Signs of infertility in men

Signs of infertility in men

Infertility is defined as the inability to conceive a baby after one year of regular, unprotected sexual intercourse in adults of reproductive age.

Contrary to common belief held by the average Nigerian, infertility is not automatically caused by women. Global statistics show that one-third of infertility cases are indeed caused by female factors. However, one-third of infertility is also attributable to male factors, while the other one-third of cases are caused by combined factors affecting both the male and female partners. A small percentage is caused by unknown causes.

Irregular menses, amenorrhea (lack of menstruation), abnormal bleeding, obesity and hair overgrowth are some of the common symptoms that cause women to visit their gynaecologist. Many people are aware of the symptoms of possible reproductive challenges in women, but most do not know what to look out for in men.

In this article, we will highlight some signs of possible infertility or subfertility in men.

Signs of infertility in men

Low sex drive

Do you know that low libido could be a pointer to fertility issues? Sex drive is directly controlled by testosterone. Low testosterone levels lead to reduced sex drive.

Testosterone also facilitates sperm production in the testes; when the hormone level is reduced, there will also be reduced sperm production.

Therefore, if you are experiencing a low libido, it could mean that your testosterone, and therefore your sperm production is suboptimal, and this will increase the risk of infertility.


Both men and women have breast tissues, however, the tissues are typically not well developed in men. When an adult male begins to have larger-than-expected breasts, it is often a pointer to an underlying issue. Common causes include liver problems, and side effects of some drugs like anti-TB drug (isoniazid), cimetidine, and antihypertensive drugs like spironolactone.

Gynaecomastia can also mean that there is an alteration of the normal estrogen: testosterone levels in a man. When a man’s blood estrogen levels are higher than normal, it alters sperm production and can cause fertility issues.

Excessive loss of body hair, reduction in beard growth and loss of lean muscle mass are also signs of increased estrogen levels in a man.

Scrotal swelling

There are many causes of swelling in the scrotum. One common cause is varicocele.

Varicoceles are enlarged spermatic veins which can shrink the testes and cause problems with fertility. Varicoceles typically present as a mass in the scrotum (usually one-sided) just beside the testis, which may reduce in size on laying down or raising the scrotal sac. There could also be a dragging sensation or a dull pain.

Varicocele is a common cause of male infertility, present in 35 to 44 percent of men with primary infertility and 45 to 81 percent of men with secondary infertility.

Dry ejaculation

A man is said to have dry ejaculation when he releases little to no semen after orgasm. This is a symptom of a condition called retrograde ejaculation.

In retrograde ejaculation, semen flows backwards into the bladder instead of coming out through the penis and into the vagina. When semen cannot reach the vagina, pregnancy cannot occur.

The condition is usually caused by neuromuscular issues affecting the bladder neck. People with this condition may also notice cloudy urine (containing semen) after sex.

A word from Healthfacts

Fertility problems in men are as common as those in women. It is best to visit your doctor if you have fertility concerns, whether you have the discussed signs or not.

Till next time,

Dr Ezinne Ejele.

Quiz: Do you know what your urine colour means?