Andrology: what it is and what it does

Andrology is the branch of medicine that studies and treats male sexual and reproductive health. It covers the diagnosis, treatment and prevention of conditions affecting the male urogenital system: erectile dysfunction, infertility, ejaculatory disorders, prostate conditions, varicocele and sexually transmitted diseases. The andrologist is to men what the gynaecologist is to women: the reference physician for sexual health at every age.

It is a multidisciplinary field, combining urology, endocrinology, dermatology and psychosexology. An andrologist is not consulted only when something goes wrong: an andrological examination also serves to confirm the normal function and anatomy of the urogenital system and to establish proper prevention.

What conditions does an andrologist treat

The main andrological conditions treated by Prof. Alessandro Natali, urologist and andrologist in Florence, Italy, former Director of Andrological Urology at the University of Florence:

• Erectile dysfunction: difficulty achieving or maintaining an erection, addressed with medical treatments, surgical treatments and penile prosthesis
• Male infertility: the male factor is involved in roughly half of couples with difficulty conceiving
• Ejaculatory disorders: premature, delayed or absent ejaculation
• Prostate conditions: benign prostatic hyperplasia (BPH), prostatitis, prostate cancer
• Penile conditions: Peyronie's disease, congenital penile curvature, penile cancer
• Testicular conditions: varicocele, hydrocele, testicular cancer, testicular torsion, cryptorchidism
• Sexually transmitted diseases and genital trauma
• Plastic and reconstructive surgery of the male genitals, including hypospadias

When to see an andrologist

An andrological examination is advisable if you notice any of these signs:

• Difficulty with erection, even if occasional but recurring
• Premature ejaculation or other changes in ejaculation
• Trying to conceive without success for more than 12 months
• Pain, swelling or lumps in the testicles or groin
• Penile curvature, painful or appearing in adulthood
• Burning on urination, difficulty urinating, blood in the semen or urine
• Reduced sexual desire

The examination is also valuable in the absence of symptoms, as a preventive check: many andrological conditions, from varicocele to testicular cancer, are asymptomatic in their early stages and have better outcomes when diagnosed early.

Andrological prevention: at what age to start

Andrological prevention should begin in adolescence. With the end of compulsory military service in Italy, the only systematic andrological screening of the young male population disappeared: many boys now reach adulthood without ever having had a check-up. Yet adolescence and puberty are precisely when conditions such as varicocele, phimosis and undescended testicle first appear — conditions that, if left undiagnosed, can permanently affect future fertility and sexual health.

Prevention milestones by age

• Adolescence (12–18 years): first andrological examination to confirm normal genital development and rule out varicocele and cryptorchidism
• Adulthood (18–50 years): check-ups in case of symptoms, sexual disorders or when planning fatherhood; regular testicular self-examination
• After 50: periodic prostate check (examination and tests as indicated by the specialist), even without symptoms

Lifestyle has a direct impact on sexual health: smoking, physical inactivity, excess weight, alcohol abuse and other everyday habits are documented risk factors for erectile dysfunction and infertility. Helping patients correct them is part of the andrologist's work.

Frequently asked questions about andrology

What is the difference between an andrologist and a urologist?

A urologist treats the urinary tract in both men and women; an andrologist deals specifically with male sexual and reproductive health. Many specialists, including Prof. Natali, hold both competences: in Italy, andrological training is typically built on a urological or endocrinological background.

At what age should you have your first andrological examination?

During adolescence, roughly between 12 and 18 years of age, even without symptoms. It is the male equivalent of a first gynaecological visit.

What does an andrological examination involve?

The visit begins with a medical history interview (clinical history, lifestyle, sexual life), followed by a physical examination of the external genitalia and, where indicated, a digital rectal examination of the prostate. Depending on the findings, the specialist may request further tests such as ultrasound, hormone tests or a semen analysis. The examination is not painful.

Can infertility in a couple be caused by the man?

Yes. The male factor is present, alone or in combination with a female factor, in roughly half of all cases of couple infertility. For this reason the man's andrological assessment should run alongside the woman's gynaecological assessment, not after it.

Do you have a symptom or a question? Ask Prof. Natali for a consultation or book an appointment at his practices in Florence and Empoli, Italy.

The information on this page is provided for general educational purposes and does not replace a medical examination, which remains the only diagnostic tool for correct and effective treatment.