Testicles come in many shapes and sizes. It is also common that one testis is slightly larger than the other, and that one testis hang lower. Because of this significant variation, a person’s testicles are assessed in several different ways.
One calculation looks at volume, measuring approximately 20 cubic centimeters (cm3). Another way to assess the scale of the testis is by calculating the range from top to bottom. This length is, on average, between 4.5 and 5.1 centimetres.
Those with testicles will think about that much smaller than this. Nevertheless, there is rarely an issue when there are no associated signs.
An individual should look at whether their testicles have changed over time rather than contrasting their testicular size with that of other those. Testicles that suddenly become much smaller or larger than normal can signal an issue.
In this post, we discuss the potential causes and treatment options of small testicles. We also clarify when a person with tiny testicles should get a doctor’s advice.
Low testosterone
A 2017 study found that testicular volume could be a predictor of testosterone levels alongside body mass index (BMI). On average lower testosterone participants had smaller testicles.
Many people with low testosterone levels have testicles of normal size, so it is important to look at all the signs and not just the size of the testis.
Some Low Testosterone symptoms include:
- a low sex drive
- difficulty achieving and maintaining an erection
- fatigue
- mood changes and irritability
- depression
- a loss of muscle mass
Varicocele
An enlarged swelling of the veins within the scrotum is a varicocele. While some people can note discomfort or swelling, others may not show any symptoms.
Many individuals with varicoceles suffer fertility problems. Approximately 40 percent of men with infertility have varicoceles, although there are also men with varicoceles who are not infertile.
Many individuals with a varicocele may notice that their testicles are shrinking or that unexpectedly one testicle is smaller than another. We may also experience deep in the scrotum, an aching feeling.
Most varicoceles may be treated under surgery. In many cases following surgery the testicles return to their usual size.
Congenital disorders
A congenital condition is a disorder which occurs at birth. Many unusual congenital defects lead to tiny testicles.
Klinefelter syndrome is one such disorder. Klinefelter syndrome causes one person to have two or more X chromosomes, rather than just one.
People with Klinefelter syndrome appear to be taller than average and have little testosterone generating testicles. Many Klinefelter syndrome sufferers are infertile.
Brain and motor function may also be impaired by Klinefelter syndrome. Children with this condition may have poor coordination or may consider behavior skills that are difficult for learning.
Many boys that have the disorder grow breasts during puberty. Some people with Klinefelter syndrome are diagnosed early in their childhood, but others may not be aware of having the disorder.
Testicular atrophy
When the testes contract, the testicular atrophy occurs. Various conditions can cause atrophy of the testicles.
Surgery to repair an inguinal hernia is one well-known cause of testicular atrophy. This disorder is rare, affecting just about 0.5 per cent of males undergoing primary repair of inguinal hernia.
People with repeated inguinal hernia replacements have a higher risk of testicular atrophy, with this disorder rising by about 5 per cent.
Specific causes of testicular atrophy include:
- aging
- sexually transmitted infections (STIs), such as syphilis and HIV
- other infections, such as mumps
- alcohol-induced cirrhosis
Infertility
Little research has directly tested the connection between the size of the testis and infertility. A study in 1989 noted that 704 of the 1,029 infertile men in the study had normal sized testes. The other men had varying degrees of reduction in one or both of the testicular volumes.
Sperm count and motion reduced with testicular size. Men with lower testicular volume were often producing less sperm.
Since most infertile men had normal size testicles in this research study, the study did not establish a clear correlation between testicular size and fertility in those with normal size testes.
People with questions about fertility should ask a doctor about the sperm content assessment tests. In addition, a doctor may prescribe blood tests to assess hormone levels.
Cancer
Reducing the size of the testis after testicular torsion can be a risk factor for testicular cancer. Anyone who notices that they suddenly have smaller testicles should see a doctor.
The symptoms of testicular cancer can be hard to distinguish from those of other types of cancer.
Some testicular cancer symptoms can include:
- a lump on the testicales
- an enlargement of the testicles
- having fluid in the scrotum
- enlarging breasts
- a feeling of heaviness in the testicles or scrotum
- a dull ache in the back or abdomen
- experiencing shortness of breath
Some risk factors for testicular cancer include:
- An undescended testicle (cryptorchidism). People with cryptorchidism are more likely to develop testicular cancer than those with descended testicles.
- Family history. While most people with testicular cancer do not have a family history of the disease, having a first-degree relative with testicular cancer increases a person’s risk.
- HIV. People with HIV, particularly those with stage 3 HIV, have a higher chance of developing testicular cancer.
- Previous testicular cancer. About 3–4% of those who have received a diagnosis of cancer in one testicle will develop cancer in the other testicle.
- Race and ethnicity. White males are 4 to 5 times more likely to develop testicular cancer than black and Asian American males.
- Age. Although testicular cancer can affect males of any age, close to 50% of testicular cancers occur in those between the ages of 20 and 34 years.
Side effects
There are usually no side effects when the testicles are smaller than average but there is no underlying medical condition.
Other signs and symptoms can also come from medical conditions that cause small testicles. A varicocele in the scrotum for example can cause pain and swelling.
Testicular atrophy can have a multiple effect on sexual and reproductive health. Persons could experience:
- pain in the testicles
- decreased fertility
- low libido
- sexual problems, such as erectile dysfunction
When to see a doctor
If a person is concerned about the size of their testes and the symptoms that follow them, they should see a doctor. A doctor can determine if there is a serious underlying problem or not.
Anyone who is nervous or self-conscious about the size of their testicles should discuss their next appointment with a healthcare professional.
It is necessary to arrange a healthcare professional rendezvous whether:
- pain, shrinking, or swelling occurs in one or both testicles
- a partner does not become pregnant after a year or more of trying
- a lump appears in the scrotum
- unusual breast growth occurs
- there are symptoms of low testosterone, such as erectile problems or low energy
- other accompanying symptoms arise, such as lower back pain, shortness of breath, abdominal pain, a cough, confusion, or headaches
Outlook
Having small testicles does not automatically mean a person has a health problem.
A sudden change in the size or shape of the testicles may, however, indicate a problem.
Some serious problems, such as testicular cancer, could be easier to treat if they are diagnosed early by a doctor. Hence people should never hesitate pursuing counseling.
