One of the most concerning medical problems in men is the problem of small testicle size due to the vital role that the testicle plays in reproductive health. It is primarily responsible for the production of sperm and the secretion of testosterone, which affects the male characteristics of men. Follow this article with us to learn about the most important causes and symptoms of small testicle size and the approved methods of diagnosis and treatment.

What is the normal size of the testicles?

The testicles are the primary organ in the male reproductive system, as they play a pivotal role in producing sperm and secreting the hormone testosterone, which is responsible for masculine characteristics. The normal (total) size of the testicles is measured in milliliters, with the volume of one testicle ranging from 15 to 25 ml, while the weight ranges from 12 to 25 grams for each testicle. 

Causes of small testicles

The causes of small testicles vary between genetic, acquired, or hormonal factors, in addition to the influence of some other disorders, which we will learn about in detail below:

1.Genetic causes

Some genetic disorders are directly linked to small testicle size and poor function, most notably Klinefelter syndrome and Kallmann syndrome, which affect the secretion of sex hormones, leading to incomplete development of the testicles.

2. Birth defects

Some children are born with small testicles as a result of a problem in genetic development. These conditions are often discovered at puberty, and these defects lead to an undescended testicle, and incomplete sexual development by puberty.

3. Hormonal disorders

The function of the testicles depends primarily on the hormonal balance in the body, so any defect in the secretion or regulation of these hormones leads to a smaller size. The most prominent of these disorders are thyroid problems, a defect in the pituitary gland, or a lack of testosterone.

4. Acquired factors

The testicle is sometimes exposed to some external factors acquired after birth that lead to its smaller size, such as testicular infections, strong blows or accidents affecting the scrotum causing tissue damage, or chemotherapy and radiation used to treat tumors.

5. Other reasons

There are some reasons that may sometimes negatively affect the size and function of the testicle, such as aging, the use of anabolic steroids as occurs among athletes, malnutrition that causes vitamin and mineral deficiencies, and addiction to alcohol or narcotic substances.

Learn about: Testicular cancer Your comprehensive guide to understanding the disease and how to deal with it

Symptoms associated with small testicles

Below we learn about the most important symptoms associated with small testicles and their various causes:

• Sexual dysfunction:
  They include poor sexual desire, and sometimes erectile dysfunction, with delayed or absent ejaculation.
• Physical symptoms:
  Which includes pain and heaviness in the scrotum, especially when suffering from varicocele, noticeable swelling in one of the testicles, and delayed puberty.
• Hormonal symptoms:
  Which includes weight gain and fat accumulation in certain areas of the body, a change in the tone of the voice, and poor growth of body and facial hair due to a low level of testosterone.
• Effect on fertility:
  Symptoms that suggest that small testicle size has affected fertility include low sperm count and weak sperm motility, which causes delayed childbearing or infertility in some cases.

How to diagnose small testicles?

Diagnosis of small testicle size is carried out in several steps by specialized doctors, and must be accurate to determine whether the condition is normal or pathological. Among the most important diagnostic methods are:

• The patient's medical history and examination: The doctor asks about the symptoms associated with the condition and previous infections or injuries, then the testicle is examined and the size is initially estimated.
• Laboratory tests: One of the most important tests is an analysis of hormones, the most important of which are testosterone, FSH and LH, along with examining the level of thyroid and pituitary hormones to find out the causes of small testicles.
• Imaging examination: The doctor relies on ultrasound to measure size with greater accuracy. The examination also helps detect cases of varicose veins or tumors. He also relies on CT scans or MRI in more complex cases, or when there is suspicion of the presence of birth defects and malformations.
• Semen analysis: The doctor, of course, resorts to analyzing the patient's semen to measure the number and movement of sperm, in order to determine the extent to which small testicle size affects fertility.

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What is the treatment for small testicles?

After making an accurate diagnosis of the condition, the doctor chooses the appropriate method for treating small testicles, while combining more than one method to achieve the best result. In the following lines, we learn about 5 effective methods of treatment:

1. Drug and hormonal treatment

The most important types of drug and hormonal treatment used to treat small testicles are the following:

• Testosterone injections and tablets in the event of a clear deficiency in the hormone level.
• Stimulating medications that help stimulate the testicles to increase sperm production.
• Medications that treat hormone deficiency resulting from hypothyroidism or hypopituitarism through an endocrinologist. 

2.Surgical treatment

In many cases, the doctor resorts to surgical treatment, and the type of operation depends on the cause and severity of the condition. Among the most prominent surgical operations performed to treat small testicles are:

• Varicocele surgery: It is a successful operation that helps improve blood flow around the testicle and prevent its temperature from rising, which contributes to increasing its size later.
• Removal of the undescended testicle: This is an operation performed on children if the testicle does not descend in its normal place, so surgical intervention is performed to stabilize it.
• Tumor removal: In the event of a tumor or mass pressing on the testicular tissue, the doctor resorts to removing it surgically.  

3. Treating testicular infections

Some cases may only need to treat testicular infections using antibiotics in the case of bacterial infections, or analgesics and anti-inflammatories in the case of mumps or other viral infections.

4. Lifestyle change

An essential part of the treatment lies in changing the lifestyle and getting rid of bad habits that affect the size of the testicles. The change consists of doing the following:

• Stop smoking and drinking alcohol permanently.
• Stop using anabolic steroids that are widespread among athletes.
• Make sure to exercise regularly while avoiding any excess pressure on the pelvic area and testicles.
• Ensure healthy nutrition through a balanced diet rich in vitamins and minerals such as zinc and vitamin B12.

5. Auxiliary options

In some severe cases that affect a man's reproductive health, doctors resort to auxiliary options to treat delayed childbearing due to small testicle size, the most important of which are:

• IUI artificial insemination.
• IVF technology.
• ICSI in case of weak sperm

Frequently asked questions

Below we answer the most important questions related to small testicle size and how to treat it:

How can the size of the testicles be increased?

How to increase the size of the testicles depends on the underlying cause, whether a lack of hormones, so the patient needs some hormonal medications, or a varicocele, so he needs surgery to repair the varicose veins. However, in the case of birth defects, their size cannot be increased.

Is a large testicle better than a small testicle?

Advantage cannot be measured by testicle size alone, as there are several other factors, such as how efficient the testicle is in producing sperm, hormones, and functional performance. A testicle that is small but performs its function normally may be better than a larger one.

Does small testicle size affect erection?

Usually, small testicle size does not directly affect erection except in small size due to low testosterone, because the erection process depends primarily on blood flow and nerves.

What are the best medications to treat small testicles?

There is no unified medicine for treating small testicle size. Doctors rely on hormonal treatment in the case of low testosterone, or medications to stimulate sperm production in other cases, so only a medical examination determines the best therapeutic medications.

Book an appointment with the best doctors to treat infertility and male diseases at Al Mousa Specialist Hospital to start treating small testicles by knowing the reasons that led to this problem, and working to diagnose and treat it in the appropriate way, whether hormonal therapy or surgery. We have integrated clinics that provide you with service and medical care around the clock.

المصادر:

What to know about small testicles – medicalnewstoday

What Causes Small Testicles, and How Does Testicle Size Affect Your Health? – healthline