Gynecology — the branch of medicine that focuses on the female reproductive system — has been considered a modern medical specialty since the 19th century. Its closest male counterpart, andrology, on the other hand, was only established as a medical specialty during the second half of the 20th century

While andrology remains a niche medical specialty, it’s still worth learning more about the physicians who practice andrology, what they do, and how they can potentially help, especially with male fertility issues. After all, even though it may feel like women bear the brunt of infertility, the facts don’t lie: male factor is an issue in nearly 50% of all infertility cases

To help you better understand the role of an andrologist, and whether it may be time for your guy to make an appointment with one, Rescripted spoke with Ranjith Ramasamy, MD, Director of Reproductive Urology at the Desai Sethi Urology Institute, and an associate professor at the University of Miami, Miller School of Medicine. 

couple being affectionate

So, what is an andrologist?

“An andrologist is a medical doctor who specializes in the treatment of male reproductive health and urological issues,” says Dr. Ramasamy. “They diagnose and treat various conditions affecting the male reproductive system.”

In many ways, andrology goes beyond the typical urology field of study, which is typically limited to diseases of the urinary tract (including the kidneys, bladder, ureters, and urethra), as well as some male reproductive issues. 

What's the difference between an andrologist and a urologist?

“Andrology is a subspecialty of urology,” explains Dr. Ramasamy. “After urology residency, andrologists complete a fellowship to specialize in this area of urology.” While he says andrologists “often work closely with urologists and REs,” it’s important to remember that “they are all medical specialists who have slightly different areas of expertise and focus.” So if you know you’re looking for a physician who specializes in male reproductive health as opposed to one who can treat your bladder infection, you’ll want to seek out an andrologist. 

When should your male partner consider seeing an andrologist? 

“Patients should consider seeing an andrologist if they experience any issues related to male reproductive health, sexual health, or hormonal imbalances,” says Dr. Ramasamy. He recommends patients first discuss their concerns with their primary care physician, and then they can be referred to the correct specialist for expertise and guidance for diagnosis and treatment.

Common reasons patients see an andrologist include infertility concerns, erectile dysfunction, fertility preservation, and hormonal imbalances.

doctors consulting with one another

What kind of health concerns can an andrologist help address? 

Dr. Ramasamy recommends consulting an andrologist when experiencing any of the following:

  • male infertility with low sperm count 

  • Poor sperm motility (sperm movement)

  • abnormal sperm morphology (the size and shape of sperm)

  • erectile dysfunction

  • hormonal imbalances

  • Premature or delayed ejaculation

He goes on to recommend seeking out an andrologist for male-specific fertility issues: “Andrologists offer expertise in fertility preservation options,” he says, “particularly for individuals undergoing treatment which may impact future fertility.” Dr. Ramasamy suggests working with an andrologist as opposed to a urologist or RE for these options because, “an andrologist receives focused training on male reproductive health, making them well-suited to diagnose, treat, and manage these types of symptoms and medical conditions in males.”

What are some possible causes of male factor infertility? 

As with females, there are a variety of potential reasons for male infertility. According to Dr. Ramasamy, they can include oligospermia (low sperm count), poor sperm motility, abnormal sperm morphology, Varicocele, obstruction within the reproductive tract, hormonal imbalances such as low testosterone, underlying genetic conditions, and ejaculation disorders.

He also warns that “underlying medical conditions such as diabetes, along with lifestyle factors including exposure to toxins, obesity, and smoking can all have an impact on fertility.” With so many potential factors out there, Dr. Ramasamy says “a combination of factors may be contributing to male factor infertility when trying to conceive.” Therefore, he recommends that both partners undergo a comprehensive fertility assessment if they are having difficulty conceiving.

Are there recommended treatment options for male infertility?

It depends on the underlying issue, explains Dr. Ramasamy. “For example, varicocele is a relatively common contributor of male factor infertility and can be repaired through surgical intervention,” he says. “Other interventions often include lifestyle changes including maintaining a healthy weight, avoiding smoking, and hormone therapy in cases of hormonal imbalance.” Dr. Ramasamy goes on to say that assisted reproductive technologies are also often explored, such as intrauterine insemination (IUI), in-vitro fertilization (IVF), intracytoplasmic sperm injection, and testicular sperm extraction. “It is important to consult with a fertility specialist or reproductive endocrinologist to guide personalized treatment for a couple’s individual situation,” he advises. 

couple consulting with an andrologist

What about lifestyle changes to help improve male fertility?

Dr. Ramasamy’s recommendations in this area are really no different than what women are told on a regular basis: Maintaining a healthy lifestyle “will not only improve fertility but also be beneficial to a patient’s overall health.” He also suggests eating a balanced diet, maintaining a healthy weight, and staying physically active. Finally, he advises patients not to smoke, to “limit exposure to toxins that can affect reproductive health, and to practice safe sex to avoid sexually transmitted infections that can impact fertility.”

There’s no doubt that finding an andrologist can initially be challenging for patients: It’s a field of medicine that falls beneath the urology umbrella, but it’s still a new-ish subspecialty. So if you are dealing with specific male reproductive health concerns, it’s a good idea to first connect with your primary care physician, who can then refer you to an andrologist as needed. 

Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.