Sudden testicle shrinkage. No libido, fatigue. Varicocele?

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  1. Sudden testicle shrinkage. No libido, fatigue. Varicocele?


    I've read through a lot of posts on here and other boards - looking for information.

    In January this year (2015), I experienced a sudden loss of libido and extreme fatigue.
    This happened within 24 hours (overnight). From being totally fine, healthy and full of lust for life, to nothing.
    After a couple of days, I noticed my testicles had shrunk to 50% volume/total size.
    I panicked, thought I had had testicular torsion, went to the hospital. No torsion, 'seemed healthy'.
    Referred me to a urologist.

    Since then, almost 9 months have passed. I've seen 6 urologists, an endocrinologist and several general doctors.
    I have had:
    - numerous manual examinations (including the valsalva maneuver)
    - a scrotal ecography
    - abdomenal ecography (kidneys and bladder),
    - two blood tests for hormone levels

    None have encountered this before - nor have any given a diagnosis or any kind of treatment whatsoever.

    The scrotal ecography revealed a 'small' varicocele (4mm), a couple of 'small' hydroceles - all on the left testicle.
    The abdomenal ecography was in around June, following 24 hours of 'a large quantity of blood in the urine'.
    That showed nothing whatsoever in the bladder or kidneys.

    No cause has been presented for the blood in the urine either.

    I'm 35, physically fit, do not drink alcohol or caffeinated drinks, do not smoke or anything else. I have no other medical problems
    and take no medication whatsoever.
    My diet is balanced - and one week after the testicle shrinkage - I improved my diet further to include testosterone boosting
    foods (more red meat, dairy, brasil nuts, walnuts, dark green vegetables, mushrooms and so on). None of these are eaten
    in excess. It hasn't cured me - nor had any great effect that I can notice.

    I can post my full bloodwork in a later reply, if anyone is interested.
    Testosterone a month afterwards (in February) was around 670 ng/ml.
    In the beginning of September, it was 890 ng/ml. The diet may have helped that, but when I questioned one doctor in particular
    in July - he said my testosterone (given my fitness and age and so on) should be around 1,000.

    The blood tests supposedly all fall within normal ranges - which really isn't helpful - as the doctors just tell me it is in my head
    which is compounding my hopelessness.

    The doctors have brushed me off, giving me a followup appointment 2 months down the line each time, last one was set for
    3 months from that one (mid December). The endocrinologist was one of the worst - refuting that I had any real cause,
    either physical or hormonal - saying "it is probably psychological".

    I've had more pain above my left testicle since the beginning of July - which I suppose is from the varicocele.

    From my guess, something burst or failed in the end of the January, very suddenly, my ball shrank and messed up my hormonal
    system (adrenals/thyroid) in some way that is irreversible unless treated in the proper sequence.

    My symptoms include: no morning erections, no spontaneous erections, not much sensation down there,
    no sexual fantasies or even sexual dreams, no libido.
    Along with that, a pain in the groin above my left testicle which lasts for almost all the day.

    Some other things I have noticed which may be related. I have no real urge anymore to use the toilet, for liquids or solids. Nor do I have
    any 'relief' or pleasurable feeling from doing so. I just feel 'full' or 'empty' afterwards. That's it. No great hunger or thirst either. I just
    eat when I think I should have food.
    The rest of my experiences and emotions feel almost completely flatline too - like I don't experience any pleasure from anything.
    This could be my adrenals or thyroid or a combination.

    At times, I can manually stimulate and a weak erection comes (not always) - it never reaches the full size.
    If I stop manual stimulation, the erection almost immediately deflates - it doesn't last by itself.

    Directly before this happened - I had morning erection almost every day, that would last 20-30 minutes by mild thoughts alone -
    spontaneous erections throughout the day.

    My arms and wrists seem smaller than before, I don't seem to be holding muscle as I was immediately before.

    Over the months, I have been fighting off a depression that this thing is causing.
    I really need some information and help on what to do next.

    From what I have read, a good varicocele surgery - and one of the PCT restart therapies might fix me.

    Most of the doctors have more or less laughed in my face, told me to relax and that it isn't serious.
    Frankly it has ruined my life, I don't see any future continuing like this. I don't see how that can't be serious.

