Testicular atrophy

Testicular atrophy is not related to the temporary shrinkage of the surrounding scrotum, which might occur in response to cold temperature.

[1] In a prepubescent person with testicular atrophy, there may be underdevelopment of secondary sex characteristics (e.g. lack of penis growth).

[2] In sexually developed individuals, testicular atrophy may be accompanied with lower sex drive and increased breast tissue.

Some causes include age,[1] alcohol use,[3] anabolic steroid use,[4] testosterone replacement therapy,[2][5] direct damage to the testicles,[6][7] and infection.

[11] Signs and symptoms before puberty include: Testosterone is a hormone that is found primarily in a portion of the male reproductive system called the testes and is normally measured in nanograms per deciliter.

As a person with testes hits puberty, androgen, a steroid sex hormone, is produced at an increased rate, which creates terminal hair follicles.

Decreased testosterone values caused by testicular atrophy can lead to and explain many of the signs and symptoms listed above, including a reduced sex drive, infertility, soft testicles, reduction of hair, and lower muscle mass throughout the body.

If testosterone levels drop below normal values, libido (sexual drive) is reduced, which can lead to the development of erectile dysfunction (a condition in which the penis is not able to get or stay erect).

[15] Signs and symptoms of testicular atrophy that are due to a secondary medical condition include: Secondary medical conditions that may cause the signs and symptoms listed above include testicular cancer, chronic alcohol use, sexually transmitted infections, COVID-19, orchitis, varicoceles, or torsion of the testes.

[16] Anabolic steroid use and testosterone replacement therapy (TRT) have been found to cause testicular atrophy through similar mechanisms.

[2][1][17] Anabolic steroids and TRT are both used (either by prescription or illicitly) to mimic the effects of testosterone produced by the body, such as building muscle and maintaining sex drive.

Around 97-98% of people with cystic fibrosis who have testicles are infertile due to a missing vas deferens, the tube in the male reproductive system that carries sperm out of the testes.

[21][22] Additionally, cystic fibrosis can result in the atrophy of male reproductive organs by causing dehydrated secretions.

[26] Treatment with selective estrogen receptor modulators (SERMs) alone or in addition to self-administered injections of hCG aim to correct hormonal imbalances caused by anabolic steroid use and can help prevent or reverse testicular atrophy for some people.

Performance of an orchiectomy on individuals diagnosed with testicular atrophy has a possible negative impact on their testosterone levels in the long term.

[28] In addition to drug therapies and surgical interventions to treat testicular atrophy, lifestyle modifications might also be recommended by healthcare providers.

Limiting or abstaining from alcohol intake, smoking, and drugs such as anabolic steroids, cannabis, or opioids can help with infertility.