Testicular Failure Overview
Learn About Testicular Failure
Testicular failure occurs when the testicles cannot produce sperm or male hormones, such as testosterone.
Primary hypogonadism - male
Testicular failure is uncommon. Causes include:
- Certain medicines, including glucocorticoids, ketoconazole, chemotherapy, and opioid pain medicines
- Diseases that affect the testicle, including hemochromatosis, mumps, orchitis, testicular cancer, testicular torsion, and varicocele
- Injury or trauma to the testicles
- Obesity
- Genetic diseases, such as Klinefelter syndrome or Prader-Willi syndrome
- Other diseases, such as cystic fibrosis
The following can increase the risk of testicular failure:
- Activities that cause constant, low-level injury to the scrotum, such as riding a motorcycle or bicycle
- Frequent or heavy use of marijuana
- Undescended testicles at birth
Symptoms depend on the age when testicular failure develops, either before or after puberty.
Symptoms may include:
- Decrease in height
- Enlarged breasts (gynecomastia)
- Infertility
- Loss of muscle mass
- Lack of sex drive (libido)
- Loss of armpit and pubic hair
- Slow development or lack of secondary male sex characteristics (hair growth, scrotum enlargement, penis enlargement, voice changes)
Men may also notice they do not need to shave as often.
Male hormone supplements may treat some forms of testicular failure. This treatment is called testosterone replacement therapy (TRT). TRT can be given as a gel, patch, injection, or implant.
Avoiding the medicine or activity that is causing the problem may bring testicle function back to normal.
Sonora Community Hospital
Jason Jeffery is an Internal Medicine provider in Sonora, California. Dr. Jeffery and is rated as an Advanced provider by MediFind in the treatment of Testicular Failure. His top areas of expertise are Familial Hypertension, Hypertension, Glucocorticoid-Remediable Aldosteronism, and Vertigo.
Sonora Community Hospital
Donald Westbie is an Endocrinologist in Sonora, California. Dr. Westbie and is rated as an Advanced provider by MediFind in the treatment of Testicular Failure. His top areas of expertise are Type 2 Diabetes (T2D), Maturity Onset Diabetes of the Young, Hypothyroidism, and Obesity in Children.
Sonora Community Hospital
Ryan Carey is a Family Medicine provider in Sonora, California. Dr. Carey has been practicing medicine for over 9 years and is rated as an Experienced provider by MediFind in the treatment of Testicular Failure. His top areas of expertise are Otitis, Hypertension, Glucocorticoid-Remediable Aldosteronism, and Familial Hypertension.
Many forms of testicular failure cannot be reversed. TRT can help reverse symptoms, although it may not restore fertility.
Men who are having chemotherapy that can cause testicular failure should discuss freezing sperm samples before starting treatment.
Testicular failure that begins before puberty will stop normal body growth. It can prevent adult male characteristics (such as deep voice and beard) from developing. This can be treated with TRT.
Men who take TRT need to be carefully monitored by their provider. TRT may cause the following:
- Enlarged prostate, leading to difficulty urinating
- Blood clots
- Changes in sleep and mood
- Changes in good cholesterol (HDL)
- Blood becomes too thick (polycythemia)
Contact your provider for an appointment if you have symptoms of testicular failure.
Also, contact your provider if you're on TRT and you think you're having side effects from the treatment.
Avoid higher-risk activities if possible.
Remain active and prevent weight gain as you get older.
Summary: This is a large randomized, double-blind, placebo-controlled trial to determine the efficacy of testosterone replacement on cancer-related fatigue in older men with solid or hematologic (blood) cancer who report fatigue and have low testosterone levels.
Summary: This is a 52-week open label single arm study to investigate the effects of XYOSTED, as testosterone replacement therapy, on adolescent males with either primary or secondary hypogonadism. The study aims to determine the effectiveness of XYOSTED measured by continuation or induction of puberty in addition to XYOSTED dosage, safety and testosterone levels.
Published Date: May 12, 2023
Published By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Morgentaler A, Zitzmann M, Traish AM, et al. Fundamental concepts regarding testosterone deficiency and treatment: international expert consensus resolutions. Mayo Clin Proc. 2016;91(7):881-896. PMID: 27313122 pubmed.ncbi.nlm.nih.gov/27313122/.
Schlegel PN. Clinical management of male infertility. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 113.
Swerdloff RS, Wang C. The testis and male hypogonadism, infertility, and sexual dysfunction. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 221.
US Food and Drug Administration website. FDA drug safety communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-cautions-about-using-testosterone-products-low-testosterone-due. Updated February 26, 2018. Accessed May 29, 2023.