Does Testosterone Therapy Shrink Your Testicles?

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.


Testosterone therapy can be an effective solution for men experiencing low testosterone levels, yet some guys may experience testicular atrophy (the shrinkage of testicles). While this side effect may occur occasionally, it should be known that it's completely treatable.

What is testosterone therapy?

Testosterone therapy refers to using medications to increase low testosterone levels, which may result in various symptoms including fatigue, loss of libido and difficulty sleeping. Men are generally advised that testosterone therapy treatments are safe, effective and masculinizing.

Long-term hormone therapy to address low testosterone has its own set of concerns, however. Some experts suspect these treatments could increase heart-related risks. Therefore, it's essential that any man considering these therapies be fully aware of all possible consequences prior to making their decision.

Treatments for low testosterone typically include injections, which can be administered either at home or a physician's office and given regularly in order to maintain even levels. Gels and patches that can be applied directly onto the skin.

Some individuals also opt to obtain their hormones through a compounding pharmacy, as this allows for customized dosage and safer administration than traditional hormones. Unfortunately, however, these medications have yet to be FDA-approved so their safety and effectiveness remains unknown.

No matter which form of therapy is chosen, it's crucial to only take as much testosterone as is prescribed. Doing otherwise could cause unpleasant side effects and potentially dangerous conditions like gynecomastia (the growth of breast tissue), high blood pressure or other health concerns. 

Most men with low testosterone report improved energy levels and quality of life after receiving consistent doses of medication for several months. 

If you're thinking about starting testosterone therapy, it is essential that you consult a male urology expert. Doctors can discuss all your options while offering guidance to avoid unwanted side effects or complications from hormone replacement therapy.

In addition, doctors can help determine if there are alternative causes of your fatigue and low libido that might be easier treated without hormone therapy - for instance stress or poor diet may be contributing factors - instead.

What is Testicular Atrophy?

Testicular atrophy refers to when your testicles begin to shrink or narrow, making them appear smaller. It is an extremely common occurrence and may be brought on by several causes including ageing, medical conditions or injury. Furthermore, it could be an indicator of deeper problems such as sexually transmitted diseases (STIs), HIV/AIDS or cancer.

Your testicles consist of two types of cells - Leydig cells and germ cells. Leydig cells produce testosterone, the male sexual hormone; while germ cells make sperm.

When these two cell types work in harmony with one another they will be produced in equal amounts. However if one or both cells become damaged they could shrink over time and result in testicular atrophy.

Your doctor will typically diagnose testicular atrophy by performing a physical examination to study their shape, size, firmness and texture as well as looking for any abnormalities or infections.

In some instances, blood work and/or a urine sample or swab may also be ordered to check for infection and illness indicators. They may also conduct ultrasound procedure and/or testosterone level test to help pinpoint its cause.

Treatments for testicular atrophy vary depending on its cause, as each condition varies greatly. Antibiotics will likely be prescribed to address any bacterial or viral infections, while surgery might be needed if trauma has caused torsion of your testis or torsion has taken place.

Hormone therapy may help stimulate production of testosterone to restore normal function; while in other instances home remedies or herbal treatments may also be tried out to enlarge an atrophy testis.

Men can experience normal age-related atrophy of the testicles; other possible causes could include long term use of steroids, certain medical conditions and medications. Steroid use, for instance, can damage Leydig cells that produce testosterone when stimulated by LH. This over time leads to atrophy of testicles.

Other medications, such as steroid-based oral contraceptives and some forms of antibiotics can have similar results. Heavy alcohol consumption may also damage testicles and cause the same effect; to protect your health it's wise to limit how much you drink each week.

Testosterone Therapy and Testicular Atrophy

Testosterone therapy aims to restore normal testosterone levels in men with low-T, and physicians may administer it through injections, topical gel rubbed on daily, patches worn across the body or scrotum or subdermal pellets inserted every few months through minor procedures.

Although testosterone's primary function is to boost male fertility and increase sperm count, it can also have adverse effects on testicle size if administered externally.

It is worth noting that external testosterone use can trigger signals sent from the brain that shut off testes' natural production of hormones which leads to atrophy of testicles as a result.

This is because when excessive testosterone is administered from an external source the body sends signals to reduce and potentially stop producing gonadotropins. 

Once the gonatotropin leves in the blood are low it will decrease the size of the testicles, known as testicular atrophy.

Doctors sometimes prescribe human chorionic gonadotropin (hCG) with testosterone to maintain fertility and avoid testicular atrophy. HCG is an analogue of the pregnancy hormone luteinizing hormone that stimulates testes to produce testosterone naturally.

