Testicular Atrophy: Symptoms, Causes, Diagnosis, Treatment, Prediction and Prevention

It refers to the decrease of the testicles, which are the two male reproductive glands located in the scrotum.

The scrotum’s primary function is to regulate the temperature around the testicles, decreasing it in response to low temperatures and relaxing in response to warmer temperatures.

This can make you feel that your testicles are larger or smaller than usual.

However, testicular atrophy refers to the contraction in your actual testicles, not in your scrotum. This can be due to several things, including an injury, an underlying condition, or exposure to certain chemicals.

Testicular atrophy can reduce or stop the normal functioning of the organs and cause problems of fertility or even infertility.

Testicular atrophy is caused mainly by a disease or condition, such as certain genetic or childhood diseases, chronic infections, injuries to the testicles, regular use of alcohol or drugs, chronic anemia, or testicular cancer.

Anabolic steroids are also a frequent and recognized cause of testicular atrophy.


Read on to learn more about the possible causes and if testicular atrophy is reversible.

What are the symptoms of testicular atrophy?

Although the main symptom of testicular atrophy is the contraction of one or both testicles, several other symptoms may accompany it, depending on your age.

The symptoms of testicular atrophy include:

  • Pain in the testicles.
  • Sterility.
  • Sexual dysfunction
  • Decrease in libido

Symptoms before puberty:

For people who have not gone through puberty, the additional symptoms of testicular atrophy include not developing secondary sexual characteristics, such as:

  • Facial hair.
  • Pubic hair.
  • Largest penis size

Symptoms after puberty:

If you have gone through puberty, additional symptoms of testicular atrophy may include:

  • Decrease in sexual desire
  • Sterility.
  • Reduced muscle mass
  • Absence or decrease in the growth of facial hair.
  • Growth of pubic hair absent or reduced.
  • Testicles softer.

The symptoms of bilateral testicular atrophy can be traced to a general decrease in scrotal volume; palpation reveals small dimensions and sagging testicles.

Some particularly severe cases are characterized by the fact that the palpation of the scrotum reveals an atrophied testicle in the form of a thin plate.

With a decrease in the size of the testicle, the level of testosterone production decreases accordingly. This, in turn, causes a significant weakening of the libido and reduces the amount of seminal fluid.

It should be noted that changes in spermogram rates with unilateral atrophy occur even when the second testicle is not affected by this process. This is because the pathological phenomena in a testicle somehow imply alterations in the functioning of the other.

The concomitant manifestations are decreased muscle tone and an oppressed emotional state.

As a general rule, a man may notice such symptoms of testicular atrophy and, having detected disturbing progress in reducing his size, seek help from the appropriate specialist to prescribe timely treatment.

The presence of bilateral testicular atrophy as a complication of orchitis before puberty may cause a phenomenon such as a eunuchoidism.

Varicocele testicular atrophy:

The vessels responsible for the venous blood supply of the testicle have a large amount of communication between them: the scrotal anastomosis and the inguinal canal. They form the so-called lobed plexus.

There is an excessive pathological expansion of said lineage in some cases, which causes varicocele.

Atrophy of the testis with varicocele occurs because due to this phenomenon with the veins in the plexus of the plexus, the blood flow deteriorates. This leads to the fact that the testicle is exhausted, and its internal structure deteriorates.

When the veins enlarge, stagnant blood processes begin with low oxygen saturation. The local hypoxia testicles cause changes in their structure, negatively affecting the quality and quantity of sperm produced.

This is due to increased scrotum and overheating of the testicles due to the filling of veins enlarged with venous blood.

Atrophy of the testis with varicocele is caused by alterations in the structure of the testicles. The harmful effects on your condition also have the resulting hormonal alterations.

The atrophic processes in the testicle can be treated by appropriate surgical intervention. As a result, the testicle grows to a standard size; its internal structure is restored, and, as a result, the quality of the sperm is improved.


Testicular atrophy is the medical term given to shrunken testes. The testes are organs involved in the male reproductive system that resides in a structure similar to a bag called the scrotum.

They are involved in the production of sperm and the secretion of male sex hormones. The contraction of one or both testicles depends on the severity and duration of atrophy.

There are several causes for the condition, such as hormonal imbalance and the use of medications.

The widespread opinion is that the risk group is exclusively men dedicated to lifting weights, particularly those who regularly visit the gym and participate in strength exercises for muscle development.

However, it can be stated that this belief is entirely wrong.

All types of drugs from the group of anabolic steroids, which are often accompanied by bodybuilding, are by no means the only and foremost reason that leads to the appearance of testicular atrophy.

The probability of appearance and development of this disease is quite significant for the rest of the mass of men. And the fact that a man has never been treated with steroids and all kinds of appropriate bioactive additives does not rule out such a possibility.

The atrophic processes of the testes occur over a long period. In the case of the timely diagnosis of the appearance of pathological changes, their subsequent development can be prevented.

The causes of testicular atrophy can occur during the period of intrauterine development. They are represented in particular by cryptorchidism.

