Avoiding Toxins Including Spermatotoxic Medications

Gillian Stearns, MD; Paul J. Turek, MD


Semin Reprod Med. 2013;31(4):286-292. 

In This Article


Severe alcoholism has been shown to affect the HPG axis, resulting in testicular dysfunction. In addition, it is also likely that alcohol directly affects the testis, as the oxidation of alcohol competes with testicular production of testosterone, decreasing sperm density.[3] Increased hepatic enzymatic activity associated with high alcohol intake also increases liver conversion of testosterone to estrogens through aromatases. Elevated estrogen levels further decrease circulating testosterone levels through HPG axis inhibition. Finally, impaired spinal reflexes result in decreased penile sensation and innervation, often causing erectile dysfunction.[1,3] It is important to note that the changes observed with excessive alcohol use have not been reliably demonstrated men with mild-to-moderate alcohol intake.[1–5]