Andrology is the area of medicine that studies mens health, particularly male reproductive health. In urology, andrology focuses on male infertility and androgen (male sex hormone) deficiency.

Male infertility has a variety of causes, which can be broadly divided in to pre-testicular, testicular, or post testicular. Examples include hormonal problems (pre-testicular), and blockage of genital tract ducts such as the vas deferens – the tube carrying sperm from the testis (post-testicular). Whilst an underlying problem should be sought, it may not be correctable, and sometimes must be “bypassed” by using assisted reproductive techniques to achieve pregnancy. Examples of such technique are IVF (in vitro fertilization) and ICSI (intra-cytoplasmic sperm injection) which uses sperm that has been obtained directly from the testis and is microscopically injected into an ovum (egg).

Androgens, such as testosterone, are not only required for male fertility. They also play an important role in determining a man’s energy levels, mood, muscle strength, bone density and libido (sex drive). Although testosterone levels naturally decline with age beyond the third decade of life, androgen deficiency can lead to a symptomatic decrease in each of these areas. It can occur at any age, but is increasingly recognized as being associated with the ageing process.

Androgens are primarily produced by the testes, and an abnormality may lead to deficiency. However, androgen deficiency does necessarily infer a testicular abnormality. The testes are stimulated by hormonal messages from the pituitary gland (which sits directly below the brain), so that abnormal pituitary gland function may also lead to androgen deficiency. It is important to seek a cause, as androgen deficiency may be a sign of underlying illness (examples include Diabetes, Sleep Apnoea, and Depression). When symptomatic, androgen deficiency is amenable to highly effective treatments, such as testosterone replacement.

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