Written by Ben Bunting: BA(Hons), PGCert.
There is definitely a relationship between emotional disorders like depression and male fertility. However, this relationship is complex, difficult to understand, and dual-sided.
It means that a person living with infertility due to various reasons is quite likely to develop emotional issues, stress, low self-esteem, and depression. But on the other hand, depression has been associated with low testosterone, poor sexual health, and infertility.
Both male infertility and depression are no longer rare conditions, and their prevalence is rising.
Thus, there is reason to explore their relationship. Regretfully, despite the known role of mood in sexual health, researchers have paid less attention to the association between depression and male infertility.
In the article we shall cover the following points:
- Infertility and depression
- The association between infertility and testosterone
- Low testosterone
- Depression and its complications
Male infertility and depression are equally common
One of the interesting facts to consider is that male infertility and depression rates in the US are quite similar.
Thus, studies show that about 5% of the population is living with depression in the US. Interestingly enough, it appears that about 4.5% to 6% of the male population (some report even greater prevalence) is also living with infertility.
Further, what is worrisome is that both these conditions are on the rise at an almost equal pace. As a result, both are now significant health issues.
However, exploring the association between the two is challenging for science due to the presence of many other so-called confounding factors.
Infertility is caused by so many reasons, and thus it is difficult to understand the role of depression. Moreover, the dual-sided relationship between the two further complicates things.
Exploring the association between infertility and depression
It is not difficult to guess that male infertility would lead to emotional disorders and a considerably greater risk of depression.
However, the greater area of interest is the role of depression in infertility. How much and in what way can depression affect male fertility?
There could be many ways in which depression may reduce male fertility. But, generally, it is seen that those living with depression at a young age are less likely to have children.
A person living with depression may have a poor social life and thus significantly poor sexual life. This may ultimately negatively impact fertility, having adverse consequences.
However, if a person living in a relationship develops depression, it would still affect fertility. Perhaps the most significant impact would be on male sexual performance.
It appears that men living with depression are more likely to suffer from erectile dysfunction and premature ejaculation.
Thus, they might start avoiding sexual contact, which may adversely impact testosterone levels and fertility.
Another issue with depression is the greater prevalence of other health issues like metabolic disorders or substance abuse.
For example, some may abuse food, drink, smoke, drugs or others may try to 'man-up' and hit the steroids hoping that they will help. However, there would be a decline in testosterone levels in those cases.
It is a complex issue because depression increases the risk of substance abuse, which causes a decline in testosterone and infertility.
It is vital to understand that depression and its associated decline in testosterone levels have a widespread impact on male health.
It is pretty straightforward to understand that decline in testosterone levels would lead to reduced sperm production, oligospermia, and thus infertility.
However, the impact of testosterone is not just essential for sperm production. The role of testosterone in mood is well known.
Those with low testosterone levels would feel fatigued, less interested in sex (reduced libido), and more likely to be living with infertility.
One of the issues with studies is that they have significantly focused on how male infertility and sexual dysfunction lead to increased anxiety and depression.
However, science has made very little attempt to understand how depression may ultimately lead to infertility.
Depression and its complications
Perhaps one reason for less focus on infertility as one of the complications of depression is that it is limited to the male population and is not life-threatening.
Moreover, infertility is a less significant problem for older adults, who are more prone to depression.
When trying to understand the relationship between infertility and depression, one more thing is extremely vital to know.
Most of the medications used to treat depression might negatively impact sexual health and fertility.
Most drugs used to treat depression are pretty toxic, and they are frequently prescribed.
These medications are also prescribed to manage anxiety, neuropathic pains, seizures, and many other health conditions.
Thus, doctors prescribe antidepressants to treat a range of conditions. Unfortunately, they are one of the most overprescribed drugs these days.
Studies show that those who regularly use antidepressants have almost three times the greater risk of developing infertility.
Additionally, it is interesting to notice that antidepressants also adversely impact female fertility and libido.
Another interesting fact to notice is that infertility treatment may often positively impact the mood, unlike the treatment of depression.
Thus, in those living with infertility and depression, perhaps the focus should be on treating infertility and sexual dysfunction.
Science knows that those who are given testosterone replacement therapy are less likely to have depression.
Similarly, treating male sexual dysfunction may also help with depression.
Some of the early studies indicate that PDE5 inhibitors like sildenafil may also have some direct role in reducing depression and elevating mood.
To conclude, infertility and depression are common problems in men of various age groups, and both conditions are on the rise.
Although there is no doubt that male infertility or sexual dysfunction considerably increases the risk of depression, how much depression can affect fertility levels in men is poorly understood.
Keeping in mind that antidepressants can also cause infertility, if the condition occurs concurrently, it is always good to start treating infertility and sexual dysfunction first.
But, of course, lots would depend on the severity of depression in such cases. As the treatment of major depressive episodes cannot be delayed.