Testicular atrophy (shrinkage) – Causes, Diagnosis & Treatment

Causes:

• Hormonal Imbalances: Low testosterone levels (hypogonadism) can lead to testicular atrophy. This can be due to primary testicular failure or problems with the pituitary gland.
• Varicocele: Enlarged veins within the scrotum can raise the temperature around the testicle, potentially affecting sperm production and causing shrinkage.
• Infection: Certain infections, such as orchitis (inflammation of the testicle), can damage the testicle and lead to atrophy.
• Testicular Torsion: While primarily causing severe pain, if testicular torsion is not treated promptly, it can lead to testicular death and shrinkage.
• Trauma: Injury to the testicles can cause damage and subsequent atrophy.
• Certain Medications: Some medications, such as anabolic steroids, can affect testicular size and function.
• Aging: Some degree of testicular shrinkage can occur with age as part of the natural aging process.
• Cryptorchidism (Undescended Testicle): If a testicle fails to descend into the scrotum during childhood, it can become atrophic.
• Cancer: Testicular cancer, while often presenting as a painless mass, can sometimes be associated with testicular shrinkage.

Diagnosis:

• Physical Exam: Careful examination of the scrotum and testicles, noting size, consistency, and any other abnormalities.
• Patient History: Gathering information about the onset of shrinkage, any other symptoms, past medical history, medication use, and any history of injury or infection.
• Hormone Levels: Blood tests to measure testosterone and other hormone levels.
• Semen Analysis: May be performed to evaluate sperm count and quality, especially if fertility is a concern.
• Ultrasound: A common imaging test to visualize the testicles and surrounding structures, helping diagnose conditions like varicocele or tumors.

Treatment:

• Hormone Replacement Therapy (HRT): If low testosterone is the cause, testosterone replacement therapy may be recommended.
• Varicocele Repair: If a varicocele is contributing to testicular atrophy, surgery or embolization (a procedure to block the affected veins) may be considered.
• Infection Treatment: Antibiotics are prescribed to treat infections like orchitis.
• Testicular Torsion: Requires immediate surgical intervention to restore blood flow to the testicle.
• Medication Adjustment: If medication is suspected to be the cause, the doctor may adjust the dose or recommend an alternative.
• Surgery: Surgery may be necessary for undescended testicles or testicular cancer.
• Treatment of Underlying Cause: If the atrophy is due to an underlying medical condition, treatment will be directed at that condition.

Important Considerations:

• It’s important to consult a healthcare professional for any noticeable testicular shrinkage. Early diagnosis is crucial, especially for conditions like testicular cancer or testicular torsion.
• Do not attempt to self-treat testicular atrophy. Proper diagnosis is essential for effective treatment.
• If you experience sudden, severe testicular pain, seek immediate medical attention as this could be a sign of testicular torsion, a medical emergency.