    Thanks for reading, I'd appreciate any help.

  2. If you're worried about your hormones why haven't you gotten bloodwork for your hormones at privatelabsmd? It's like 60 dollars

  3. I had my general practitioner take a quick look during a regular checkup, and he spotted a varicocele on me. Why not just go see any doctor and ask them? A quick/easy visual examination by any doctor will give you the answer.

  4. I had blood work done twice this year, which was checked by urologists and an endocrinologist. They lazily just said "It falls within normal ranges" and declared there was "nothing medically wrong with me", while accepting that my testicles had shrunk and libido gone to nothing.

    The varicocele showed up on ecography, but they say that it is too small, and usually doesn't effect anything. They only deal with statistics it seems, not facts.

    Thanks for the advice though. Gutterpump, did your varicocele cause any probems, and were they fixed?

  5. Can you post up your labs and if you don't have them, can you request a print out from your DR's secretary? This will tell a lot. I always have to ask my Dr or his secretary to mail me a copy so I can study them. My test was around 300 but my dr originally said this falls within normal range. Very low normal yes, which I found out for myself. I went to a new doctor and started TRT.

    Unfortunately, I was already on TRT for a few years before they found the varicocele. I didn't get checked out beforehand for this. I didn't bother getting it fixed because being over 30 and on TRT for a few years already means I don't have much chance of restarting my natural production to a satisfactory amount anymore. I'm a lifer now. If I ever try for kids, I'll stay on a low dose of test and add in HCG + HMG.

  6. I'll post the main ones for now.

    In April they were:

    FSH - 3.0 UI/ml
    LH - 6.3 mUI/ml
    Prolactin - 17.6 ng/ml
    Testosterone - 6.32 ng/ml
    TSH - 3.35 ųUI/ml

    At the end of August they were:

    FSH - 2.4
    LH - 6.4
    Prolactin - 17.34
    Testosterone - 7.82
    TSH - 3.06
    Estradiol - 29.66 (not tested the first time)

    I read somewhere that TSH should be around 1.0 to be optimal, the doctors of course reacted with irritation when I tried to ask what is optimal instead of average. One andrologist/urologist said "What is normal for everyone is normal for everyone!".

    Another symptom I forgot to include, I had a very sensitive left nipple for a few weeks before this happened. It reduced in sensitivity a couple of weeks after the ball shrinking, and remained partially sensitive until July when it returned to normal.

    The first blood test was 2-3 months after the hypersensitivity,
    caused by prolactin - so the prolactin levels could have been far
    higher in January.

  7. Gutterpump, is there no chance they can repair your varicocele and give you a PCT restart? I heard the cut off ages vary, from 35-40. On one forum someone was near 60 and it worked for him.
    Do you feel normal, day to day?

  8. I'd appreciate some input on the blood results, if anyone has experience with this kind of thing.

  9. Quote Originally Posted by fweed View Post
    Gutterpump, is there no chance they can repair your varicocele and give you a PCT restart? I heard the cut off ages vary, from 35-40. On one forum someone was near 60 and it worked for him.
    Do you feel normal, day to day?
    I had started TRT many years ago though, about 5-6 years ago, so it's pretty much too late for me to come back to normal now. I've been on too long.

  10. You'll have to post the lab ranges for your bloodwork for feedback

  11. Detailed time line would be highly suggested or just throwing darts against the wall.

    90% of imbalances are found with in a detailed time line. Which is the missing key in majority of medical cases as you goto a specialist who focuses on one area never looking at other factors
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

  12. Matrix, what so you mean by a detailed timeline? Of events, symptoms, or I need more blood results?

    Early April results with lab ranges, followed by results of late august:
    FSH - 3mUI/ml (range 1-19) - august 2.4
    LH - 6.3mUI/ml (2-11) - august 6.4
    prolactin - 17.6 ng/ml (4-15) - august 17.38
    testosterone - 6.32 ng/ml (2.5-11.0) - august 7.82
    TSH - 3.35 ųU/ml (0.27-4.2) - august 3.06
    estradiol - untested in April (11-55) - august 29.66 pg/ml

  13. Timeline of events (not all were connected by me until some time after when I had learned more information.

    Early January, highly stressed from girlfriend trouble, being cheated by landlord at the time, and a sudden new workload in my job.
    Left nipple became incredibly sensitive. Retrospect tells me it was prolactin, perhaps caused by the emotional and physical stresses.

