Testicular atrophy, prevention and treatment

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Testicular atrophy, is a condition in which the male testes shrink significantly. In case of testicular atrophy, the function of testes almost completely disappears, that is, the production of testosterone and sperm is sharply reduced. The resulting conditions are called “Androgenic deficiency” and “Male infertility”, respectively. Testicular atrophy is irreversible. The volume of an atrophied testicle is usually 6 cubic centimeters or less. The average volume of a healthy, undamaged testicle in men is 17-18 cubic centimeters. There are reversible states of damaged testicles – hypotrophy with partial loss of function.

Taking steroid hormones can stop the natural testosterone production. This happens due to the reverse mechanism, when the hypothalamus recognizes over-abundancy of sex hormones (including androgens, progestins and estrogens) and stops producing of gonadotropic hormone. It normally stimulates Leydig cells in the testes to produce testosterone. The lack of gonadotropic hormone causes testes stop functioning and shrink.

HPTA hypothalamus-pituitary-testes axis: The hypothalamus produces gonadotropic hormone, which promotes testosterone production in the testes. Testosterone, in turn, suppresses the activity of the hypothalamus and the pituitary gland to some extent.

Signs of testicular atrophy / hypotrophy

Decreased testosterone production, which is accompanied by worsening of general well-being, decreased performance, mood, desire and willingness to exercise, decreased libido, impaired potency, muscle loss, feminization and other signs of testosterone deficiency.

Decrease in semen volume, sperm quantity and quality.

Leydig cells make up only about 5% of the testicle mass. Therefore, palpation analysis of testicular size is not a reliable method for assessing the loss of Leydig cells, since the volume can change very slightly (only 5%) with almost complete suppression of function. The loss of spermatogenesis cells is more noticeable on examination and palpation; from the loss of these cells, the volume of the testicles is significantly reduced.

Treatment and prevention of Testicular atrophy

Testicular atrophy can develop into primary hypogonadism, which does not respond to treatment, but it can be successfully prevented. For this, HCG (human chorionic gonadotropin) is used, which is available under the trade names Pregnyl, Profazi, Horagon, etc. 4 weeks of HCG cycle is enough to prevent the development of testicular atrophy. The use of gonadotropin during a long cycle (longer than 6 weeks) is recommended by many experts. Already existing testicular atrophy is treated only symptomatically. Testosterone replacement therapy is used to replenish the lack of testosterone.

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