In the eighth month of carrying the child, the testicles are lowered into the scrotum. If the testicle remains in the cavity of the peritoneum or the inguinal canal during this process, this can lead to the cessation of its development and subsequent atrophy.

Atrophy of the testes can occur due to injuries and inflammatory processes, hydrocele, or orchitis.

Blood flow disorders also cause testicular atrophy. It arises from the side with which the spermatic artery can be compressed. The compression of the seed route is one of the possible consequences of surgical intervention in the scrotum and inguinal canal plastic.

Traumatic causes also occur in cases of injury to the spine in the lumbar region, in which the innervation of the testicles is affected. Lead to atrophy of the testicles can also cause orchids caused by trauma.

The parenchyma of the testicle with its inflammation is characterized by a predominantly unilateral character, which causes the probability of testicular atrophy from the side that is susceptible to said inflammatory process.

Some causes of testicular atrophy are also hormonal. The atrophic processes of the testes are possible in the context of obesity in its severe stages and the hormonal imbalance associated with the regulation of sex hormones.

The testes are composed mainly of two types of cells responsible for their function:

Germ cells: the germ cells are responsible for the production of sperm.

Leydig cellsLeydig cells are responsible for the production of testosterone, the male sex hormone.

The normal development of the testicle produces both types of cells in equal proportions and results in the testicles being round, firm and full.

Decreasing the levels of one or both of these cell types can lead to changes in testicular fluid levels, resulting in highly shrunken testicles.

Hormone imbalance:

Imbalances due to side effects of medications, radiation exposure, or even the chronic use of steroids may cause.

When hormonal imbalances occur, the body perceives that it has more than enough sex hormone circulating in the body, which leads to less production in the testicles, which causes them to shrink.

The interruption of these offensive medications can often reverse this occurrence, depending on the severity.


It is known that medical conditions such as mumps virus and HIV cause testicular atrophy. The situation can be reversed with the treatment of the disease, but it depends on the severity of the atrophy.


Orchitis refers to the inflammation of the testicles. Its main symptoms are pain and swelling in the testicles, but it can also cause nausea and fever. While swelling can initially make your testicles look bigger, orchitis can eventually lead to testicular atrophy.

There are two main types of orchitis:

Viral orchitis: this is usually caused by the mumps virus. Up to a third of men who have mumps after puberty develop orchitis. This often occurs within four to seven days after the appearance of the mumps.

Bacterial orchitis: this type of orchitis is often due to a sexually transmitted infection (STI), such as gonorrhea or chlamydia. In some cases, it is caused by an infection in the urinary tract or by inserting a catheter or other medical instrument into the penis.

Other causes of testicular atrophy:

In addition to orchitis, several other things can cause testicular atrophy, which includes:

Age: While women go through menopause, some men go through a similar process known as andropause. This causes low levels of testosterone, which can lead to testicular atrophy.

Testicular atrophy can be a consequence of natural aging and is observed more frequently in men who have passed their reproductive stage.

Varicoceles: A varicocele is like a varicose vein, but it is found near the testicles instead of the legs. Varicoceles usually affects the left testicle and can damage the sperm-producing tubes inside the testicles. This can make the affected testicle smaller.

Testicular torsion: this happens when a testicle turns and twists the spermatic cord, which carries blood to the scrotum. Decreased blood flow can cause pain and swell in the testicles. If left untreated for a few hours, it can cause permanent testicular atrophy.

Testosterone replacement therapy (TRT): Some men undergoing TRT experience testicular atrophy. This is because testosterone replacement therapy can stop the production of gonadotropin-releasing hormone (GnRH).

Without the gonadotropin-releasing hormone, the pituitary gland stops producing luteinizing hormone (LH). Without luteinizing hormone, the testicles stop secreting testosterone and stimulate smaller testes.

Use of anabolic steroids or estrogens: taking anabolic steroids or estrogen supplements can cause the same effect on hormones as testosterone replacement therapy.

Alcohol use disorder: Alcohol can cause low testosterone levels and testicular tissue, which can cause testicular atrophy. Chronic alcohol consumption leads to cases of liver cirrhosis, which can hurt the testicles and cause atrophy.


When you first consult a doctor for a case of suspected testicular atrophy, you will first take a detailed history to rule out any external cause, such as the use of steroids or medications.

The details will also be addressed to discover what causes testicular atrophy; your doctor or specialist may ask you questions about your lifestyle, medical history, and sexual history since sexually transmitted diseases may play a role.

This will help them determine if alcohol or a sexually transmitted infection could cause.

Next, your doctor will also evaluate the external genitalia for additional clues; an examination will be performed, physical examination of your testicles is likely, with the doctor having to feel the inguinal region directly, the penis, and the scrotum with the testicles verifying its size, texture, and firmness, looking for any change.

The palpation of the genitals is carried out to identify the possible presence of nodules or seals, which indicates oncology, as well as other pathological manifestations.

As a result of the examination of the testes, it is possible to determine why the symptoms of pain appear, detect foci of inflammation or determine the fact of congenital anatomical abnormalities, such as an absent testicle or that did not descend to the scrotum during prenatal development.

