Here at Natural Womanhood, we never tire of teaching girls and women of all ages how the menstrual cycle is a vital sign of health. Over and over, we emphasize that ovulation–not your period–is actually the main event of the cycle. Furthermore, ovulation specifically impacts bone, brain, breast, immune, and heart health (in addition to preparing the body for future healthy pregnancies). Fortunately, we’re seeing a slow societal shift to acknowledge this reality, and we’re especially buoyed by the increasing numbers of women–particularly young women–who are ditching hormonal birth control and opting for body literacy and fertility awareness instead.
We need to talk about men’s fertility as a vital sign, too
Now it’s time to start spreading the word that male fertility is also an indicator of whole body health. On the flip side, when a male is infertile, his body is flashing a ‘check engine’ light that should not be ignored. Here’s what to know about the connection between male fertility and whole body health, plus what research suggests about increased risk of certain health conditions in infertile men.
The ability to conceive is an indicator of whole body health in females and males
Just as with females, the ability to conceive naturally indicates health in the body. This is because a complex hormonal interplay is behind the seemingly straightforward process of sperm uniting with egg to form a genetically separate human being.
The male’s body must successfully prevent defective sperm cells from maturing, facilitate the transport of healthy sperm throughout his reproductive tract—plus hers!—to eventually penetrate an egg, and contribute the genetic code that directs his newly-formed offspring to travel through the fallopian tube and burrow Goldilocks-deep into the uterine lining. In other words, there’s a lot that could go wrong—and much that has already gone right—by the time a days-old life has implanted and rapid fire cell division is kicking into overdrive.
The male’s body must successfully prevent defective sperm cells from maturing, facilitate the transport of healthy sperm throughout his reproductive tract—plus hers!—to eventually penetrate an egg, and contribute the genetic code that directs his newly-formed offspring to travel through the fallopian tube and burrow Goldilocks-deep into the uterine lining. In other words, there’s a lot that could go wrong—and much that has already gone right—by the time a days-old life has implanted and rapid fire cell division is kicking into overdrive.
And to think: all of this has occurred before that first pregnancy test has even turned positive, let alone before the man’s genetics (and his preconception health) have influenced the baby’s side of the placenta and the mother’s preeclampsia risk.
Prevention is the best medicine
There’s tremendous value in broadcasting the relationship between infertility and certain health issues, as summarized by this writeup of a 2016 National Institute of Child Health and Human Development (NICHD) and Centers for Disease Control and Prevention (CDC) workshop. Since couples tend to present for infertility workups in their late twenties, thirties, or early forties, they can get a ‘headstart’ on preventing, slowing, or reversing related health conditions that otherwise might not manifest until their fifties, sixties, and beyond.
As the experts noted, “If infertility serves as a window on future health, it could be a clinical ‘game changer’, providing new insights for the diagnosis of chronic disease and its underlying mechanisms. Clinical care would be transformed by early identification of those at risk for a disease (who otherwise may not know), in addition to treating those already diagnosed [1].
“If infertility serves as a window on future health, it could be a clinical ‘game changer’, providing new insights for the diagnosis of chronic disease and its underlying mechanisms. Clinical care would be transformed by early identification of those at risk for a disease (who otherwise may not know), in addition to treating those already diagnosed.”
In fact, a 2025 article in Nature Reviews Urology advocates for incorporating regular semen analysis into primary care, noting “a semen analysis, traditionally used to assess fertility, holds untapped potential as a tool for promoting lifestyle changes and preventing chronic diseases in men. Spermatogenesis is highly sensitive to environmental and lifestyle factors and can be an early indicator of overall health.” [2].
Couples experiencing infertility are motivated to make lifestyle changes
Of course, couples who are trying to conceive are highly motivated to make lifestyle changes to increase their likelihood of getting pregnant. This same motivation can be leveraged to possibly help prevent, slow, or reverse major health conditions.
As noted in the NICHD/CDC workshop review, “Knowledge of the existence of such a [sic] relationship [between infertility and risk of health problems] could provide an enormous opportunity for early detection, prevention, and intervention in serious, chronic diseases. With increased attention to infertility (Prevention, 2014), there is increased potential to reach people during their reproductive years, when they are highly motivated to protect their current and future health, yet young enough to begin to make changes to their lifestyle/health, which may mitigate later disease risk” (emphasis added) [1].
Infertility is associated with increased risk of cardiovascular and metabolic disease, cancer
From the 2016 workshop writeup, we read that “In general, infertile men are less healthy than fertile men” (Salonia et al., 2009) [1]. Restorative reproductive medicine experts like Dr. Phil Boyle sometimes say that “infertile men live sicker and die younger,” reflecting multiple studies suggesting that men with abnormal semen analyses are more likely to die early of all causes (Jensen et al., 2009; Eisenberg et al., 2014). Furthermore, the risk appears to be highest for men with azoospermia, meaning no sperm in their ejaculate. It’s important to keep these findings in context, though, since the overall likelihood of early death from any cause remains “minimal.”
