Slow development or lack of secondary male sex characteristics (hair growth, scrotum enlargement, penis enlargement, voice changes)
Men may also notice they do not need to shave as often.
Exams and Tests
A physical exam may show:
Genitals that do not clearly look either male or female (usually found during infancy)
Abnormally small, firm testicles
Tumor or an abnormal mass in the testicle or the scrotum
Other tests may show low bone mineral density and fractures. Blood tests may show a low level of testosterone and high levels of prolactin, FSH, and LH.
Your doctor may also order a semen analysis to examine the number of healthy sperm you are producing.
Sometimes, an ultrasound of the testes will be ordered.
Testicular failure and low testosterone level may be hard to diagnose in older men because testosterone levels normally decrease slowly with age.
Male hormone supplements may treat some forms of testicular failure. Men who take testosterone replacement therapy need to be carefully monitored by a doctor. Testosterone may cause the following:
Excess growth of the prostate gland
Abnormal increase in red blood cells
Changes in blood cholesterol
Changes in sleep and mood
Avoiding the medicine or activity that is causing the problem may bring testicle function back to normal.
Many forms of testicular failure cannot be reversed. Hormone replacement therapy can help reverse symptoms, although it may not restore fertility.
Testicular failure that begins before puberty will stop normal body growth. It can prevent adult male characteristics (such as deep voice and beard) from developing. This can be treated with testosterone therapy.
When to Contact a Medical Professional
Call for an appointment with your health care provider if you have symptoms of testicular failure.
Avoid higher-risk activities if possible.
Allan CA, McLachlan RI. Androgen deficiency disorders. In: Jameson JL, De Groot LJ, de Kretser DM, et al., eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 139.
Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.