A new wave of fitness culture and social media influence has driven increasing numbers of men—including many in their 20s and 30s—to use testosterone supplements in pursuit of enhanced masculinity, muscle gain, and sexual vitality. However, recent research and expert warnings are raising red flags: these supplements, widely marketed as a path to becoming an ‘alpha male,’ can actually cause infertility, with potentially irreversible effects.
Across gyms and online platforms in Thailand and worldwide, testosterone boosters—ranging from herbal products to powerful hormone injections—are being promoted as quick solutions for increased strength, confidence, and libido. This market boom has been further fuelled by aggressive advertising, gym trainer recommendations, and the influence of fitness influencers online. Yet, experts are cautioning that the promised benefits may come at the cost of a man’s future ability to father children, and that misuse can have wider health implications (NDTV).
Testosterone, a natural hormone produced primarily in the testicles, is essential for building muscle mass, deepening the voice, growing facial and body hair, and regulating libido, mood, and energy. Normal levels decline with age, typically by 1–2% annually after age 30, but stress, obesity, and poor lifestyle can hasten this drop. Legitimate medical use of testosterone—known as testosterone replacement therapy (TRT)—is reserved for men with diagnosed hypogonadism, where the body cannot produce enough testosterone due to illness, injury, or genetic conditions (Wikipedia - Testosterone therapy). In such cases, strict medical supervision ensures therapy is only given where necessary, with appropriate monitoring of effects and risks.
However, the misuse of testosterone supplements by men without medical need is at the core of the problem. “The body will suppress its own testosterone production if it senses high external levels,” explains a Director of Robotic Urology at a leading private Thai hospital. “This can shut down natural hormone production, causing the testicles to shrink and sperm count to fall—sometimes to zero.” For many, this leads to long-term or even permanent infertility. One prominent reproductive health specialist in Pune, India, highlighted that 60% to 75% of men who misuse testosterone supplementation experience significant infertility, with some cases persisting for months or becoming irreversible (NDTV).
The link between testosterone supplementation and infertility is supported by clinical research. In a widely cited study in Thailand, testosterone enanthate injections were shown to effectively suppress spermatogenesis (sperm production), leading to azoospermia (absence of sperm in semen) in the majority of participants (PubMed). The underlying mechanism, as explained by an endocrinologist at a major Thai hospital, involves down-regulation of the hypothalamic-pituitary-testicular axis—an intricate hormonal feedback system. Once this axis is suppressed by supplement intake, the body can take months to recover, and for a significant subset, normal sperm production does not return.
The global surge in supplement use is not just a health story but a cultural one. From late-night gym discussions to viral social media “testimonials,” testosterone has been recast as the ultimate shortcut to physical and social dominance. Influencer posts and supplement brands frequently tout benefits with little reference to risks. A 2023 study published in the journal Drugs: Education, Prevention and Policy found that performance and image enhancing drugs, including testosterone boosters, enjoy widespread marketing on Facebook and Instagram, with few effective controls to inform users of potential dangers (PMC).
Fitness trainers, often lacking formal medical training, have become gateways to this trend in Thailand as in other regions. Conversations with personal trainers and gym regulars in Bangkok and Chiang Mai suggest a normalization of supplementation as a “necessary” part of gaining muscle or increasing energy—despite little evidence for benefits in men with normal testosterone levels. “There’s a misconception that more testosterone automatically means faster muscle growth or higher sex drive, but for healthy men, the evidence is weak and the side effects are real,” observes a consultant diabetologist at a Bangkok hospital.
The promise of a quick fix has brought the testosterone supplement market in India alone to over USD 5.5 billion, with Southeast Asia showing parallel growth (NDTV). In Thailand, legal testosterone replacement can be obtained through specialized clinics (such as WellMed and MENHANCE clinics in Bangkok), yet unregulated sales abound online and in gyms (WellMed Bangkok). Regulatory oversight from the Thai Food and Drug Administration (FDA) is inconsistent, and public warnings about supplement safety have lagged behind the market’s rapid expansion. While the FDA has issued advisories and banned some imported “sex boost” products for containing unlisted pharmaceuticals (FDA Thailand), testosterone boosters themselves are widely available—with minimal requirement for users to prove medical need.
