An andrologist is a doctor who specializes in men’s health, with a focus on issues related to the male reproductive system. Some of the key responsibilities and procedures performed by andrologists include:
Evaluating Male Fertility and Sexual Health
A major part of an andrologist’s job involves evaluating and treating male fertility issues. They will take a detailed medical history and perform exams to diagnose any problems with sperm production, libido, erection and ejaculation issues, or other factors that can impact fertility.
Some of the common fertility tests and procedures conducted by andrologists include:
- Semen analysis – Examining a semen sample under a microscope to evaluate sperm count, morphology, and motility
- Hormone testing – Checking testosterone, FSH, LH and other hormone levels via bloodwork
- Genetic testing – Screening for chromosomal disorders like Klinefelter syndrome
- Testicular biopsy – Removing a small tissue sample to check for sperm production problems
- Imaging tests – Scrotal ultrasound, transrectal ultrasound or MRI to visualize potential issues
Based on the results, the andrologist will determine the cause of infertility and work with the patient to develop a treatment plan. This may involve medications, surgery, assisted reproductive techniques like IVF, or lifestyle changes.
Treating Sexual Dysfunction
Andrologists also diagnose and treat various sexual disorders in men, including:
- Erectile dysfunction (ED) – Inability to achieve or maintain an erection firm enough for sex
- Premature ejaculation – Ejaculating sooner than desired, often within 1 minute of sex
- Low libido – Reduced sex drive and lack of interest in sex
- Retrograde ejaculation – Semen enters the bladder during orgasm instead of exiting the penis
After identifying the cause of the sexual problem, the andrologist will recommend appropriate solutions. These may include:
- Oral medications – Drugs like Viagra, Cialis, stendra for ED; antidepressants for premature ejaculation
- Counseling – Sex therapy or psychotherapy for psychological factors
- Hormone therapy – Testosterone supplements for low libido
- Penile injections – Medications injected into the penis to treat ED
- Surgery – Penile implants, vascular surgery for ED; circumcision for premature ejaculation
Treating Conditions Affecting the Male Reproductive Organs
Andrologists diagnose and manage disorders involving the male genitals and reproductive tract including:
- Epididymitis – Inflammation or infection of the epididymis
- Hydrocele – Fluid buildup around the testicles
- Varicocele – Enlarged veins in the scrotum
- Testicular torsion – Twisting of the testicles cutting off blood flow
- Hypospadias – Abnormal opening of the urethra on the underside of the penis
- Peyronie’s disease – Penile curvature due to scar tissue buildup
Treatments may involve medications, surgery, drainage procedures, and other solutions aimed at relieving symptoms, correcting underlying problems, and preserving fertility.
Providing Wellness Care and Counseling
Andrologists also provide general preventive care to promote men’s health and wellbeing, including:
- Testicular cancer screening – Teaching proper self-exams and ordering ultrasounds if abnormalities are found
- STD testing and counseling – Testing for sexually transmitted diseases and providing education on safe sex practices
- Healthy lifestyle counseling – Advice on diet, exercise, stress management, and other factors to maintain sexual and reproductive health.
When to See an Andrologist
You should consider consulting an andrologist if you experience any of the following symptoms or conditions:
- Problems with sexual function – Erectile dysfunction, premature ejaculation, low libido, etc.
- Fertility issues – Difficulty conceiving a child
- Genital pain, lumps or swelling – Possible sign of infection or other disorder
- Abnormalities in the scrotum or testicles – Varicocele, hydrocele, spermatocele, etc.
- Hormonal imbalances – Low testosterone, high prolactin, etc.
- Urinary problems – Frequent or painful urination, blood in urine
Seeing an andrologist promptly for evaluation of such symptoms can help identify any underlying problems and lead to quicker, more effective treatment.
Finding an Andrologist
Here are some tips for finding and choosing an andrologist:
- Ask your primary care doctor for a referral to an andrology specialist
- Search online directories such as those from the American Medical Association or American Urological Association
- Look for an andrologist associated with a university medical center or major hospital
- Confirm the doctor is board certified in andrology or male infertility
- Read patient reviews online to learn about others’ experiences
- Schedule a consultation to meet the andrologist and determine if you feel comfortable with them
- Check with your insurance provider to be sure the doctor is in-network
It’s advisable to choose an andrologist who has extensive training and expertise in male health issues specific to your needs.
