The Hormone Cafe

In this episode of The Hormone Café, Dr. Sarah Pederson teams up with Physician Assistant Sierra Wolfe to break down one of the most overlooked areas in fertility: men’s reproductive health.

With male factors contributing to 30–60% of infertility cases, understanding sperm health is essential — yet most men never get evaluated.

🧪 How We Test Sperm Health

Most fertility clinics use outdated methods — having men produce a sample alone in a clinic room. But WHO6 guidelines (2021) show sperm quality is higher when collected:

• Through intercourse
• Using a sterile, non-spermicidal collection condom
• At home, in a natural environment
• Delivered promptly to the clinic for analysis

Sierra explains exactly how this works and why it improves sample accuracy and comfort.

🔬 What a Semen Analysis Measures

A semen analysis evaluates both the fluid and the cells. It checks:

1. Count. How many sperm are present.

2. Motility. How well they move — and whether movement is strong enough to reach the egg.

3. Morphology. Shape of the sperm:

• Normal vs. abnormal heads
• Normal vs. abnormal tails
• Indicators of DNA fragmentation
• Morphology helps predict whether a sperm can successfully fertilize an egg.
  

Why it matters:
Semen analysis is the only definitive test to determine whether male factors are contributing to infertility.

📅 When Men Should Get Tested

• Any man planning to conceive
• Especially couples who have tried for a few months without success
• Because men’s reproductive cells are uniquely exposed to environmental damage (heat, toxins, age)
  

Studies now show that men’s fertility declines more sharply with age than previously understood.

🥦 Nutrition for Better Sperm Quality

These foods hurt sperm quality:

• Processed meats (sausage, deli meat, brats)
• Frequent high-fat red meat
• Fast food / fried foods
• High-sugar diets
• High-fat dairy (whole milk is good for women — not for men)
  

These foods help sperm quality:

• Oysters (huge zinc boost)
• Salmon & fatty fish (omega-3s needed for sperm formation)
• Fruits & vegetables (antioxidants reduce DNA damage)

“Oxidative stress is exactly what causes abnormal sperm DNA — antioxidants are essential.”

🍺 Alcohol, Caffeine & Substances

Alcohol

• Best: avoid completely while trying to conceive
• Acceptable:
  • No more than 2 drinks at a time
  • No more than 7 drinks per week
• Sperm take 3 full months to regenerate — so 3 months of being alcohol-light = new, healthier sperm.

Caffeine

• Limit to ≤200 mg/day
• About 2–3 cups of coffee

Nicotine (including Zyn)

• Constricts blood vessels → reduces blood flow to testicles → lowers sperm count and quality.

Marijuana

• THC binds to receptors in the testicles → directly suppresses sperm production.
  Men who use regularly have lower counts, poorer motility, and worse morphology.

🌡️ Temperature Matters

Testicles must stay 3°C cooler than the rest of the body. Heat exposure damages sperm.

Avoid:

• Saunas
• Hot tubs
• Long hot baths
• Tight pants
• Long bike rides
• Sitting for hours with legs closed
  

Cooling Therapy (“Ice the balls”)

Options:

• Snowballs underwear (ice-pack underwear specifically designed for fertility — Sierra’s favorite)
• Frozen peas over underwear (never on bare skin)
  

30 minutes/day significantly improves sperm quality over several months.

💉 Testosterone & Male Fertility

External testosterone acts as male birth control:

• Shuts off natural testosterone production
• Stops sperm production entirely
• Semen analysis often shows zero sperm
  

Good news: There are safe ways to raise testosterone without shutting down fertility — and Sierra teaches this to patients daily.

🏋️‍♂️ Exercise, Sleep & Stress

Exercise

• Best: resistance training + cardio
• Too much of one type is not ideal
• Cardio helps endurance during intercourse
• Strength training supports testosterone

Sleep

• Missing one night of sleep can drop testosterone by 50%.
• During sleep, men naturally get erections to increase blood flow to the testicles — crucial for maintaining sperm health.

Stress

• Stress hormones constrict blood vessels → reduces blood flow → affects:
  • Sperm production
  • Testosterone
  • Libido
  • Erectile function

Long-term stress = long-term fertility impact.

Key Takeaways

• Male fertility is just as important as female fertility.
• Sperm health can change significantly in 3 months.
• Focus on:
  • Clean nutrition
  • Reducing heat exposure
  • Cooling therapy
  • Limiting alcohol & caffeine
  • Avoiding nicotine and marijuana
  • Prioritizing sleep and stress reduction
  • Balanced exercise
• Testosterone therapy is not fertility-friendly — there are safer options.
  

“Easy on the beer, ice your balls, sleep well, eat real food, and your sperm will thank you.”