    Nearly the end of January, was fine one day (apart from the nipple thing), masturbated twice in two days in a row in the shower. Next day felt incredibly tired, absolutely no libido.
    Exhausted for several days, felt my balls and noticed the left was half sized, felt lifeless, almost no sensation there. Right was also diminshed.
    Left had always (following puberty) been around twice the size of the right testicle. Now they were the same size.
    Panicked and went to emergency.
    They manual checked, blood flow with a kind of torch through scrotum. Said it was normal and had blood flow.
    Booked me with urologist for 1 month later.

    1 week after ball shrinkage, I read a lot about testosterone foods,
    changed my diet to include a lot of natural boosters.
    More vegetables, red meat, brasil nuts, mushrooms etc.

    2 weeks after the ball shrinkage, left nipple reduced in sensitivity, by half. Still remained more sensitive than before January.
    Uncomfortable feeling in left groin started around now. Pulling feeling, or like the cord holding the testicle was in the wrong place. I thought it was because the testicle had suddenly lost half its mass, so the cord was pulling with twice as much force as it now needed.
    Also, felt that there were extruded veins on lower front area of left testicle. They had never been there before. I thought at the time "oh good, blood flow is increasing, my body must be repairing" - realised months later that it was from blood flow not exiting the area properly, varicocele.

    End of February - Urologist performed manual check. Didn't find problems. Booked blood test and ecography. He noticed that
    my left cord was thicker than my right. Proving the testicle had been considerably larger.

    April - Blood taken, ecography of scrotum.
    Ecography found 2 cysts/spermatoceles on left testicle epidimus, 4mm in size. Also a small variocele on left side (tubes of 2-3mm).They claim testicles are normal size (again, meaningless ranges) of 4.5cm (right) and 4.4cm (left). My estimate is that before this happened, left was about 6cm long, firm and uniform.

    Ecography showed normal blood flow.

    Minor hydrocele on the left.

    Early June - sudden sharp pulsing pain in right lower abdomen, "large amount of blood" in urine for 24 hours following. Urine looked like coca cola, opaque. Tested at doctors, "+++++" for blood, one + for protein.

    July - ecography of kidneys and bladder (due to blood in urine).
    Nothing found.

    Beginning of August - nipple stopped being sensitive, returned to normal. All other symptoms remained the same. No libido, fatigued, almost no emotions, no urges or relief from using the toilet. No sexual dreams. Morning wood once a month maybe,, very weak and short lived. No spontaneous erections. Masturbation possible but difficult - done in order to exercise the member and keep bloodflow.
    More pain (usually for half the day) from varicocele, continues now).

    End of August - blood extraction.

    September - Met endocrinologist for the first time. Checked my testicle size against wooden beads,,said they are normal,,slightly larger than the larger wooden bead on the string of them he had.
    Checked me for body hair, hadn't changed that I had noticed.
    Said prolactin levels are slightly high on both tests,,but wasn't concerned. Said that since urologist and he could not find anything clinically "out of ranges", then it was officially not a medical problem, and by that reasoning told me it is therefore psychological. Made me feel like I had wasted his time. He didn't want to help me. Said wait 3 months, if it hasn't improved, see a psychiatrist.

    Him saying this has ironically killed my hope. I haven't done anything since. The hospital lost my appointment for 3 months in the summer, until I turned up at emergency again, then they suddenly refound it.

    This has happened again. The mid December blood test, urologist and endocrinologist appointments I was marked to have, have never been sent to me.

    The hospital doesn't care, doesn't want to help me, and I have been left for 11 months without diagnosis or treatment.

    This has seriously affected,my mental state. I don't feel like the same person anymore.

    I am living in Spain (makes everything harder), and I spoke with an american doctor via the internet 1-2 months ago.
    Described my problems, sent the results. He thought it might be a combination of things. One of which was a small microadenoma/prolactinoma - that I need a full panel blood test (something the doctors here didn't think was important), and an MRI of my pituitary. Also that I should ask for a drug to reduce the prolactin in the meantime.

