BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuTesticular failurePrimary hypogonadism - maleTesticular failure occurs when the testicles cannot produce sperm or male hormones, such as testosterone.TesticlesThe testes are 2 egg-shaped male reproductive organs located in the scrotum. They produce sperm and the male hormone, testosterone.ImageRead Article Now Book Mark Article Causes 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 HemochromatosisHemochromatosis is a condition in which there is too much iron in the body. It is also called iron overload.ImageRead Article Now Book Mark Article MumpsMumps is a contagious disease that leads to painful swelling of the salivary glands. The salivary glands produce saliva, a liquid that moistens food...ImageRead Article Now Book Mark Article OrchitisOrchitis is swelling (inflammation) of one or both of the testicles.ImageRead Article Now Book Mark Article Testicular cancerTesticular cancer is cancer that starts in the testicles. The testicles are the male reproductive glands located in the scrotum.ImageRead Article Now Book Mark Article Testicular torsionTesticular torsion is twisting of the spermatic cord, which supports the testes in the scrotum. When this occurs, blood supply is cut off to the tes...ImageRead Article Now Book Mark Article VaricoceleA varicocele is the swelling of the veins inside the scrotum. These veins are found along the cord that holds up a man's testicles (spermatic cord)....ImageRead Article Now Book Mark Article Injury or trauma to the testicles Obesity Genetic diseases, such as Klinefelter syndrome or Prader-Willi syndrome Klinefelter syndromeKlinefelter syndrome, also called 47,XXY, is a genetic condition that occurs in males when they have an extra X chromosome. This can cause problems ...ImageRead Article Now Book Mark Article Prader-Willi syndromePrader-Willi syndrome is a disease that is present from birth (congenital). It affects many parts of the body. People with this condition feel hung...Read Article Now Book Mark Article Other diseases, such as cystic fibrosisCystic fibrosisCystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of th...ImageRead Article Now Book Mark Article 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 ScrotumThe scrotum is a part of a male's body that is located below the penis. The scrotum is the sac (pouch) that contains the testes, epididymis, and the...ImageRead Article Now Book Mark Article Frequent or heavy use of marijuana MarijuanaMarijuana comes from a plant called hemp. Its scientific name is Cannabis sativa. The main, active ingredient in marijuana is THC (short for delta-...Read Article Now Book Mark Article Undescended testicles at birthUndescended testiclesUndescended testicle occurs when one or both testicles fail to move into the scrotum before birth.ImageRead Article Now Book Mark Article Symptoms Symptoms depend on the age when testicular failure develops, either before or after puberty.Symptoms may include:Decrease in height Enlarged breasts (gynecomastia) Enlarged breastsWhen abnormal breast tissue develops in males, it is called gynecomastia. It is important to find out if the excess growth is breast tissue and not ...ImageRead Article Now Book Mark Article Infertility InfertilityInfertility means you cannot get pregnant (conceive). There are 2 types of infertility:Primary infertility refers to couples who have not become preg...ImageRead Article Now Book Mark Article 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. Exams and Tests A physical exam may show:Genitals that do not clearly look either male or female (usually found during infancy) Abnormally small, firm testicles Tumor or an abnormal mass in the testicle or the scrotumOther tests may show low bone mineral density and fractures. Blood tests may show a low level of testosterone and high levels of prolactin, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). These hormone levels determine if testicular failure primary or secondary (due to a pituitary gland problem).TestosteroneA testosterone test measures the amount of the male hormone, testosterone, in the blood. Both men and women produce this hormone. The test described...Read Article Now Book Mark Article FSHThe follicle stimulating hormone (FSH) blood test measures the level of FSH in blood. FSH is a hormone released by the pituitary gland, located on t...Read Article Now Book Mark Article LHThe LH blood test measures the amount of luteinizing hormone (LH) in blood. LH is a hormone released by the pituitary gland, located on the undersid...Read Article Now Book Mark Article If your concern is fertility, your health care provider may also order a semen analysis to examine the number of healthy sperm you are producing.Semen analysisSemen analysis measures the amount and quality of a man's semen and sperm. Semen is the thick, white fluid released during ejaculation that contains...ImageRead Article Now Book Mark Article Sometimes, an ultrasound of the testes will be ordered.Testicular failure and low testosterone level may be hard to diagnose in older men because testosterone level normally decreases slowly with age.Testicular failure and low testosterone level also may be hard to diagnose in obese men. This is because obesity lowers a carrier molecule for testosterone called sex hormone binding globulin (SHBG). The free testosterone level in the blood is usually normal in obese men who do not have testicular failure. Treatment 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. Outlook (Prognosis) 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. Possible Complications 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 Enlarged prostateThe prostate is a gland that produces some of the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube th...ImageRead Article Now Book Mark Article Blood clots Changes in sleep and mood Changes in good cholesterol (HDL) Blood becomes too thick (polycythemia) When to Contact a Medical Professional 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. Prevention Avoid higher-risk activities if possible.Remain active and prevent weight gain as you get older.Open ReferencesReferencesMorgentaler 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.AllVideoImagesTogMale reproductive anatomy - illustration The male reproductive structures include the penis, the scrotum, the testicles (testes), the epididymis, the seminal vesicles, and the prostate.Male reproductive anatomyillustrationMale reproductive anatomy - illustration The male reproductive structures include the penis, the scrotum, the testicles (testes), the epididymis, the seminal vesicles, and the prostate.Male reproductive anatomyillustrationRelated Information Testes(Special Topic)Testicular torsion(Condition)Mumps(Condition)Testicular cancer(Condition)Scrotum(Special Topic)Substance use(Special Topic)Undescended testicle(Condition) Review Date: 5/12/2023 Reviewed 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. