Testicular Atrophy: Causes, Diagnosis, And Treatment

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Medical News TodaySubscribeWhat causes testicular atrophy?

Medically reviewed by Helen Chen MCMSc, PA-C — Written by Jenna Fletcher — Updated on May 30, 2025

What is testicular atrophy?
Causes
Symptoms
Diagnosis
Treatment
Natural treatments
FAQ
Summary

Testicular atrophy occurs when the testes shrink. Several potential causes include aging, underlying medical conditions, or infections.

The testes are two reproductive glands located in the scrotum just behind the penis. These glands are responsible for creating sperm.

What is testicular atrophy?

Basketballs in nets — BreakingTheWalls/Getty Images

Testicular atrophy is the testes shrinking. In the case of testicular atrophy, the testes get smaller due to a loss of some of the germ cells and Leydig cells.

Germ cells produce sperm while Leydig cells produce testosterone.

If the testes shrink, a person could have a lower sperm count, lower testosterone levels, or both, due to the loss of these cells.

Testicular atrophy differs from the shrinking that occurs due to cold temperatures. In cooler temperatures, the scrotum retracts or shrinks, pulling the testes closer to the body to maintain warmth. In warmer temperatures, it loosens, allowing the testes to cool.

Causes

Possible causes of testicular atrophy include:

age
testicular cancer
orchitis
diseases
excessive alcohol usage
hormone imbalance
testicular torsion
varicocele

Age

Over time, the testes will likely begin to shrink. This is a natural process, as the body produces less testosterone or sperm after the peak reproductive years.

Hormone imbalance

Hormonal imbalances can sometimes cause testicular atrophy. If the body produces less testosterone, the testicles may begin to shrink.

Some potential causes of a hormone imbalance that suppress testosterone production include:

testosterone replacement therapy
taking estrogen
anabolic steroids
certain medications

Orchitis

Orchitis is an infection that causes pain and inflammation in the testicles. It can result from a virus or a bacterial infection.

Some of the common causes of orchitis include:

chlamydia
gonorrhea
intestinal bacteria that travels up the reproductive tract following anal intercourse
urinary tract infections (UTIs)
surgery on the urinary tract
use of a catheter

»Learn more about orchitis

Diseases

Certain diseases or infections, including mumps and HIV, may increase the risk of testicular atrophy. Depending on the severity of the shrinkage, treatment may reverse the atrophy.

Excessive alcohol usage

Regularly consuming excessive amounts of alcohol may cause a decrease in testosterone levels. Excessive alcohol consumption can also cause testicular tissue damage, which may result in testicular atrophy.

IE CE 5/21/2025: Cannot seem to find a suitable source for this section either! IE CE 5/27/2025: It seems that the MR comments below are for a source that also is not suitable.

Testicular torsion

Testicular torsion occurs if a testicle rotates, twisting the spermatic cord that connects the testes to the rest of the reproductive tract.

In addition to pain and swelling, the twisted cord causes blood loss to the testicles. If a person does not receive prompt treatment, the loss of oxygen and blood flow could lead to permanent testicular atrophy.

»Learn more about testicular torsion

Varicocele

Varicocele occurs when the veins that run through the scrotum become enlarged. It typically occurs on the left side only.

In many cases, a person may not realize they have a varicocele, as it may not cause any symptoms. However, they may notice that the left testicle appears smaller than usual.

Testicular cancer

In rare cases, testicular cancer can cause testicular atrophy. According to the American Cancer Society (ACS), the average age for a diagnosis of testicular cancer is 33.

While testicular cancer tends to affect younger men, it is highly treatable.

»Learn more about testicular cancer

Symptoms

Usually, the most obvious symptom of testicular atrophy is the noticeable shrinkage of one or both testicles.

However, depending on the person’s age and underlying conditions, a person may notice some additional symptoms.

Those who have not yet gone through puberty may notice a:

larger penis size
lack of facial or pubic hair

If testicular atrophy occurs after puberty, additional symptoms may include:

soft testicles
lower sex drive
reduction in muscle mass
infertility
reduction in facial or pubic hair

If an underlying medical condition is causing testicular atrophy, a person may also experience:

pain in the testicles
inflammation
fever
nausea

Diagnosis

A doctor will normally start to diagnose testicular atrophy by asking questions about the individual’s lifestyle and medical history. They will also ask about any medications a person is taking.

A doctor will also likely conduct a physical examination of the testicles, looking at the following qualities:

size
shape
texture
firmness

Finally, a doctor may order some additional tests to help determine what is causing the testicular atrophy. Possible tests include:

an ultrasound of the testicles to look at abnormalities and blood flow
blood work to look for signs of infection
swabs or urine tests to test for sexually transmitted infections
hormone level tests

Treatment

How a doctor treats testicular atrophy depends on its underlying cause. Possible treatments may include:

antibiotics for an infection
lifestyle changes
hormone therapy
surgery, particularly in cases of testicular torsion

If a person discovers testicular atrophy early and receives treatment as soon as possible, it might be possible to reverse the shrinkage.

Some conditions, such as testicular torsion, require immediate treatment to avoid permanent damage to the testicle.

Do natural treatments work?

Some people claim there are natural treatments for testicular atrophy. There is no clinical evidence to suggest that any natural remedies can correct testicular atrophy or its underlying causes.

Frequently asked questions

What is the most common cause of testicular atrophy?

Common causes of testicular atrophy include age, which occurs as a natural process of the body producing less testosterone as a person ages.

Can testicular atrophy be reversible?

Early treatment of testicular atrophy has a better outcome and a higher possibility of improving the issue.

Summary

Testicular atrophy can occur from various causes, including infections, diseases, or underlying conditions such as testicular cancer. It is important to contact a doctor promptly to examine the testicles and rule out possible causes.

People should be aware of the regular size and shape of their testicles. If one or both of the testicles become noticeably smaller, it is best to speak to a doctor as soon as possible.

There is a greater chance of reversing testicular atrophy with early intervention and treatment.

Men's Health
Alcohol / Addiction / Illegal Drugs
Infectious Diseases / Bacteria / Viruses
Sexual Health / STDs

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

https://www.ncbi.nlm.nih.gov/books/NBK553165/
Azmat CE, et al. (2023). Orchitis.
Choi H-I, et al. (2020). Testicular atrophy after mumps orchitis: ultrasonographic findings.
https://www.sciencedirect.com/science/article/pii/S2214854X20300121
Hussain A, et al. (2020). The human testes: Estrogen and ageing outlooks.
https://www.cancer.org/cancer/types/testicular-cancer/about/key-statistics.html
Key statistics for testicular cancer. (2025).
https://www.ncbi.nlm.nih.gov/books/NBK448113/
Leslie SW, et al. (2023). Varicocele.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8619877/
Matzkin ME, et al. (2021). Hallmarks of testicular aging: The challenge of anti-inflammatory and antioxidant therapies using natural and/or pharmacological compounds to improve the physiopathological status of the aged male gonad.
https://www.ncbi.nlm.nih.gov/books/NBK448199/
Schick MA, et al. (2023). Testicular torsion.

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Medically reviewed by Helen Chen MCMSc, PA-C — Written by Jenna Fletcher — Updated on May 30, 2025

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