According to abbreviationfinder, testicular atrophy is pathologically reduced testicles ( shrink testicles ). Severely reduced testicles are usually no longer functional, ie neither hormones nor intact sperm are produced. Possible causes include years of abuse of anabolic steroids, but also genetic defects, such as Klinefelter’s syndrome or an inflammation of the testicles.
What is testicular atrophy?
The doctor understands testicular atrophy to be conspicuously reduced testicles. While normal-sized testicles have a volume of about three cubic centimeters, shriveled testicles are sometimes only about one cubic centimeter in size.
Shrinkage testicles are usually no longer functional – the man suffers from azoospermia and – if both testicles are affected – is infertile. The sex hormones produced in the testicles – especially testosterone – are no longer produced.
The causes of testicular atrophy are very different. Shrunk testicles are relatively widespread among athletes who use large amounts of anabolic steroids to support muscle building.
Another cause are various congenital genetic defects, such as Klinefelter syndrome. In addition, an untreated and not completely healed inflammation of the testicles can lead to a shrinking testicle. As part of sex-changing therapy, transsexual men can shrink their testicles by taking female sex hormones ( oestrogens ) in order to prevent the testicles from secreting the male sex hormone testosterone.
Circulatory disorders ( varicocele ) or general trauma are less common causes of testicular atrophy.
Symptoms, Ailments & Signs
Visually, testicular atrophy can be recognized by the significant reduction in testicular volume. In addition, there is sometimes pain and an uncomfortable feeling of pressure in the area of the testicles. Discoloration of the scrotum can occur, which increases as the disease progresses and clearly indicates testicular atrophy. Testicular atrophy is also associated with infertility and erectile dysfunction.
If the testicular atrophy is based on inflammation, it usually progresses slowly and unnoticed. Those affected often only notice it when repeated erection problems occur or a desire to have children remains unfulfilled over a longer period of time. If drugs or growth hormones are the cause, a shrinking testicle usually develops quite quickly and is pain-free.
Testicular atrophy itself does not result in any other physical symptoms. However, it can sometimes lead to severe psychological problems. Due to the reduction of the testicles and the associated infertility, inferiority complexes, social anxiety and depression can set in. The partners are often also affected by the psychological problems. For this reason, it is advisable to consult a doctor at the first symptoms of testicular atrophy. Early treatment can often reverse atrophy and avert impending infertility.
Diagnosis & History
A urologist can diagnose a shrinking testicle relatively easily because it is clearly visible. To clarify the exact size, the urologist can carry out a sonography (ultrasound examination).
If the causes of the testicular atrophy are not obvious – for example in the case of gender reassignment therapy for transsexual men or if Klinefelter’s syndrome is present – the urologist will clarify the causes as part of the diagnosis, for example the presence of a varicocele or an inflammation.
In addition, the urologist can check the functionality of the testicles by making a spermiogram. If azoospermia is present, there are no sperm in the ejaculate. In this case, the testicles have stopped functioning and the man is infertile. The course or the formation of a shrinking testicle is very different depending on the cause.
While testicular atrophy caused by inflammation usually progresses insidiously and unnoticed and is only noticed when a desire to have children is not fulfilled, a shrinking testicle formed by taking medication or anabolic steroids forms quite quickly. Testicular atrophy is usually painless.
Due to the severe reduction in the size of the testicles, they have no function in most cases. This can mean not only physical, but also severe psychological problems for the patient. As a rule, this leads to infertility, which can often lead to depression or reduced self-esteem. This often results in an inferiority complex.
It is not uncommon for partners to be affected by psychological problems and thus also suffer from testicular atrophy. Furthermore, testicular atrophy has no particular negative effects on the health of those affected. In many cases, the mental health problems can be treated by a psychologist without complications. The life expectancy of the patient is usually not affected by the disease and is therefore not reduced.
If testicular atrophy occurs due to a circulatory disorder, this is usually treated first. Furthermore, other ways of pregnancy can also be used for the partner. It is not uncommon for the symptom to also occur in people who want to change their clothes for a sex change. However, testicular atrophy is not treated in this way. There are no other complications from this disease.
When should you go to the doctor?
Testicular atrophy does not always require medical attention. Less severely contracted testicles regress on their own as soon as the causative drug is discontinued. A disease-related testicular atrophy should be clarified by a specialist. Children suffering from Klinefelter syndrome or a comparable disease always require medical treatment. Parents should consult a doctor at the first sign of testicular atrophy and have the symptoms examined and treated if necessary.