What to Expect at an Andrologist Appointment
During your first visit with an andrologist, you can generally expect the following process and procedures:
- Intake – Paperwork regarding your medical history, medications, symptoms, etc.
- Consultation – Discussion of your condition and concerns
- Physical exam – May include an examination of your penis, testicles, prostate, etc.
- Tests – Bloodwork, urine sample, semen analysis, etc. depending on your situation
- Diagnosis – The andrologist will explain their assessment of your condition
- Treatment recommendations – The doctor will present a treatment plan tailored to your needs
- Follow-up plan – Schedule additional appointments and procedures as needed
It’s advisable to be open and honest when providing information to the andrologist. Accurate details about your symptoms, medical history and sexual health lead to more precise diagnosis and treatment.
Andrologist Procedures and Equipment
Some of the procedures and equipment andrologists may use during diagnosis and treatment include:
| Procedure/Equipment | Purpose |
|---|---|
| Physical exam | Inspect and palpate the penis, testicles, epididymis for abnormalities |
| Semen analysis | Evaluate semen volume, sperm count and motility |
| DNA fragmentation analysis | Assess sperm DNA integrity |
| Hormone testing | Measure testosterone, FSH, LH and other hormone levels |
| Ultrasound | Obtain images of the scrotum and testicles to identify issues |
| Testicular biopsy | Remove testicular tissue sample to check sperm production |
| Sexual function testing | Assess erections and ejaculation; tests may include a penile Doppler ultrasound, nocturnal penile tumescence testing, etc. |
| Genetic tests | Screen for chromosomal abnormalities associated with infertility |
Common Medications Prescribed by Andrologists
Some medications andrologists may prescribe to treat male reproductive and sexual disorders include:
| Medication | Uses |
|---|---|
| Clomiphene | Stimulates sperm production in men with low sperm counts |
| Tamoxifen | Treats infertility in men with high prolactin levels |
| Human chorionic gonadotropin (hCG) | Increases testosterone and sperm production |
| Aromatase inhibitors | Boost testosterone levels in infertile men |
| Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) | Treats erectile dysfunction (ED) |
| Alprostadil | ED medication injected into the penis or inserted as a suppository |
| Testosterone | Testosterone replacement therapy for men with low testosterone |
Potential Surgical Procedures
Andrologists may perform or assist with the following surgical procedures in some cases:
- Varicocele repair – Surgery to treat varicocele, a common cause of male infertility
- Vasectomy reversal – Reconnecting the vas deferens to restore fertility after vasectomy
- Treatment of Peyronie’s disease – Surgery to correct curvature of the penis due to scar tissue
- Circumcision – May be used to treat premature ejaculation or phimosis
- Prostate surgery – Removal of all or part of the prostate to treat cancer or enlargement
- Penile implant surgery – Insertion of inflatable devices to treat erectile dysfunction
- Testicular sperm extraction – Retrieval of sperm directly from the testicles for IVF
When to Refer to a Reproductive Endocrinologist
Andrologists and reproductive endocrinologists (fertility specialists) often work together to treat couples with infertility issues. The andrologist evaluates and treats the male partner, while a reproductive endocrinologist focuses on the female partner.
Reasons an andrologist may refer a patient to a fertility specialist include:
- A female factor contributing to infertility is identified
- Intrauterine insemination or IVF is recommended as part of the treatment plan
- Advanced sperm retrieval techniques are required
- The use of donor sperm or a gestational surrogate is recommended
- The man’s spouse or partner requires specialized fertility treatment
Working together, the andrologist and reproductive endocrinologist can develop a coordinated treatment approach to maximize the chances of conception.
Conclusion
Andrologists play a crucial role in men’s reproductive health. They diagnose and treat fertility problems, sexual dysfunction, hormonal disorders, and diseases of the male genital tract. Skilled in specialized procedures and treatments, andrologists can help men of all ages restore, maintain and enhance their sexual and reproductive wellbeing.