prolonged period of time.
  6. Avoid hormone disrupting chemicals, the most important ones are plastics, BPA, Phthalates and fragrances. Check your home and body care products, and eliminate any plastic water bottles, tupperware or other sources of plastics you are regularly exposed to.
  7. Exercise. Get about 30 minutes of exercise pretty much everyday. This will help with sleep and stress as well as with sperm count and testosterone production. A combination of strength training and cardio is best.
  8. Avoid harmful substances like alcohol, cigarettes, tobacco, nicotine, dip and cannabis. If you are really serious about improving test levels and sperm quality, no alcohol is best. If you have trouble with that, no more than 2 drinks per week should be your hard limit.


Have more questions on this subject?

Dr. Emily Rea is here to answer your fertility questions and walk with you on your fertility journey. Send us a message any time!