An andrologist is a medical specialist focused on male reproductive health and associated conditions. This branch of medicine deals specifically with the male genital system, including the testes, penis, and related organs, and is often considered the male counterpart to gynecology. Andrologists diagnose and treat issues related to a man’s ability to reproduce and his sexual function. The specialty combines elements of urology, endocrinology, and reproductive medicine.
The Core Focus of Andrology
Andrology centers on the unique functional and structural aspects of the male reproductive system. Primary organs of focus include the testes, the epididymis, the vas deferens, and accessory glands, such as the prostate and seminal vesicles. Andrologists are experts in spermatogenesis, the process of sperm production and maturation within the testes.
The specialty also involves the relationship between hormonal balance and reproductive health. Andrologists manage endocrine factors, particularly the regulation of male hormones like testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). They investigate how deficiencies or excesses of these hormones affect fertility, sexual drive, and overall well-being, aiming to optimize the function of the male reproductive tract.
Common Conditions Treated
Patients typically seek an andrologist for issues impacting their fertility or sexual performance. Male infertility is a frequent reason for consultation, often caused by factors such as low sperm count (oligospermia) or poor sperm motility. Structural issues like varicocele, an enlargement of veins within the scrotum, are also managed due to their negative effect on sperm quality.
Erectile dysfunction (ED), the inability to achieve or maintain an erection firm enough for sexual intercourse, is another central focus. Andrologists investigate the underlying causes of ED, which can be vascular, neurological, hormonal, or psychological. They also treat hypogonadism, a condition where the body does not produce enough testosterone, leading to symptoms like reduced libido, fatigue, and decreased muscle mass.
Specific anatomical disorders, such as Peyronie’s disease, fall under this specialty. This condition involves the formation of fibrous scar tissue inside the penis, causing a painful curvature during erection. Andrologists also manage ejaculation disorders, including premature or delayed ejaculation, which affect reproductive and sexual health.
Diagnostic Tools and Treatment Approaches
The diagnostic process begins with a detailed medical history and physical examination, followed by specific laboratory tests. The most fundamental tool for male fertility is the semen analysis, which assesses the volume, concentration, motility, and morphology (shape) of the sperm to identify male-factor infertility.
Hormonal blood tests measure levels of testosterone, FSH, LH, and prolactin to check for endocrine imbalances. Imaging studies, such as scrotal ultrasound, visualize the testes, epididymis, and blood flow, helping to diagnose conditions like varicocele or testicular masses. For complex cases, specialized tests like sperm DNA fragmentation testing or genetic screening may be used.
Treatment approaches are tailored to the diagnosis. For hormonal issues, medication management, such as testosterone replacement therapy for hypogonadism, is common. Erectile dysfunction can be treated with oral medications, vacuum devices, or injectable therapies. Surgical interventions include microsurgical varicocelectomy and procedures like vasectomy reversal. Andrologists also perform sperm retrieval techniques for assisted reproductive technologies like in vitro fertilization (IVF).
Andrologist vs. Urologist: Clarifying the Difference
While there is overlap, the two specialties have distinct focuses. Urology is a broader medical field addressing diseases of the urinary tract in both men and women, including the kidneys, bladder, and urethra. Urologists also treat the male reproductive system, but their scope includes issues like kidney stones, urinary tract infections, and urological cancers.
Andrology, by contrast, is a subspecialty focusing exclusively on the male reproductive system and its function. An andrologist is often a urologist who has pursued fellowship training in male fertility, sexual health, and male endocrinology. While a general urologist handles basic reproductive care, an andrologist is the expert for complex male infertility, severe sexual dysfunction, and hormonal disorders.