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    Testicular failure

    Definition

    Testicular failure is the inability of the testicles to produce sperm or male hormones.

    Alternative Names

    Primary hypogonadism - male

    Causes

    Causes of testicular failure include chromosomal abnormalities, testicular torsion, direct trauma to the testicles, diseases that affect the testicle (such as mumps, orchitis [inflammation of the testes], and testicular cancer ), and a variety of drugs. The condition is uncommon.

    Increased risk is linked to activities that may cause constant, low-level injury to the scrotum, such as riding a motorcycle. Frequent use of a drug known to affect testicular function, such as heavy marijuana  use or some prescription medications, also increases the risk of testicular failure. Men who had undescended testicles at birth are at higher risk.

    Symptoms

    • Lack of libido (sex drive)
    • Delay in development or absence of secondary male sex characteristics (growth and distribution of hair, scrotal enlargement, penis enlargement, voice changes)
    • Infertility
    • Gynecomastia (enlarged breasts in males)
    • Lack of muscle mass

    Exams and Tests

    A physical examination may reveal:

    • Genitals that do not clearly look either male or female (usually noted in infancy)
    • Abnormally small testicle
    • Tumor or mass (group of cells) on or near the testicle

    Hormonal levels determined through blood tests may detect low testosterone levels and high levels of gonadotropins (pituitary hormones FSH and LH).

    Treatment

    Supplementation of male hormones may be successful in treating some forms of testicular failure. In cases that seem to be due to specific exposure or activity, removal of the drug or activity may result in return of normal function.

    Outlook (Prognosis)

    Many forms of testicular failure cannot be reversed. Androgen (male sex hormone) replacement is effective in reversing symptoms, though it may not restore fertility.

    Possible Complications

    Testicular failure before to the onset of puberty will stop normal growth, specifically the development of adult male characteristics.

    When to Contact a Medical Professional

    Call for an appointment with your health care provider if symptoms occur.

    Prevention

    Avoid higher-risk activities, or watch testicular function when involved in such activities. Also, stop the activity with the first sign of symptoms.


    Review Date: 8/1/2005
    Reviewed By: Nikheel S. Kolatkar, MD, Clinical and Research Fellow, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Review provided by VeriMed Healthcare Network.
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