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Testicular failurePrimary hypogonadism - maleTesticular failure occurs when the testicles cannot produce sperm or male hormones, such as testosterone.TesticlesThe testes are 2 egg-shaped male reproductive organs located in the scrotum. They produce sperm and the male hormone, testosterone.ImageRead Article Now Book Mark Article Causes 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 HemochromatosisHemochromatosis is a condition in which there is too much iron in the body. It is also called iron overload.ImageRead Article Now Book Mark Article MumpsMumps is a contagious disease that leads to painful swelling of the salivary glands. The salivary glands produce saliva, a liquid that moistens food...ImageRead Article Now Book Mark Article OrchitisOrchitis is swelling (inflammation) of one or both of the testicles.ImageRead Article Now Book Mark Article Testicular cancerTesticular cancer is cancer that starts in the testicles. The testicles are the male reproductive glands located in the scrotum.ImageRead Article Now Book Mark Article Testicular torsionTesticular torsion is twisting of the spermatic cord, which supports the testes in the scrotum. When this occurs, blood supply is cut off to the tes...ImageRead Article Now Book Mark Article VaricoceleA varicocele is the swelling of the veins inside the scrotum. These veins are found along the cord that holds up a man's testicles (spermatic cord)....ImageRead Article Now Book Mark Article Injury or trauma to the testicles Obesity Genetic diseases, such as Klinefelter syndrome or Prader-Willi syndrome Klinefelter syndromeKlinefelter syndrome, also called 47,XXY, is a genetic condition that occurs in males when they have an extra X chromosome. This can cause problems ...ImageRead Article Now Book Mark Article Prader-Willi syndromePrader-Willi syndrome is a disease that is present from birth (congenital). It affects many parts of the body. People with this condition feel hung...Read Article Now Book Mark Article Other diseases, such as cystic fibrosisCystic fibrosisCystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of th...ImageRead Article Now Book Mark Article 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 ScrotumThe scrotum is a part of a male's body that is located below the penis. The scrotum is the sac (pouch) that contains the testes, epididymis, and the...ImageRead Article Now Book Mark Article Frequent or heavy use of marijuana MarijuanaMarijuana comes from a plant called hemp. Its scientific name is Cannabis sativa. The main, active ingredient in marijuana is THC (short for delta-...Read Article Now Book Mark Article Undescended testicles at birthUndescended testiclesUndescended testicle occurs when one or both testicles fail to move into the scrotum before birth.ImageRead Article Now Book Mark Article Symptoms Symptoms depend on the age when testicular failure develops, either before or after puberty.Symptoms may include:Decrease in height Enlarged breasts (gynecomastia) Enlarged breastsWhen abnormal breast tissue develops in males, it is called gynecomastia. It is important to find out if the excess growth is breast tissue and not ...ImageRead Article Now Book Mark Article Infertility InfertilityInfertility means you cannot get pregnant (conceive). There are 2 types of infertility:Primary infertility refers to couples who have not become preg...ImageRead Article Now Book Mark Article 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. Exams and Tests A physical exam may show:Genitals that do not clearly look either male or female (usually found during infancy) Abnormally small, firm testicles Tumor or an abnormal mass in the testicle or the scrotumOther tests may show low bone mineral density and fractures. Blood tests may show a low level of testosterone and high levels of prolactin, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). These hormone levels determine if testicular failure primary or secondary (due to a pituitary gland problem).TestosteroneA testosterone test measures the amount of the male hormone, testosterone, in the blood. Both men and women produce this hormone. The test described...Read Article Now Book Mark Article FSHThe follicle stimulating hormone (FSH) blood test measures the level of FSH in blood. FSH is a hormone released by the pituitary gland, located on t...Read Article Now Book Mark Article LHThe LH blood test measures the amount of luteinizing hormone (LH) in blood. LH is a hormone released by the pituitary gland, located on the undersid...Read Article Now Book Mark Article If your concern is fertility, your health care provider may also order a semen analysis to examine the number of healthy sperm you are producing.Semen analysisSemen analysis measures the amount and quality of a man's semen and sperm. Semen is the thick, white fluid released during ejaculation that contains...ImageRead Article Now Book Mark Article Sometimes, an ultrasound of the testes will be ordered.Testicular failure and low testosterone level may be hard to diagnose in older men because testosterone level normally decreases slowly with age.Testicular failure and low testosterone level also may be hard to diagnose in obese men. This is because obesity lowers a carrier molecule for testosterone called sex hormone binding globulin (SHBG). The free testosterone level in the blood is usually normal in obese men who do not have testicular failure. Treatment 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. Outlook (Prognosis) 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. Possible Complications 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 Enlarged prostateThe prostate is a gland that produces some of the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube th...ImageRead Article Now Book Mark Article Blood clots Changes in sleep and mood Changes in good cholesterol (HDL) Blood becomes too thick (polycythemia) When to Contact a Medical Professional 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. Prevention Avoid higher-risk activities if possible.Remain active and prevent weight gain as you get older.Open ReferencesReferencesMorgentaler 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.