Everything You Need To Know About Testicular Atrophy (2021)

Elite HRT

Written by Elite HRT on September 09, 2021

Medically reviewed by

Camille Freking, Regulatory Affairs Specialist, MEDICAL ADVISOR

Testicular atrophy is not something that is often talked about, but it happens to many people. Testicular atrophy can happen due to a variety of different circumstances, some of which you can control and some you cannot. 

Knowing what testicular atrophy is, how to identify it, what causes it, and how to prevent it is very important for taking charge of your own health. Keep reading to learn everything you need to know about testicular atrophy. 

What Is Testicular Atrophy?

The testicles, or testes, are glandular organs in the scrotum that are responsible for producing testosterone and sperm. Testicular atrophy develops when the testicles shrink. Because the testicles are responsible for making testosterone and the production of sperm, sperm count may begin to drop. The testicles may also make less testosterone than before, which could lead to a hormone deficiency. 

The testicles may appear to shrink when it gets cold outside, but this is not the same as testicular atrophy. The testicles may “shrink” in the cold in order to regulate their temperature. The muscles surrounding the testicle contract and bring the testes closer to the body to keep them warm. Again, this is not the same thing as testicular atrophy, as testicular atrophy occurs when the tissue of the testes starts to waste away. 

People experiencing testicular atrophy may also notice sexual dysfunction, puberty growth delays, decreased libido, or pain.

What Causes Testicular Atrophy?

The underlying cause of testicular atrophy is not attributed to a single thing. 

Some causes can be controlled and addressed, like an infection, alcohol consumption, testicular torsion, or certain medications you may be taking. 

Other causes are unavoidable, such as older age or testicular cancer. 

Either way, knowing what can cause testicular atrophy is important so that you can understand your risk factors.


As you get older, your testicles may naturally begin to shrink at a slow rate. Men make testosterone and sperm throughout their entire life, but after their peak reproductive years, there is less of a need to produce large amounts of testosterone and sperm. A small amount of shrinkage with age is normal, but excessive shrinkage may indicate a hormone deficiency. 

Testosterone Hormone Replacement

Testosterone hormone replacement therapy involves taking testosterone hormones as a medication to replace low levels of testosterone in the body. This might seem counterintuitive, but since the medication is giving your body testosterone, your body may not feel triggered to produce its own testosterone as much. Due to the lack of stimulation of the body to produce testosterone, the testicles can begin to shrink due to a lack of use. Luckily, some things can be done to prevent this from happening. A hormone imbalance of sex hormones, like testosterone or estrogen, is the most common cause of testicular atrophy.

Estrogen Medications

Estrogen medications have a similar effect as testosterone when it comes to testicular atrophy. Estrogen may not directly cause testicular atrophy, but it can worsen the issue if it has already developed. Estrogen can decrease testosterone production in the Leydig cells that are located in the testes. Estrogen medications may also cause a decrease in sperm production and pubic hair as well. Estrogen medications can be taken safely and effectively, but testicular atrophy is a symptom that may develop. 


Several infections can lead to testicular atrophy. HIV, mumps, chlamydia, gonorrhea, and more infections can lead to testicular atrophy. The human immunodeficiency virus (HIV) has been associated with testicular atrophy, but the cause of it is not exactly known. Mumps is also very well known for causing testicular atrophy. The mumps virus directly damages the testicular tissue as a result of inflammation. Inflammation increases pressure in the testicles and blocks off blood flow to the testicles, which leads to tissue death. Other sexually transmitted infections, such as chlamydia and gonorrhea, can also lead to orchitis, or inflammation of the testicles. These infections can be very serious and lead to long-lasting problems if not treated promptly and appropriately.  

Drinking Excessive Alcohol

Your favorite afternoon beverage of choice may be leading to some unwanted side effects. Excessive alcohol use has actually been found to lead to some degree of testicular atrophy. Short- and long-term alcohol use can cause low sperm counts and lowered testosterone levels. In those who stop drinking alcohol, there may not be a complete recovery of the testicular tissue, and some problems can still remain even afterward. Testicular atrophy is worse in people who have other risk factors, such as a poor diet or certain health conditions. 

Testicular Cancer

Testicular cancer is another potential cause of testicular atrophy. Testicular atrophy does not develop in all cases of testicular cancer. In fact, it is actually quite rare for testicular cancer to cause atrophy, but it can happen. Atrophy may occur if a testicular tumor is in a location that cuts off blood supply to the cells in the testicles. Other symptoms of testicular cancer may include varicocele, which is when scrotum veins become larger. 

How Can You Prevent Testicular Atrophy?

Of course, some things are not preventable; however, there are certain ways that you can help protect your health and prevent testicular atrophy from occurring. 

For example, you can protect yourself from different infections, use a comprehensive testosterone therapy treatment, make lifestyle modifications, and get regular checkups for testicular cancer.

Protect Yourself From Infection

Infections can be transmitted from person to person in different ways. 

For example, the mumps is spread through respiratory droplets and saliva. You can protect yourself from this type of infection by being vaccinated against the mumps as well as encouraging others around you to cough and sneeze into their inner arm, washing your hands, not sharing drinks or food with others, and staying away from those that you know are sick.  

HIV can be transmitted through blood and body fluids. You can protect yourself by using condoms, knowing your own STD status, and not sharing needles. 

For STIs like chlamydia and gonorrhea, you can protect yourself by using condoms for any sexual activities.

Comprehensive Testosterone Therapy

Testosterone replacement therapy does not have to result in testicular atrophy. Using a comprehensive approach to testosterone therapy can help the body continue producing testosterone on its own. 

A comprehensive approach includes taking human chorionic gonadotropin (HCG) alongside testosterone. The use of the HCG allows the body to keep making endogenous testosterone. It can also support a higher testosterone level overall since you will be taking and making testosterone. 

Choosing a provider like Elite HRT who understands the intricacies of a comprehensive treatment plan can support your body in continuing to work efficiently and prevent unwanted effects like testicular atrophy. 

You can learn more about comprehensive hormone therapy with Elite HRT by clicking here. 

Lifestyle Changes

Since alcohol can lead to testicular atrophy, there are some lifestyle modifications that may help prevent atrophy from occurring. 

The best thing you can do is limit how much you drink, or just stop drinking alcohol altogether. That said, any amount that you can decrease will be helpful. However, if you are a chronic drinker, according to the research, you may not fully recover any lost testicular tissue. 

Also, it should go without saying that anabolic steroid use is a no-go if you’re experiencing testicular atrophy.

Get Checked for Testicular Cancer

Testicular cancer may not be something that you can prevent from happening altogether as it may be genetic or caused by something out of your control. 

Getting checked by the doctor for testicular tumors is so important to do on a regular basis. The earlier you catch testicular cancer, the better so that it does not continue to grow or even spread to other areas of the body. 

The average age of diagnosis for testicular cancer is only 33, so it happens to younger men more than you would expect. Your doctor can perform an ultrasound to look for abnormalities, and they’ll probably order a blood test as well to look for other signs of disease like hormone imbalance. 


Testicular atrophy is the shrinking of the testicular tissue, and can be caused by many things, including infections, testosterone treatments, and even lifestyle choices like drinking alcohol. 

By understanding the risk factors and what you can do to prevent these things from happening, you can take charge of your own health and how to keep yourself as healthy as possible. 


Testis Atrophy – an overview

Testicular atrophy after mumps orchitis: ultrasonographic findings.

Alcohol induced testicular damage: Can abstinence equal recovery?.