Shrinking Testicles: Causes and Concerns in Urology

The testicles are getting smaller, but the cause has not been identified?

I have been experiencing issues with my urinary system for a while.
Since last year, I noticed that my semen has become increasingly thin and the volume has decreased significantly.
After undergoing tests at Taipei Hospital, they informed me that the volume is normal and the count is within the normal range, but compared to two years ago, it has decreased considerably—by more than half (I had previously checked my sperm count).
In March or April of this year, I visited a clinic for an ultrasound, and they said my testicles were within the normal range at 3 centimeters on both sides.
However, I found online that the normal size is approximately 5 centimeters.
Recently, I have been checking daily, and I feel that my testicles have shrunk even more than before.
My partner has also mentioned that both my testicles and penis seem to have decreased in size, which has made me feel very depressed and unsure of what to do.

Nìmíng, 20~29 year old female. Ask Date: 2020/08/23

Dr. Cai Zhuorong reply Urology

It is recommended to conduct a blood test to check male hormones.

Reply Date: 2020/08/23

More Info

Understanding the concerns surrounding shrinking testicles and changes in semen quality is crucial for maintaining reproductive health. Your observations about the changes in your semen volume and the size of your testicles are valid and warrant further exploration.
Firstly, it’s important to note that testicular size can vary significantly among individuals. While the average testicle size is often cited as being around 4 to 5 centimeters in length, a size of 3 centimeters can still fall within a normal range, especially if there are no accompanying symptoms of pain or discomfort. However, if you are noticing a consistent decrease in size or if your partner has also observed these changes, it may be indicative of an underlying issue that should be addressed.

Several factors can contribute to the shrinking of testicles and changes in semen quality. Hormonal imbalances, particularly involving testosterone, can lead to a decrease in testicular size. Conditions such as hypogonadism, where the body doesn’t produce enough testosterone, can result in smaller testicles and reduced sperm production. Additionally, lifestyle factors such as obesity, smoking, excessive alcohol consumption, and drug use (especially anabolic steroids) can negatively impact testicular function and size.

Infections or inflammation in the reproductive system, such as epididymitis or orchitis, can also cause changes in testicular size and semen quality. These conditions can lead to swelling, pain, and a decrease in sperm production. If you have experienced any symptoms such as pain, swelling, or changes in urination, it is essential to consult a healthcare provider for a thorough evaluation.

Another potential cause of changes in semen quality is varicocele, which is an enlargement of the veins within the scrotum. This condition can affect sperm production and quality, and it is often associated with a feeling of heaviness or discomfort in the scrotum. A physical examination and ultrasound can help diagnose this condition.

Stress and mental health issues can also play a significant role in sexual health. Anxiety and depression can lead to hormonal changes that may affect libido and semen quality. If you are feeling particularly anxious or depressed about these changes, it may be beneficial to speak with a mental health professional.

Given your concerns, it is advisable to follow up with a urologist or a reproductive health specialist. They can perform a comprehensive evaluation, including hormone level testing, semen analysis, and possibly imaging studies to assess the health of your reproductive organs. Open communication with your healthcare provider about your symptoms and concerns is essential for accurate diagnosis and treatment.

In summary, while changes in testicular size and semen quality can be concerning, they can often be addressed with the right medical guidance. It is crucial to seek professional help to determine the underlying cause of your symptoms and to explore potential treatment options. Remember, you are not alone in this, and there are resources available to help you navigate these changes in your reproductive health.

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