If the shrinking testicles are accompanied by pain or other symptoms, medical treatment is also required. Men who are infertile due to testicular atrophy are best advised to speak to their family doctor. In addition, a visit to a therapist can also be useful. In any case, abnormally small testicles must be examined in order to narrow down the possible causes and to be able to take appropriate countermeasures. People who have had testicular atrophy from birth are best advised to speak to a specialist. It is often possible to insert implants or to enlarge the shrinking testicles through hormonal measures.
Treatment & Therapy
Depending on the cause, the treatment of a shrinking testicle is very different. If testicular shrinkage is intentional – which is the case with transsexual men who want to undergo sex reassignment surgery – testicle shrinkage will not be treated.
If the shrinking testicles have been triggered by taking anabolic steroids, it is advisable not to take the preparations any further. Sometimes the shrinking testicles recede after the preparations have been discontinued. The same applies if there is a circulatory disorder – after surgical removal of the varicocele, the blood flow can be normalized.
The consequences of a shrinking testicle can be counteracted by administering various medications containing testosterone. If the man already suffers from azoospermia, an attempt can be made to induce a pregnancy in the partner by means of artificial insemination with simultaneous TESE.
If the shrinking testicle causes pain or if the man suffers from the appearance, removing the shrinking testicle and inserting an implant can be considered.
Outlook & Forecast
In testicular atrophy, the testicles are significantly smaller. There is also pain and an uncomfortable feeling of pressure in the testicular region. Discolouration or sensory disturbances can also occur. Testicular antrophy is usually associated with erectile dysfunction or even infertility. If inflammation is the cause of the shrinking testicles, the signs of the disease become increasingly severe. The atrophy is often only noticed when repeated erection problems occur or the testicles have already become significantly smaller. As the disease progresses, the pain can radiate into the buttocks and abdomen, causing severe discomfort in the patient.
Untreated testicular atrophy can lead to the loss of one or both testicles. On the other hand, mental problems develop, such as depression or inferiority complexes. If the testicular atrophy is based on drug abuse, a variety of accompanying symptoms can also occur. Possible symptoms that occur in connection with shrinking testicles are digestive problems, cardiovascular problems such as tachycardia or blood pressure fluctuations and skin changes such as acne or redness.
If the cause of testicular atrophy is not addressed, the disease progresses progressively and, depending on the trigger, can lead to organ dysfunction, infertility and mental disorders. Atrophy treated early often subsides without long-term effects.
Shrinkage testicles themselves cannot be prevented. However, every man can minimize the risk of developing an (unwanted) shrinking testicle. This includes not taking anabolic steroids as well as going to the urologist as soon as the person concerned feels pain that suggests an inflammation of the testicles.
If the man feels a varicose vein (varicocele), he should also see a doctor. As a rule, the consequences of azoospermia with infertility can be prevented with early treatment of a shrinking testicle.
Follow-up care for testicular atrophy depends on the cause of the disease and the therapy that has been carried out. If anabolic steroid abuse was the cause, no more anabolic steroids may be consumed even after the end of the therapy, as otherwise there is a risk of renewed atrophy. If the cause was a circulatory disorder due to a varicose vein and the treatment was surgical removal of this varicocele, the patient must cool his scrotum with ice for the first 24 hours after the procedure to prevent bleeding and swelling.
The following day, an ultrasound check-up and a wound check are carried out, followed by the patient being discharged. During the first week, the person concerned must not do heavy physical work or play sports. A check-up appointment with the local urologist is then indicated, to whom the discharge letter from the clinic is to be handed over. Six weeks after the operation, the final check-up takes place in the treating clinic. Disturbing residues of the self-dissolving suture material can be removed here.
If the prescribed testosterone therapy does not result in a significant reduction in atrophy to its original size, removal of the testicle and insertion of an implant can be considered. This is recommended in the case of existing pain or psychological suffering as a result of aesthetics. After six to twelve months, a statement can be made about the remaining fertility by means of a semen test.
You can do that yourself
What those affected can do themselves in the event of testicular atrophy depends on the cause of the disease. If a particular drug is responsible for the testicular atrophy, treatment consists of stopping the drug responsible or changing the medication. If the shrinking testicles occur after taking anabolic steroids, the causative preparation should be avoided. Accompanying this, a medical clarification of the testicular atrophy is always necessary. Medications are often required to promote recovery. An individual diet can sometimes help to treat the shrinking testicles. This always depends on how severe the testicular atrophy is and whether accompanying symptoms occur.
Testicular atrophy that occurs in connection with a sex reassignment is desired by those affected and therefore does not need to be treated.
In the case of azoospermia, the testicular atrophy can no longer be counteracted. The most important self-help measure is to reduce any mental distress by joining a support group early on. Sometimes it makes sense to see a therapist. Pain can be alleviated by various natural remedies in addition to drug treatment. However, this should be discussed with the doctor treating you beforehand.