Azoospermia is the absence of spermatozoa and is diagnosed when after two ejaculates a semen study is performed and no spermatozoa are seen under the microscope. There are different causes that can lead to an absence of spermatozoa, among them are those that are produced at pretesticularily, that is to say, it is not a direct problem of the testicle itself but something happens in the male's hormonal axis, in the regulation of spermatozoa production, which leads to their not being produced.
It is now known that stress influences hormone production. Among the effects on the hormones that can be produced is the increase of prolactin, a hormone that is produced at a cerebral level in the pituitary gland and which influences the production of the GnRH hormone at a hypothalamic level, also in the brain. GnRH, in turn, regulates the pituitary hormones FSH and LH which modulate testicular production of testosterone and sperm production.
If prolactin increases due to stress, or other factors such as medications related to depression or hypertension, brain tumors or for causes that sometimes remain unknown, the production of GnRH is inhibited, the production of FSH and LH is reduced and the testicle may stop producing sperm and testosterone. Prolactin can be detected in a blood test and its levels can point to one or another cause of the azoospermia problem.
As a result of all these hormonal changes, men may notice other associated symptoms such as: decreased fluid, increased breast size and pain, secretion of milk from the breasts (galactorrhea), headache, tiredness, and erectile dysfunction.
The phenomenon that stress, as the only factor, can produce a total absence of spermatozoa is not frequent. Generally, there are other associated factors and a complete study must be carried out in the event of azoospermia in order to rule out all the problems and implement the appropriate measures. In the case of hyperprolactinemia, depending on the cause, medical treatment can be given to reduce the levels and control the symptoms.