The Effects of Testosterone Replacement Therapy on the Testicles

The male hormone, testosterone, has primary responsibility for causing the normal development of male sex characteristics and libido. When insufficient levels of testosterone are produced by the testes, the result is a condition known as hypogonadism. The most common treatment for hypogonadism caused by testicular failure is Testosterone Replacement Therapy (TRT). TRT is typically thought to be safe and effective for treating testosterone deficiency, but it may have negative effects on the testicles of men with normal testosterone levels.

Diagnosis

• In order to make an accurate diagnosis of hypogonadism, a physician will require a complete medical history. The physician will also conduct a thorough physical examination and specific lab work. If the patient has not yet entered puberty, this condition can present itself as infantile genitalia and undeveloped testicles. If the patient developed hypogonadism after the onset of puberty, the symptoms can include erectile dysfunction, infertility, diminished libido, male breasts and decreased bone mass.

Benefits

• TRT shows multiple benefits when administered to boys and men with testosterone deficiencies. In prepubescent boys, TRT helps to jumpstart puberty. Growth of facial and pubic hair increases, as does muscle mass. Testosterone therapy will cause the penis to grow, but does not appear to affect growth of the testicles in prepubescent boys. After the onset of puberty, TRT results in an elevated mood, enhanced libido, as well as increases in muscle mass and bone density. Secondary sexual characteristics such as beard and body hair also increase.

Risks

• TRT can cause an increase in red blood cells, which may be helpful for anemic patients. But, for otherwise healthy men, this can cause a blockage of the blood vessels which may lead to stroke or heart attack. TRT can cause changes to the prostate and is not recommended for men with conditions such Benign Prostatic Hyperplasia (BPH), a common enlargement of the prostate that occurs as men age. In men with normal testosterone levels, TRT can cause the testicles to shrink to prepubescent size and may cause temporary sterility.