Site Map

Testicular failure

Primary hypogonadism - male

Testicular failure occurs when the testicles cannot produce sperm or male hormones, such as testosterone.

Images

Male reproductive anatomy

I Would Like to Learn About:

Causes

Testicular failure is uncommon. Causes include:

The following can increase the risk of testicular failure:

Symptoms

Symptoms depend on the age when testicular failure develops, either before or after puberty.

Symptoms may include:

Men may also notice they do not need to shave as often.

Exams and Tests

A physical exam may show:

Other 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).

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.

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:

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.

Related Information

Testes
Testicular torsion
Mumps
Testicular cancer
Scrotum
Substance use
Undescended testicle

References

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.

BACK TO TOP

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.

ADAM Quality Logo
Health Content Provider
06/01/2025

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complied with the HONcode standard for trustworthy health information from 1995 to 2022, after which HON (Health On the Net, a not-for-profit organization that promoted transparent and reliable health information online) was discontinued.

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. © 1997- 2024 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.