Furthermore, it's important to remember that atrophic testicles could also be caused by undescended testis (where one or both testicles haven't fallen into the scrotum), urethral strictures or trauma, Klinefelter syndrome (where both testicles have shrunken down), cystic fibrosis which thickens mucus coats around organs.

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Testosterone replacement therapy side effects

When testosterone levels dip below optimal, depression, fatigue and motivation issues arise alongside muscle loss and weak bones - with testosterone replacement therapy an effective natural solution to addressing these symptoms.

However it should be discussed thoroughly with your healthcare provider first as there may be certain side effects such as acne breakouts or an increased risk of heart problems associated with it.

Some men who begin testosterone replacement therapy experience immediate side effects. These may include changes to sexual desire or erectile function or breast growth (gynecomastia). Aside from physical changes, testosterone therapy could also lead to mood swings, fatigue and decreased concentration and memory.

On a longer term, testosterone may also increase your risk for cancer and heart disease. Researchers recently suspended an ongoing trial involving male participants taking testosterone replacement therapy after early results showed an increase in heart problems and deaths among participants.

Therefore, those taking long-term hormone treatments must conduct regular blood work checks to assess cholesterol, blood pressure, and other indicators of cardiovascular health.

An FDA warning on testosterone replacement therapy warns of a twofold increase in heart attack risk during its first 90 days, particularly among men who already have preexisting heart disease. Testosterone may worsen obstructive sleep apnea symptoms and should therefore be avoided by anyone suffering from this disorder.

Facial hair growth and male-pattern baldness, for instance, are two symptoms that require years to reverse. Testosterone can also influence cholesterol levels and raise your blood clotting risk; increasing the likelihood of an unexpected blood clot breaking loose from leg veins traveling up into the lungs blocking circulation causing heart attack or stroke.

If you have high cholesterol, your doctor may advise against testosterone therapy or limit its dosage. Also, using testosterone therapy could put you at increased risk if there's a family history of prostate or breast cancer or any type of cancer; similarly for men who have had high blood pressure or vascular diseases such as atherosclerosis or varicose veins.

Gender affirming hormone therapy may also exacerbate autoimmune conditions like arthritis or lupus, or increase mental health issues like anxiety or depression. If this occurs to you, your doctors will likely suggest that you remain in close contact with a mental health provider during and after transition. 

Should You Consider Testosterone Therapy?

Testosterone therapy may not be right for everyone, and if you are considering it it is essential that your physician understands your goals for therapy. Setting clear objectives will enable better communication with them as they assess whether this form of treatment will work.

testosterone should not be taken if you experience severe urinary tract symptoms due to an enlarged prostate (benign prostate disease), as testosterone can worsen these problems.

Furthermore, according to guidelines issued by the Endocrine Society it should also not be used if breast cancer or being at risk are factors. Finally if blood clots have occurred or you take blood thinners you should also refrain from using testosterone.

Natural testosterone boosters

Testosterone levels decline naturally with age, yet replacing testosterone may carry health risks for some.

Natural supplements designed to boost testosterone can help treat symptoms associated with low testosterone, including reduced sexual drive/erectile dysfunction/infertility/body hair loss/reduced muscle mass/increased abdominal fat/ and swollen or tender breasts (gynecomastia).

These all-natural products are safe when used according to directions, without side effects in most men. Furthermore, their prices allow most to purchase them without breaking their budgets.

Military Muscle utilizes a combination of nutrients and herbs to boost testosterone production, such as zinc, fenugreek, Vitamin D3, and boron.

Fenugreek contains furostanolic saponins which inhibit enzymes that convert testosterone to estrogen. Furthermore it has also been known to increase testosterone and LH levels, stimulating Leydig cells into producing more testosterone.

Additional ingredients include nettle root extract, D-aspartic acid, iron, mucuna pruriens, and ashwagandha to improve libido, increase muscle growth, and maintain bone density. 


Testosterone replacement therapy (TRT), also known as bioidentical hormone replacement therapy (BHRT), is a form of medication designed to restore normal testosterone levels to the body by way of oral, topical or implanted pellets.

TRT can improve sexual function, energy and mood as well as muscle mass and bone density; in addition to relieving conditions associated with low testosterone such as depression or irritability.

Although TRT may increase cholesterol and triglyceride levels slightly it has also been found helpful for improving insulin sensitivity for those living with diabetes

However, by increasing testosterone levels by synthetic means may throw off hormonal equilibrium, prompting your body to stop its natural production of the sex hormone and leading to testicular atrophy.

A doctor may suggest medications which mimic pituitary luteinizing hormone and stimulate your testicles into producing more of their own testosterone production. Alternatively hCG, a gonadotropin used for increasing testosterone and sperm, could also be prescribed.

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