Will Your Testes Shrink if You Take Testosterone?

Testicular Atrophy for Men on Testosterone Replacement Therapy

Why do testicles shrink when men take steroids?    

Will My Balls Shrink if Take Testosterone?

Testicular atrophy, a common concern for those considering testosterone replacement therapy (TRT), is an effect experienced by men on prescribed testosterone. Understanding this side effect and its management is crucial. Here’s a detailed exploration:

Why Does Testicular Atrophy Occur?

The use of exogenous testosterone, like testosterone cypionate in TRT, can lead to testicular atrophy. This occurs because external testosterone intake can signal the body to produce less natural testosterone. When the body senses higher-than-normal testosterone levels due to external intake, it reduces its natural production as a negative feedback mechanism, causing testicular shrinkage. This disruption in the body's natural hormone balance is reversible once the steroid use stops, but it might take time for the testicles to regain their normal size and for natural hormone production to resume.

Understanding the Neuroendocrine Control Behind
Testicular Atrophy (neuroendocrine control of the hypothalamo-pituitary–gonadal axis)

Absolutely, discussing the neuroendocrine control of the hypothalamo-pituitary-gonadal axis provides crucial insights into the dynamics of testosterone replacement therapy (TRT) and its impact on hormonal balance.

The hypothalamus, a vital part of the brain, plays a pivotal role in regulating the release of hormones involved in reproductive function. Geoffrey Harris's work in 1955 (“Neural control of the pituitary gland.”) shed light on the neurobiology underlying the pulsatile release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. GnRH, in turn, triggers the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the anterior pituitary gland. These hormones travel to the gonads (testes in men), where they facilitate the production of testosterone and sperm.

In the context of testosterone replacement therapy, the hypothalamus continuously monitors testosterone levels in the bloodstream. When necessary, it releases GnRH in a pulsatile manner. This initiates a feedback loop that prompts the anterior pituitary to release LH and FSH. These hormones then travel to the testes and contribute to spermatogenesis (sperm production) and steroidogenesis (testosterone production).

However, the introduction of exogenous (external) testosterone into the body can disrupt this delicate balance. When the body senses an excess of testosterone due to external intake, it may reduce the pulsatile secretion of LH and FSH. As a result, the testes may experience reduced demand for sperm and testosterone production, leading to testicular atrophy.

Understanding this intricate feedback mechanism helps elucidate how exogenous testosterone can impact the body's natural hormonal regulation, contributing to testicular atrophy by altering the pulsatile release of essential hormones involved in reproductive function.

How can i prevent my testes from shrinking if I'm on TRT?

Preventing Testicular Atrophy on TRT

Men on TRT may also experience reduced sperm count and fertility due to the negative feedback action at the pituitary level. Human chorionic gonadotropin (hCG), mimicking LH, helps maintain natural testosterone and sperm production in the testes, countering atrophy and fertility issues. Additionally, medications like enclomiphene have been used by fertility specialists to boost sperm count.

Consult with a Licensed Professional Understanding the effects and managing the potential side effects of TRT require expert guidance. An experienced healthcare provider can explain the risks, benefits, and available treatments associated with low testosterone. Consulting a licensed physician knowledgeable in hormone replacement therapy is essential to explore TRT as a potential treatment for Low T and its associated symptoms. If you wish to learn more about TRT or discuss options regarding Low T, feel free to reach out to our office for a personalized consultation.