Testicular atrophy

The symptoms of testicular atrophy depend on your age. The characteristic symptom, however, remains the same: that is, the shrinking of one or both testes. Several other symptoms include:

• Decreased sex drive
• Softer testicles
• Reduced facial hair growth 
• Reduced pubic hair growth 
• Infertility 
• Reduced muscle mass

In patients who haven’t undergone puberty, the symptoms of testicular atrophy may include larger penis size as well as the occurence of facial and pubic hair.

Several factors could be responsible for testicular atrophy. These include:

• Age: After peak production of testosterone during the reproductive years, this eventually slows down. Much like menopause, men go through a process called andropause which is a potential cause of testicular atrophy. 
• Hormonal imbalance: An imbalance in hormones due to taking certain medication including anabolic steroids or estrogen.
• Alcohol consumption: Excessive consumption of alcohol may cause a decrease in testosterone levels as well as tissue damage in the testes, resulting in atrophy. (Read more: Alcoholism)
• Orchitis: Orchitis is an inflammation in the testes. It may be viral or bacterial in origin. While the inflammation may cause the testicles to look enlarged initially, eventually it results in atrophy. Sometimes sexually transmitted diseases like chlamydia and gonorrhoea and urinary tract infections may also result in orchitis.
• Testicular torsion: This happens if the testicle rotates, twisting the spermatic cords, which results in not just pain but the loss of blood and oxygen to the testicles.
• Varicocele: When veins that run through the scrotum become swollen (a condition known as varicocele), they cause particularly the left testicle to appear shrunken.
• Certain diseases: Diseases like mumps and HIV/AIDS can cause testicular atrophy.
• Certain medical procedures: Having a catheter or other medical devices inserted into your penis could also cause testicular atrophy.

Read more: Testicular swelling: symptoms, causes, prevention, diagnosis, treatment

Here's what to expect when you visit a doctor due to shrunken testes: 

• The doctor will conduct a physical examination, to check the size, shape, texture as well as firmness of your testicles. He/she may also ask questions about your lifestyle and if you are on any medication.
• The doctor may order blood tests to look for signs of infection.
• Hormonal tests may be done to rule out the possibility of an imbalance.
• An ultrasound may be done to check the blood flow as well as look for any abnormalities.

Treatment largely depends on the underlying cause of testicular atrophy. Early diagnosis and treatment may even help reverse the shrinkage. Possible treatments include:

• In case of a bacterial infection, antibiotics may be prescribed 
• Lifestyle changes are recommended 
• Hormone therapy is a treatment option in case of imbalance or low production of testosterone
• Testicular torsion may require surgery

Early intervention and treatment are very important to improve the outcome in testicular atrophy. In case either testicle looks significantly smaller, seek medical help immediately. While the conditions that cause this are easy to treat, reversing atrophy depends on a lot of factors.