A male is born with two testicles. The testes are oval in shape and are responsible for producing the male hormones and sperm. The testes are well protected in a sack of skin known as the scrotum, which hangs outside the body right below the penis. It is quite common for a male to have testicles in two different sizes. Testicular atrophy is a condition that can affect males of various ages for various reasons.
Testicular atrophy is a condition when a male’s testes shrink in size. Either one or both testicles can shrink in size, which in turn can affect or compromise the functioning of the testicles and the fertility.
The testicles tend to shrink a little in winter as the skin shrinks due to the cold weather. This helps keep the testicles warm by holding them closer to the body. Testicular atrophy is very different. In this condition, the testicles – one or both can shrink for various reasons at varying degrees – meaning they can shrink just a little or continue shrinking over time, resulting in a noticeable difference.
The testicles can shrink due to the loss of germ cells or Leydig cells or both. While the germ cells are responsible for producing the sperm, the Leydig cells are responsible for producing testosterone. So, in testicular atrophy, when the testes shrink due to the loss of some cells, it can lead to a decrease in the production of sperm, testosterone or both.
Some possible causes for testicular atrophy are:
1. Age – As a male age, his testosterone and sperm production will decrease over time. This can lead to a reduction in the size of the testicles, which is very natural and nothing to worry about.
2. Hormones – An imbalance in the hormones that causes the body to decrease the production of testosterone or sperm, can lead to testicular atrophy due to hormonal imbalance. This can usually happen when taking estrogen supplements or certain medications. Anabolic steroids and hormone replacement therapy can also affect the testosterone production.
3. Health Issues – Diseases like mumps or HIV can cause the testicles to shrink. Infections like orchitis can cause pain and inflammation in the testicles. Orchitis can be caused by bacteria or viruses like chlamydia, gonorrhea, UTIs, surgery on the urinary tract, intestinal bacteria travelling up after anal intercourse or even by the use of a catheter.
4. Lifestyle – Excessive consumption of alcohol can negatively impact the testosterone levels in the body or affect the testicular tissue, both of which can result in testicular atrophy.
5. Testicular Torsion – If a testicle rotates and twists the spermatic cord that connects the reproductive tract and testicles, it can result in testicular torsion. This can cause severe pain and swelling that requires immediate medical attention. The twisted cords can disturb the blood and oxygen supply to the testicles, resulting in permanent testicular atrophy if not treated immediately.
6. Varicocele Veins – In this condition, the veins that carry out the oxygen-depleted blood away from the testicles, swell up. Instead of circulating, the blood starts pooling up in the scrotum causing pain and discomfort. This can lead to poor development of the testicles and usually shows no symptoms. It generally happens on the left side of the body, thus causing the left testicle to be smaller or underdeveloped than the right testicle.
7. Cancer – In very rare cases, testicular cancer can lead to testicular atrophy. This condition tends to affect young men but is treatable.
The most common symptom of testicular atrophy is the shrinking of one or both testicles. However, some additional symptoms may be present for different age categories.
For those who are yet to reach puberty –
● The penis can be larger
● There may be no facial or pubic hair
For those who have reached puberty –
● Testicles can feel soft
● General muscle mass can be low
● Low sex drive
● Fertility issues
● Facial or pubic hair can be lesser
If the testicular atrophy is due to certain underlying health conditions, the following additional symptoms may also be present –
● Fever
● Nausea
● Pain in the testicles
● inflammation
A doctor will go through the following steps before confirming a testicular atrophy diagnosis:
● Physical examination to check the size, shape, texture and firmness of the testicles
● Ask questions about the medical history
● Enquire about the lifestyle and habits
● Ultrasound of the testicles to check the blood flow
● Blood tests to check for possible infections
● Urine tests to check for STIs
● Test the hormone levels
The treatment for testicular atrophy will vary depending on the extent of shrinkage and the underlying cause of the atrophy. Common treatments include:
● Changes in lifestyle and habits – Quitting alcohol, smoking and drugs can help improve testosterone levels.
● Antibiotics to treat infections – In case of any sexually transmitted infections or Orchitis, medications can help treat the infection, after which the size of testicles can improve.
● Surgery in case of testicular torsion – The earlier the diagnosis and treatment, the better the results and the higher the chances of preventing permanent atrophy or damage to the testicles.
● Hormone therapy – If the body is not making enough testosterone, HRT can help increase testosterone production and restore hormone balance.
Over the years, there have been a number of natural remedies for multiple ailments. Similarly, many people claim there are tried and tested natural remedies to help treat testicular atrophy. However, there is no scientific or clinical evidence backing such remedies.
Testicular atrophy can affect any male, irrespective of their age. Diagnosing the problem at the earliest and starting the right treatment can help reduce the damage and even reverse the atrophy in many cases.
If an underlying health issue is causing the testicular atrophy, doctors will first address the underlying condition. This will include antibiotics to manage infections, medications to manage hormone imbalances, changes in lifestyle, surgery to repair the damaged veins or a testicular prosthesis to help restore the normal appearance of the testes.
If the blood flow to the testicles is affected or obstructed, it can lead to testicular atrophy. Surgically removing the block or restoring the blood flow to the testicles can help restore both fertility as well as testicle function.
Yes, it can be reversed if caught in an early stage. Starting the treatment before any long-lasting damages are caused, can help recover and reverse testicular atrophy.
