Learn About Testicular Failure
Male hypogonadism occurs when the testicles cannot produce or produce less sperm or male hormones, such as testosterone.
Primary hypogonadism - male; Testicular hypofunction
Causes of male hypogonadism include:
- Certain medicines, including glucocorticoids, ketoconazole, chemotherapy, and opioid pain medicines
- Diseases that affect the testicle, including hemochromatosis, mumps, orchitis, testicular cancer, testicular torsion, and varicocele
- Injury or trauma to the testicles
- Obesity
- Genetic diseases, such as Klinefelter syndrome or Prader-Willi syndrome
- Other diseases, such as cystic fibrosis
The following can increase the risk of male hypogonadism:
- Activities that cause constant, low-level injury to the scrotum, such as riding a motorcycle or bicycle
- Frequent or heavy use of marijuana
- Undescended testicles at birth
Symptoms depend on the age when male hypogonadism develops, either before or after puberty.
Symptoms may include:
- Enlarged breasts (gynecomastia)
- Infertility
- Less height increase than expected
- Loss of muscle mass
- Lack of sex drive (libido)
- Loss of armpit and pubic hair
- 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.
Male hormone supplements may treat some forms of hypogonadism. This treatment is called testosterone replacement therapy (TRT). TRT can be given as a gel, patch, injection, or implant.
Avoiding the medicine or activity that is causing the problem may bring testicle function back to normal.
Nelson Bennett is an Urologist in Chicago, Illinois. Dr. Bennett has been practicing medicine for over 26 years and is rated as an Elite provider by MediFind in the treatment of Testicular Failure. His top areas of expertise are Testicular Failure, Peyronie Disease, Erectile Dysfunction (ED), Vasectomy, and Prostatectomy.
Ranjith Ramasamy is an Urologist in Miami, Florida. Dr. Ramasamy is rated as an Elite provider by MediFind in the treatment of Testicular Failure. His top areas of expertise are Testicular Failure, Hypogonadism, Erectile Dysfunction (ED), Vasectomy, and Hormone Replacement Therapy (HRT).
Giovanni Corona practices in Bologna, Italy. Mr. Corona is rated as an Elite expert by MediFind in the treatment of Testicular Failure. His top areas of expertise are Hypogonadism, Erectile Dysfunction (ED), Hypogonadotropic Hypogonadism, Hormone Replacement Therapy (HRT), and Prostatectomy.
Many forms of male hypogonadism cannot be reversed. TRT can help reverse symptoms, although it may not restore fertility.
Men who are having chemotherapy that can cause hypogonadism should discuss freezing sperm samples before starting treatment.
Male hypogonadism 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 TRT.
Men who take TRT need to be carefully monitored by their provider. TRT may cause the following:
- Enlarged prostate, leading to difficulty urinating
- Blood clots
- Changes in sleep and mood
- Changes in good cholesterol (HDL)
- Blood becomes too thick (polycythemia)
Contact your provider if you have symptoms of hypogonadism.
Also, contact your provider if you're on TRT and you think you're having side effects from the treatment.
Avoid higher-risk activities if possible.
Remain active and prevent weight gain as you get older.
Summary: This is a 52-week open label single arm study to investigate the effects of XYOSTED, as testosterone replacement therapy, on adolescent males with either primary or secondary hypogonadism. The study aims to determine the effectiveness of XYOSTED measured by continuation or induction of puberty in addition to XYOSTED dosage, safety and testosterone levels.
Summary: To assess endothelial dysfunction in young men (aged 30-50) with vasculogenic ED identified through penile Doppler ultrasound. To evaluate changes in endothelial function using EndoPAT before and 3-6 months after daily low-dose phosphodiesterase type 5 (PDE5) inhibitor therapy. To investigate endothelial function alterations in hypogonadal patients before and 3-6 months after initiating testostero...
Published Date: April 24, 2025
Published By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Matsumoto AM, Anawalt BD. Testicular disorders. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 17.
Schlegel PN. Clinical management of male infertility. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 113.
Swerdloff RS, Wang C. The testis and male hypogonadism, infertility, and sexual dysfunction. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 216.
US Food and Drug Administration website. FDA drug safety communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-cautions-about-using-testosterone-products-low-testosterone-due. Updated February 28, 2025. Accessed May 8, 2025.