To date, the strongest research links infertility with increased risk of cardiovascular (heart or blood vessel) disease, metabolic disease (such as diabetes or metabolic syndrome), and cancer.
To date, the strongest research links infertility with increased risk of cardiovascular (heart or blood vessel) disease, metabolic disease (such as diabetes or metabolic syndrome), and cancer.
Infertility and risk of cardiovascular and/or metabolic disease
Research has linked men with infertility to increased likelihood of developing ischemic heart disease and diabetes. Men with infertility are also more likely to have prediabetes and high blood pressure (hypertension). A 2022 longitudinal study (study conducted over a long period of time, with multiple followups with participants) of Asian men found that after 15 years, those with infertility were more likely to have been diagnosed with cardiovascular disease [3].
Similarly, a 2017 study of over 32,000 men found that those with infertility were more likely to develop diabetes. The risk was highest in men with no sperm in their ejaculate and those unable to ejaculate at all [4].
Infertility as an indicator of increased testicular cancer risk
According to the writeup of the 2016 NICHD and CDC workshop mentioned above, as far back as the 1970s and 80s, case reports have been linking infertility–specifically testicular germ-cell dysfunction—with testicular cancer risk (Skakkebaek, 1978; Berthelsen et al., 1982) [1]. Larger, better-designed research trials, especially a 2002 study of over 30,000 men, affirmed the earlier research findings of elevated testicular cancer risk (2.3x higher) for men with abnormal semen analysis results. (Jacobsen et al., 2000). Men with abnormal results were also at three times higher risk of developing testicular cancer in the years immediately following evaluation (Walsh et al., 2009). While men with infertility were not at high risk of developing testicular cancer overall, their risk was relatively higher compared to fertile men [1].
What about infertility and prostate cancer?
Of note, to date, infertility and prostate cancer have been less definitively linked, with mixed findings of increased, decreased, or no change in risk. (Ruhayel et al., 2010; Walsh et al., 2010; Eisenberg et al., 2015) [1]. One large population-based 2019 study did find that men who sought out in vitro fertilization were significantly more likely to develop prostate cancer, including early onset prostate cancer, though the overall risk remained low [5].
In a 2020 systematic review and meta-analysis, men with subfertility (taking longer than twelve months to conceive despite regular, unprotected intercourse) or infertility (inability to conceive at all) were twice as likely to develop prostate or testicular cancer, though the overall risk was still very low [6]. Only 1% of these men actually went on to develop prostate or testicular cancer.
But why is male infertility connected with these specific health conditions?
According to this 2023 literature review, researchers suspect three main reasons for the connection between infertility and cardiovascular disease, metabolic disease, and cancer. They include genetic issues, in-utero development issues, and lifestyle and health factors [7]. Lifestyle and health factors include smoking, drug and alcohol use, obesity, little or no physical activity, COVID-19, and psychological stress.
Researchers suspect three main reasons for the connection between infertility and cardiovascular disease, metabolic disease, and cancer. They include genetic issues, in-utero development issues, and lifestyle and health factors [7]. Lifestyle and health factors include smoking, drug and alcohol use, obesity, little or no physical activity, COVID-19, and psychological stress.
The writeup of the 2016 NICHD and CDC workshop (mentioned above) posited that accelerated cell aging could explain the link [1]. Accelerated cell aging may also be caused by the lifestyle and health factors listed above.
The bottom line
When a man presents with infertility, a further workup is in order to determine why he and his partner are having trouble conceiving, but a physical evaluation and semen analysis are not the only tests he should have. Since fertility is an indicator of overall health in the body, he should be assessed for other health problems—particularly metabolic and cardiovascular disease as well as cancer risk—at the same time.
Just as infertility is a symptom of something wrong in the female body, not a disease in and of itself, the same holds true for men. This is why restorative reproductive medicine (RRM) practitioners seek whole body health rather than focusing exclusively on making conception happen.
Just as infertility is a symptom of something wrong in the female body, not a disease in and of itself, the same holds true for men. This is why restorative reproductive medicine (RRM) practitioners seek whole body health rather than focusing exclusively on making conception happen.
While assisted reproductive technologies can only override the body’s ‘check engine’ lights, restorative reproductive medicine understands infertility’s broader implications and seeks to address the root causes. Though RRM specialists cannot and do not promise that a child will result from lifestyle changes, medications, and/or surgeries, they seek to bring the body back to health, and often increase the likelihood of conception in the process. And since the preconception health of both parents (not just mom!) impacts their children’s health, assessing and addressing a couple’s whole body health can impact multiple generations [8].
