The doctor for the male reproductive system is a urologist. Urologists diagnose and treat conditions affecting both the urinary tract and the reproductive organs in men, covering everything from fertility problems and erectile dysfunction to testicular pain and hormonal imbalances. For issues that are specifically and exclusively related to male sexual and reproductive health, a more specialized doctor called an andrologist may be the best fit.
What a Urologist Does
A urologist is a physician and surgeon who handles conditions of the urinary system (kidneys, bladder, and the tubes connecting them) as well as the male reproductive organs. Because the urinary and reproductive systems share anatomy in men, urology naturally covers both. This makes the urologist the first-line specialist for nearly any concern involving the penis, testicles, prostate, or sperm-carrying tubes.
Urologists treat a wide range of conditions, including:
- Erectile dysfunction (ED): the inability to get or maintain an erection firm enough for intercourse, which is most often caused by a physical issue rather than a psychological one
- Varicocele: an enlarged vein in the scrotum that can cause pain, testicular shrinkage, or fertility problems
- Peyronie’s disease: scar tissue buildup inside the penis that leads to curvature, pain, or difficulty with erections
- Prostatitis: inflammation or infection of the prostate gland
- Male infertility: low sperm count, poor sperm movement, or absence of sperm in the semen
Urologists also perform surgical procedures specific to the male reproductive system. A vasectomy, the most common form of male sterilization, involves cutting or blocking the two small tubes in the scrotum that carry sperm into semen. It’s a simple outpatient procedure. Urologists also perform vasectomy reversals and surgical sperm retrieval for men who want to conceive after a vasectomy or who produce no sperm in their ejaculate.
Andrologists: A More Focused Specialist
An andrologist is a urologist who has done additional training specifically in male sexual and reproductive health. Think of andrology as a subspecialty within urology, the way cardiology is a subspecialty within internal medicine. While a general urologist splits attention between the urinary system and reproductive organs in both men and women, an andrologist focuses solely on male-specific concerns: fertility, sexual function, and hormone balance.
That deeper focus matters in certain situations. Andrologists have more specialized knowledge of conditions like premature ejaculation, retrograde ejaculation (where semen flows backward into the bladder instead of out), male hormonal disorders including low testosterone, and problems with sexual development. They also coordinate closely with other fertility specialists, including reproductive endocrinologists and immunologists, when diagnosing complex causes of infertility. Chronic conditions like diabetes, high blood pressure, or kidney disease can reduce sexual function and contribute to infertility, and an andrologist is trained to untangle those overlapping issues.
If your concern is straightforward, like a vasectomy consultation or an initial evaluation for erectile dysfunction, a general urologist is the right starting point. If you’re dealing with persistent fertility problems, unexplained sexual dysfunction, or hormonal issues, asking for a referral to an andrologist can get you more targeted care.
Their Training and Certification
Urologists complete medical school followed by a residency in urology, which includes extensive surgical training. After residency, they must pass a two-part board certification process through the American Board of Urology: a written qualifying exam, then an oral certifying exam taken after at least 16 months of independent practice. Candidates have six years from the end of residency to complete the full certification. Andrologists complete this same path and then pursue additional fellowship training in male reproductive medicine.
What Happens at Your First Visit
A first appointment with a urologist or andrologist for a reproductive concern typically starts with a detailed medical history. You’ll be asked about your overall health, any chronic conditions, medications, lifestyle habits, and how long you’ve been experiencing symptoms. If fertility is the reason for your visit, expect questions about how long you and your partner have been trying to conceive.
The doctor will perform a physical exam, which usually includes examining the testicles and scrotum for issues like varicocele or structural abnormalities. From there, the most common next step is a semen analysis. This is the simplest and least expensive test for evaluating male fertility, and it measures three key things: how many sperm are present per milliliter of semen, how well those sperm move and swim, and whether their shape is normal. If the analysis shows no sperm or an extremely low count, a blood draw to check hormone levels is typically the next step. After reviewing all of the results, your specialist will discuss options with you, which could range from lifestyle changes to medication to surgical intervention.
When Multiple Specialists Work Together
Male reproductive issues don’t always stay in one doctor’s lane. When a couple is pursuing fertility treatment like intrauterine insemination (IUI) or in vitro fertilization (IVF), a reproductive endocrinologist often manages the overall process, particularly on the female partner’s side. But when there’s a male factor involved, a urologist or andrologist joins the team.
At large medical centers, these specialists work side by side. At Mayo Clinic, for example, doctors trained in reproductive endocrinology and urology evaluate both partners together, which allows them to develop a treatment plan within two or three days. This collaborative setup means test results are shared quickly, appointments are coordinated, and treatment decisions account for both partners’ health rather than being made in isolation.
Specific situations that call for referral to a reproductive urologist include abnormal semen analysis results, failed IUI or IVF cycles, a varicocele that can be felt on exam, or recurrent pregnancy loss with no clear cause on the female side. In cases of two or more miscarriages, the male partner may be screened for genetic abnormalities in sperm using specialized testing. These are situations where a general practitioner or even a gynecologist treating the female partner should loop in a male reproductive specialist to get the full picture.