The diagnosis of testicular atrophy is an essential factor in health, whether it is an adult or a child, regardless of age. This preventive measure is relevant for children because it allows you to detect a non-descending testicle or other congenital anomalies.

A non-descending testicle may be susceptible to the development of a cancerous disease. When revealing the seals in the testicle, it should be remembered that in many cases, they are malignant tumors, so do not delay the visit to the doctor for the necessary diagnostic measures and, as soon as possible, start the treatment.

To complete the diagnosis of testicular atrophy, tests should be performed; depending on what the treating doctor finds, you can request some tests that include:

  • Testicular ultrasound to evaluate blood flow and identify any abnormalities.
  • Blood test to detect any signs of infection.
  • Analysis of hormones to determine if there are urological and hormonal imbalances.
  • A testicular ultrasound.
  • A complete blood count.
  • A test of testosterone level.

How is testicular atrophy treated?

The treatment of testicular atrophy depends entirely on its cause and origin.

Doctors or specialists should initially seek to cure the disease responsible for the atrophy, and the most effective treatment will be prescribed.

If the testes have not changed more since the onset of the disease, testicular atrophy can then be treated by hormonal or surgical intervention.

Testicular atrophy is reversible when detected early, and the appropriate treatment is administered in most cases. However, if left untreated for extended periods, additional damage may occur, and the chances of reversion may decrease.

Medical conditions commonly found in younger people, such as testicular torsion, should be remedied with surgical intervention. Hormone replacement therapy can also be prescribed along with changes in lifestyle and regular exercise.

If it is due to a sexually transmitted infection or other infection, the treatment of that specific infection will likely resolve the case of testicular atrophy in time; you will probably need a round of antibiotics.

In other cases, you will have to make some lifestyle changes. In rare cases, you may need surgery to treat claims of testicular torsion.

While the conditions that can cause testicular atrophy are usually easy to treat, testicular atrophy by itself is not always reversible. Early treatment increases the likelihood that testicular atrophy is reversible in many cases.

This is especially important if your testicular atrophy is due to testicular torsion. Waiting more than a few hours to seek treatment can cause permanent damage.

There is no proven way to reverse testicular atrophy naturally. If the presence of this progressive process is diagnosed, unfortunately, treatment is not possible.

The most convenient in this case is the destruction of the testicle, affected by pathological changes. This is dictated by the consideration that there is a high probability of tumor development otherwise.

Therefore, the treatment is mainly reduced to timely intervention.

A measure as radical as the removal of the affected testicle significantly affects the condition and function of the reproductive system. This, however, does not exclude the possibility that men continue to live a whole life.

In place of the excised testis, a prosthesis is inserted to maintain the standard form of the scrotum. For fertile function and maintaining a sufficient level of male hormones, the remaining healthy testicle is adequate.

A significant role is also given to preventive measures to prevent testicular atrophy.


The atrophy of the testicles does not provide any effective treatment. To avoid further development, it is not your history of various complications and pathologies in the healthy testicle that shows the removal of the affected testicle.

The prevention of testicular atrophy is reduced, first, to the timely interpretation of anxiety symptoms and the formulation of the correct diagnosis.

Therefore, if you notice that the testicle has begun to decrease in size, it is necessary to visit the urologist without delay. Due to the treatment prescribed by a specialist, the process can be stopped successfully.

Although it can not return the testicle to its standard size, this measure will prevent the appearance of a significant hormonal imbalance in the body.

The prevention of testicular atrophy and the symptoms of the actual pathological process also suggests the identification and immediate beginning of the treatment of diseases that can lead to the death of tissues.

The ingestion of drugs can cause such diseases from the group steroids in excessive amounts. These medications adversely affect the testicles and kidneys, the pituitary gland, and the pancreas.

Since childhood diseases, especially mumps, increase the risk of testicular atrophy, vaccination is essential. The prevention of testicular atrophy also implies adopting a healthy lifestyle, where the consumption of alcohol is casual and the use of non-existent drugs.

Prognosis of testicular atrophy

The prognosis of testicular atrophy depends mainly on the causes of the progression of this process in a man’s body. It can also cause changes that affect homeostasis: the state of optimal hormone balance.

Due to the increase in the number of androgens during intense exercise, the level of natural testosterone tends to decrease. This eventually leads to the fact that the functions of the testicles become much less severe, and the testes begin to fall in size.

This phenomenon does not give reason to consider it a cause of alarm since it is a temporary symptom. At the end of the admission of the athletes, the testicles retrieve the testicles in their standard size. Also, the hormonal balance is normalized again.

The prognosis of testicular atrophy seems less favorable based on traumatic factors; there are severe dysfunctions of the glands and a significant imbalance in the hormonal background.

With a high degree of risk, there is also a significant excess of the norm of the body mass index and the presence of obesity 2-3 and the most severe and morbid stage.

Living with testicular atrophy

Many things can cause your testicles to shrink, from steroids to sexually transmitted infections. Regardless of the cause, it is essential to talk to your doctor as soon as you notice any contractions. Early treatment is key to the successful reversion of testicular atrophy.