    Following that, that there might be more causes, such as the varicocele.

    Communicating or even just seeing doctors here is a big task,,and my energy is almost gone. I feel I am giving up.

    This is a medium town,,with two hospitals. I have seen 6 urologists, none have encountered this before - neither has the endocrinologist.
    I could go to a large city, Madrid for example.
    But how to have an appointment.,or have a referal to them?

    The other option is to return to england, quit my job here and hope that a specialist in England can help me.
    The problem is, that losing my job and my routine and life here would seriously affect my mental state, when my job is all I am holding onto.

    My girlfriend of 3 years left me, I am not in a good situation.
  14. Sudden testicle shrinkage. No libido, fatigue. Varicocele?

    Fweed, not to be insensitive to your condition, but the lack of interest, attention and treatment to your condition really speaks volumes about socialized medicine. Unfortunately, ignorant Americans want to embrace this same system of which they have no knowledge or experience as to how it actually works. It's a disaster! I hope you can get treated bro!

  15. Anyone have feedback for my extra info? Or can tell me where to find a good varicocele surgeon in Europe. Spain or England preferable.

  16. Hey...have any of the docs prescribed you cabergoline for the prolactin? I'm not sure how much an impact it should have on libido, etc but I do know that a range slightly above normal is definitely not a good thing. I am meeting with my endocrinologist for the first time tomorrow and will let you know what he says.

  17. They haven't diagnosed or prescribed anything, it has been almost a full year. I went to a private doctor last week, he recommended an MRI and a blood test. Had them done today. MRI results in the next few days.

    Blood test this time:
    prolactin 389 mU/L (range 40-360), cortisol (serum) - 507 nmol/L (172-497), SHBG - 49.44 nmol/L (14-48 ), testosterone - 18.9 nmol/L (8-29).

    Some of these need converting, and use a different standard (I'm in England currently for these tests), there are websites with converters.

  18. As you can see, prolactin is still high, cortisol too, SHBG, and testosterone is lower than in September (now around 540 or something in the Spanish scale). The MRI cost a lot.

  19. For what it's worth I saw the endo yesterday. At my mildly elevated prolactin levels, he said he was not comfortable prescribing me caber or bromocriptine. Also wants me to do an MRI which is scheduled at the end of this month. For everything else he said my ranges are normal. He also told me the varicocele shouldn't matter much like the doctors you have seen are saying

  20. I am going to see a BHRT doc at the end of this month who is more forward thinking when it comes to this stuff. In the meantime, I am trying a combination of things which I'll outline in the next post

  21. 1. Restoring neurotransmitter balance
    I've ordered a bunch of nootropics including alpha-gpc, huperzine A, inositol, Sulbutiamine, and DL-phenalyne. Hopefully this will work on any neurotransmitter deficiencies which could be causing the erections problem in my head

    2. Physical ED
    Will start taking a combo of cittruline malate, raw cocoa and pycnogenol before bed each night. Also going to try the acetyl-l-cartinine and lipoic acid combo which has helped solve many ppls cardiovascular ED

    3. will also start HC generate ES for the test boost and libido

    If I can't get my mojo back with the above I don't know what else will work

  22. I think the varicocele is one of the causes for both of us. More recent research shows that they do have an effect on testosterone, sex drive and fertility. One study showed an average 180-200 point increase in testosterone after a microsurgical inguinal varicocelectomy. For me, the two most interested doctors have told me it is a combination of factors. Maybe the varicocele combined with a possible prolactinoma. Varicocele doesn't guarantee problems, but when it coincides with another endocrinological problem it seems to stall the hormone system.

    Try to find a specialist who regularly deals with varicoceles. I was recommended to look in university hospitals, I suppose as there are more researching specialists there.

  23. Yeah I'll plan to see a urologist and do the embolization procedure but I've heard mixed reviews to be honest....very hit or miss and no drastic increases post surgery in a lot of the cases.

    Ever thought of something like prolacterone for the mildly elevated prolactin?

  24. My balls shrank in a matter of hours, maybe within a day or two. From that suddeness, I would think it would be something physical. How did yours start?

  25. Mine was gradual for sure....been built up over a number of years.....


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