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Why Athletes Develop Testicular Atrophy And How To Reverse It?

March 19th, 2020

Why Athletes Develop Testicular Atrophy And How To Reverse It?

Anabolic steroids can significantly help in achieving bigger and well-defined muscles but there is a catch to it. While anabolic steroids may seem like a golden ticket to get perfect muscles, they, however, also adversely affect the testicles and cause testicular atrophy.

A study based on 500 subjects who used anabolic steroids, two-third of the subjects suffered from testicular atrophy. Fortunately, some natural approaches can undo the damage and help in restoring the testicles to their natural form.


AAS (androgenic anabolic steroids) are derived synthetically from the male sex hormone called testosterone. People who use these steroids, actually introduce a synthetic form of testosterone to the body. Hormone release works on the principle of negative feedback. 

  • When the testosterone levels go down, on the brain’s command FSH (follicle-stimulating hormone) and LH (luteinizing hormone) are produced. 
  • LH is transferred to the testes via bloodstream where it initiates the production of cholesterol and testosterone. 
  • The pituitary gland gradually slows the LH release once the testosterone levels are high enough and hence the production stops. 
  • An external source of testosterone, pituitary fails to detect the low levels of natural testosterone and therefore it does not release any LH in the bloodstream, as a result, no natural testosterone is produced. 

With the continuous use of steroids, the testes will stop producing testosterone and will become atrophic for not being used. Atrophic testicles cannot produce sufficient amounts of sperm and so this may lead to fertility-related problems.

Leydig cells are present in the testicles and are responsible for producing testosterone upon the detection of LH. Steroids are very harmful to Leydig cells and can eventually cause cell death.

Common Testicular Disorders - testicular atrophy

Other Causes of Testicular Atrophy

The use of steroids is the most commonly known and talked about, but there are other causes of testicular atrophy that can happen for unintentional reasons including age-related, trauma and even natural instances for the testicles to become smaller. These can be treated and even reverse the damage done. 


As men age, the testes can shrink. This is completely natural as the body produces less testosterone or sperm. While not every man may experience this, it is very common as men age. 

  • Common treatments include hormone replacement therapy or medications


If you have ever seen varicose veins, aka the spidery looking veins on arms or legs, this is very similar. This is the same thing, a vein that has too much blood, only it is near your testicle. These can occur naturally without any real rhyme or reason and can make the testicle look smaller. 

  • These can be surgically repaired- and should be depending on a consultation with your doctor as they place you at higher risks for bleeding and blood clots. 
  • There are also medications to help prevent the risks of blood clots and complications.


Yes, alcohol has many health complications, including causing smaller testicles. Heavy drinking can damage many of your organs, affect your overall body chemistry and cause many lasting health effects. Among them, it causes lower testosterone levels and can damage the sensitive testicular tissues. 

  • This doesn’t mean you can’t drink. But do so in moderation.


This is an infection of the testicular tissues. It can be caused by an STD like chlamydia or gonorrhea, the same virus that causes mumps, or even a UTI or catheter use. This infection can cause the testes to shrink if left untreated and can become a serious illness. 

  • Symptoms revolve around pain and swelling in the testicles but can also include nausea and fever. 
  • Speak with a doctor for a physical examination to diagnose. You’ll need antibiotics for the infection, but it can reverse the effects. 
  • HIV can also cause the testicles to shrink along with other diseases such as contracting the mumps or during STD treatment. 

Testicular Torsion

A twisting of the balls, it is as painful as it sounds. Inside your body, the testicle rotates and twists the spermatic cord that provides blood flow to the scrotum. It causes pain and swelling in the area. This is a medical emergency, and without rapid treatment, it can cause a permanent shrinkage and atrophy of the area. 

  • While it can be caused or worsened by certain physical activities, there is no exact cause or reason as to why this happens. 
  • Again, this is an EMERGENCY and requires surgical correction to prevent irreversible damage. DO NOT DELAY and get care if you experience symptoms of swelling and sudden severe pain. 
  • Surgery can correct the injury and reverse the damage, though if it happens once you are more likely to have it happen again- oh and it runs in the family so be aware. 


Testicular cancer can cause the balls to shrink. In men, this is common cancer at a young age. While many see a lump or increase in size, others notice a shrink. 

  • If you notice any changes in the size, shape or feel, you should contact your doctor immediately to rule out treatable causes and receive an early diagnosis. 
  • Treatment for testicular cancer has higher success rates, especially when caught early- so don’t wait!

Hormone Imbalances

Besides the already mentioned use of steroids, having a natural imbalance of hormones can cause the testicles to shrink. It can be caused by taking a steroid, use of testosterone replacement therapy, or even some medications. 

  • Talk with your doctor if you take any medications or use hormone therapy to talk about this. 
  • You can have your levels tested to make sure you are within a normal range. 


Diagnosing a shrinking or atrophy of the testicles should be performed by a medical professional. There are treatable and removable causes in addition to testing that can be done to reveal the cause. 

  • A physical exam will assess the size, shape, texture, and firmness of the balls to make sure there are no abnormalities. 
  • Blood work can check for signs of infection, hormone levels and other indicators of illness. 
  • A urine sample or swab can test you for STDs and determine if treatment is needed. 
  • Ultrasounds are done to look at the internal function, shape, size, blood flow, etc to see what is going on in there and diagnose difficulties. 


There are natural and holistic treatments along with conventional medicine to help with testicular atrophy. You should always consult with a doctor to look for treatable causes before resorting to natural and herbal remedies. 

  • Antibiotics are given in cases of infections. 
  • Surgeries are performed in the case of torsion and can also be done cosmetically. 
  • Hormone therapies can be done if there is an imbalance or aging is the cause. 
  • A change in diet or exercise can help to improve shrinking as well. 

In cases where there was steroid use or nonmedical causes, there are natural remedies that can be tried. 

  • Taking supplements with natural ingredients to boost testosterone production can help with shrinking. Many natural and safe products can help you to rebalance hormone levels. 
    • Vitamin K, Vitamin D, DHEA, Giner, Tribulus Terrestris, Zinc, Ashwagandha
    • Cod liver oil is high in omega 3 that helps to increase testosterone levels along with boosting heart health. 
    • Garlic has been found to have many health benefits including boosting testosterone levels naturally. It also contains selenium that promotes healthy sperm and prostate health. 
    • Pomegranate contains many antioxidants that can boost testosterone levels while improving sperm health. 

There are several causes for testicles to shrink or atrophy. Many are treatable if help is received and treatment begins immediately. For other nonemergent causes, there are lifestyle changes that can help to prevent further shrinking while also helping to naturally boost testosterone and increase testicle size


  • Kanayama, G., Hudson, J. I., DeLuca, J., Isaacs, S., Baggish, A., Weiner, R., … & Pope, H. G. (2015). Prolonged hypogonadism in males following withdrawal from anabolic–androgenic steroids: an under‐recognized problem. Addiction, 110(5), 823-831.
  • Christou, M. A., Christou, P. A., Markozannes, G., Tsatsoulis, A., Mastorakos, G., & Tigas, S. (2017). Effects of Anabolic Androgenic Steroids on the Reproductive System of Athletes and Recreational Users: A Systematic Review and Meta-Analysis. Sports Medicine, 1-15.

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