For Thai men, there are additional concerns. Cultural associations of masculinity, vitality, and competitiveness have deep roots in Thai society, with pressures on appearance intensified by media and modern dating apps. Public discussion of male infertility remains limited, and stigma can prevent affected individuals from seeking medical guidance. As an academic at a major Thai university points out, “Fertility is often treated as a private issue, and the social narrative still connects potency and masculinity. This misunderstanding can make supplement misuse both appealing and dangerous.”
Medical experts stress that most symptoms attributed to “low testosterone”—such as fatigue, mood changes, or decreased libido—may actually have other causes, including stress or lifestyle factors. Blood testing, under medical supervision, is essential before considering any form of hormone replacement. “A simple test can identify if testosterone is actually low. If not, supplementation does not help and can do real harm,” says a leading endocrinologist at a Bangkok hospital. When diagnosed appropriately, TRT can genuinely improve the quality of life for those with true hypogonadism, but off-label and unsupervised use remains hazardous.
The legal and medical context underscores the risks. According to the American Urological Association, exogenous testosterone suppresses the body’s own hormone production and spermatogenesis, increasing the risk for infertility as well as cardiovascular events and prostate problems (AUA Guidelines). A case report in the Journal of Medical Case Reports notes that even “trusted” testosterone products, when used at recommended doses, can pose health risks (PMC). Most adverse effects are reversible with prompt discontinuation, but in cases of long-term abuse, damage can be lifelong. In addition to infertility, side effects may include acne, liver toxicity, mood disturbances, cardiovascular risk, and shrinkage of testicular tissue.
Social dynamics exacerbate the problem. A study in Saudi Arabia revealed that nearly 8% of male gym attendees use anabolic hormones, most often based on peer recommendations rather than medical advice. In Thailand, anecdotal evidence suggests similar patterns, with personal trainers and online communities exerting strong peer pressure to try testosterone or related “performance boosters” (Frontiers in Public Health).
As reports of infertility among young and otherwise healthy men mount, Thai families are increasingly seeking answers. Specialists in assisted reproduction now regularly encounter cases of previously fertile men whose sperm counts plummeted after supplement use. “We see more couples struggling with unexplained infertility at younger ages, and in many cases, the common denominator is testosterone supplement use without medical oversight,” says a reproductive medicine specialist at a major Bangkok IVF clinic.
To counter this dangerous trend, Thai health authorities and advocacy groups recommend an urgent focus on public education, targeted warnings in gyms and on social media, and improved enforcement against illegal online sales. More transparent conversations about male reproductive health are also needed to reduce stigma and encourage men experiencing symptoms to seek accredited medical guidance rather than self-medicate with hormones.
For Thai readers and residents concerned about declining energy, mood, or sexual vitality, the safest path is clear: consult a licensed endocrinologist or urologist before considering any supplement, undergo proper diagnostic testing, and prioritize balanced diet, regular exercise, and stress management as primary strategies for well-being.
The pressure to be “alpha” is real, but shortcuts through hormone supplements bring risks that are often irreversible. In both individual health and family planning, the side effects of misuse far outweigh potential gains. All Thai men—and those who care for them—should be aware: advice from the gym floor or a trending hashtag can have life-changing consequences.
For additional information, consult reputable sources like the Thai Ministry of Public Health or consult a board-certified endocrinologist. Those experiencing symptoms or facing fertility concerns should avoid self-medicating and seek professional medical assessment.
Citations:
- NDTV - Alpha Male: Taking Testosterone Supplements To Be ‘Alpha’ Can Actually Make You Infertile
- PubMed - Suppression of spermatogenesis by testosterone enanthate in Thai men
- Wikipedia - Testosterone therapy
- AUA Testosterone Deficiency Guidelines
- Drugs: Education, Prevention and Policy - Social Media and IPED Marketing
- WellMed Bangkok - Testosterone Replacement Therapy
- FDA Thailand - Supplement Safety Warning
- Frontiers in Public Health - Knowledge, attitude of anabolic hormone use