What Is Testicular Failure?
Testicular failure, another name for primary hypogonadism, is a relatively rare condition in which the testicles cannot produce testosterone and sperm. The condition is thought to be caused by several factors resulting in various signs and symptoms. These elements can occasionally make it difficult to diagnose and treat testicular failure.
Testosterone is a crucial androgen (male sex hormone) for the development of the male genitalia, the maintenance of secondary sex traits in prepubescent males, the initiation and maintenance of spermatogenesis (the development of sperm cells), and the stimulation and maintenance of sexual function in postpubescent males. As a result, among other effects, its low production reduces the production of sperm and changes the body's aspect. In young pre-pubertal boys, androgen deficiency delays puberty, reduces muscle mass and hair growth, prevents typical male deep voice development, etc. Reduced libido and sexual dysfunction (erectile dysfunction) in teenage men are symptoms of testicular failure. Any man who lacks enough testosterone is more likely to develop osteoporosis.
What Causes Testicular Failure?
One of the potential causes of testicular failure is medication. Medicines like glucocorticoids, Ketoconazole, chemotherapy, and opioids, among others, may bring on the condition. Hemochromatosis, orchitis, mumps, cystic fibrosis, varicocele, testicular torsion, and cancer are some medical conditions linked to testicular failure. Another potential contributing factor is an injury or trauma to the groin area and genetic conditions like:
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Klinefelter's Syndrome (XXY): It is a typically inherited condition linked to testicular failure, a condition brought on by a congenital abnormality of the X and Y chromosomes. There is typically one X and one Y chromosome in a male. In addition to one Y chromosome, Klinefelter's syndrome is characterized by the presence of two or more X chromosomes. The genetic material that determines a child's sex and the development that goes along with it is found on the Y chromosome. The abnormal testicular development brought on by the extra X chromosome in Klinefelter's syndrome leads to a decrease in testosterone production.
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Cryptorchidism: Another condition that may have a congenital basis is cryptorchidism. It refers to the condition in which either one or both testicles are immobile in the scrotum. If the condition is not treated in childhood, it may result in testicular dysfunction and reduced testosterone production.
In general, older men have lower levels of testosterone than younger men. The amount of testosterone produced in men decreases gradually and steadily as they age. Men experience testosterone loss at varying rates. The American Association of Clinical Endocrinologists estimates that up to 30 % of men over 75 have testosterone levels that are below normal.
There are several additional risk factors for testicular failure, which include the following:
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Activities like riding a motorcycle or bicycle that result in continuous, minor scrotal injury.
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Heavy marijuana use.
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When the testicles are not descended at birth.
Risk factors should, where applicable, be reduced or treated to prevent testicular failure. In some cases, if the condition is detected early enough, it may be possible to reverse it and restore normal testicular function by minimizing and treating risk factors and causes.
What Are the Symptoms of Testicular Failure?
Testicular failure can develop before or after puberty, depending on the age at which symptoms first appear. Some signs could be:
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Decrease in height.
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Larger breasts (gynecomastia).
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Infertility.
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Muscle mass loss.
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Absence of sex drive (libido).
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Loss of pubic and underarm hair.
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Slow growth or a lack of secondary male sex traits (hair growth, penis enlargement, scrotum enlargement, voice changes).
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Men might also discover that they do not have to shave frequently.
How Is Testicular Failure Diagnosed?
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Testicular failure is typically diagnosed through a discussion of the symptoms, a physical exam, and diagnostic tests to delve further into the condition. However, because testosterone levels naturally decline with age in men, it can be challenging to diagnose in older men.
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Small, firm testicles, the presence of a growth or tumor in the testicle or scrotal region, or any of these physical characteristics may be signs of testicular failure.
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Typically, a blood test is needed to determine the body's hormone levels. Testicular failure is particularly indicated by low testosterone levels but high levels of follicle-stimulating hormone (FSH), prolactin, and luteinizing hormone (LH).
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Further testing is performed to determine whether testicular, hypothalamic, or pituitary causes are present if low testosterone levels are confirmed. These examinations could consist of genetic studies, testicular biopsies, pituitary imaging, hormone testing, and semen analysis.
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The results of additional tests or an ultrasound that visualizes the testicles may help determine bone mineral density. To determine the number of healthy sperms produced, a semen examination may also be required.
How Is Testicular Failure Treated?
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First-line therapy should be started right away if there is a specific factor that is likely to have contributed to the condition in the first place. This may entail stopping drugs that have been linked to testicular failure, managing related conditions better, abstaining from marijuana use, and giving up activities like cycling. If the damage was not severe, in some instances, this might allow the testicle function to return to normal.
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Men whose testicular function has been irreparably damaged can treat their testicular failure with testosterone replacement therapy (TRT). Although this therapy carries some risks, it is crucial that men receive the necessary medical care and follow-up attention. The risks of therapy include abnormal cholesterol levels, increased red blood cells, abnormal prostate gland growth, and changes in mood and sleep patterns.
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Treatment for inflammatory diseases involves getting rid of the infection that is causing the testicular function to decline. In such circumstances, the testicles typically resume their normal function. Surgical correction can frequently correct reproductive system malformations. If testicular failure is caused by an inherited disorder, there is no cure, and the treatment focuses on controlling the symptoms of low testosterone. It is critical for affected men to have a strong support system to help them cope with the psychological and emotional effects of testicular failure.
Conclusion
Testicular failure is a condition in which the testicles cannot produce testosterone and sperm. To prevent the condition, people must stay away from riskier activities, remain active and avoid gaining weight. Before beginning chemotherapy that may result in testicular failure, men must consult the doctor about freezing sperm samples. Numerous types of testicular failure are irreversible. TRT may not be able to restore fertility, but it can help reverse symptoms.
