Sudden testicle shrinkage. No libido, fatigue. Varicocele?

trn450

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"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."

This is not something I imagine most MD's, especially endocrinologists, would agree with. It also doesn't even make physiologic sense.

I see a lot of testosterone results from people of a wide range of ages (30s-50s most often) who receive this tests as routine blood work -- it's "luxury" medicine, so these extra panels are thrown on to many people and is therefore somewhat approaching random. In other words, the concern for low testosterone and it's symptoms are not a prerequisite to these people getting the testosterone levels checked.

Many of these otherwise normal, asymptomatic individuals have testosterone values all over the place. There is no tight-range of values that one expects for a given age and fitness value. How effective a given testosterone value is depends on a number of factors.

First and foremost, a number of people will have their labs drawn in the afternoon as opposed to 8-10AM. This can decrease values of testosterone by as much as 25% or so.

Second, the HPGA will be driven by the feedback of hormones on receptors. So, the receptor is a relatively challenging (if at all currently possible) thing to quantify.


Having said that, the story of rapidly losing testicular volume in a short period of time (hours) in the context of labs indicating a normal HPGA is rather strange to say the least. I'm not aware of cases of spontaneous hydrocele resolution (although case reports are published spontaneous resolution of hydrocele after hyperbaric oxygen treatment, but you didn't have hyperbaric O2 treatment). But, that's the only physiologic process that would make any sense whatsoever.

The effects of taking the "gas" of off the testicles with LH/FSH, so to speak, would result in a slow decline in size and firmness of the testicle itself.

A varicocele would have to be incredibly engorged to create enough backward pressure that you may result in poor arterial blood delivery to the testicle. And, even if that were the case, ischemic tissues are generally very painful. So, the lack of pain itself also becomes odd. (This would be a similar process to a testicular torsion where the "twisting" cuts off the blood supply and that "ischemic testicle" is a conduction that results in severe pain).

The adrenals and thyroid contributing to your testicular size make no physiologic sense to me whatsoever. Since you bring it up. Not to mention, the mere idea of adrenal fatigue is highly theoretical and contentious to begin with. Additionally, the effects of hyper- and hypothyroidism are going to have some stereotypical symptoms, none of which have to do with the testicle size.

With that all said, with all the imaging suggesting your testicles are normal, and otherwise normal bloodwork, what are your major concerns?

Many of the mood / fatigue / etc symptoms are highly non-specific.
 

fweed

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Hi tm450, thanks for your detailed response.
Some of what you say has been mentioned as possibilties
by the urologists/endodrinologists/generalists I have seen.
Though there does not seem to be a great deal of consensus among doctors on this subject.

I can however state what happened, and what the result has been, as it happened. How it happened, or the low probability of it happening is another matter entirely.

I recently caught mumps, despite having been vaccinated and given the booster - along with that, the infection rate in my country is about 1 per million per year. That is low odds. Yet it happened.

The left testicle was about 6.5cm in length for the 18 years or so following the end of puberty.
I checked my testicles for any changes every couple of weeks in the shower. The left testicle had always been 50+% larger in each dimension than the right, and much heavier.
3 days after the almost complete loss of libido, I checked them in the shower and found them smaller and softer. I also had a feeling of 'nothing there' as others have described.
At that time I panicked and thought they or it was dead from a torsion, and went to have them checked at the hospital.
No blood test was taken, just a manual check.
2 months after, a blood test and ecography were done.

One urologists suggested spontaneous hydrocele resolution too, but that wouldn't explain why I had had a hydrocele for all my adult life. Neither why it would resolve suddenly, or why at the exact same time I suffered total loss of libido, great persisting fatigue, and lack of night/morning (automatic) as well as daytime erections. Not to mention complete cessation of sexual fantasies or dreams.
Doesn't explain the pain either, or why palpable veins appeared on the surface of the left testicle 2 weeks after it happened.
That to me sounds like an interruption in blood flow and
some kind of overpressure causing the blood to try to reroute.

I have read of 'painless torsion' sometimes involved in partial torsion.
Also of the testicle shrinking in hours following a partial torsion, but then returning to normal size upon surgical correction within 24 hours.

Maybe that happened.
The left in in particular was larger than average, and larger testicles are more prone to torsion.

I would say the testicle problem may have led to problems with my adrenals etc - possibly. Not the other way around.

My symptoms are pretty clear:
- no night/morning erections
- almost no daytime arousal 0-5% of before, and less has time has gone on.
- no sexual fantasies or dreams
- fatigue which began the very same day. I felt exhausted after waking up that morning and it didn't stop. the fatigue level improved slightly over months, but remains - so I am constantly yawning throughout the day regardless of sleep or food.
- lack of emotions/very muted emotions - again you say this is unspecific. I feel no bonding to anyone anymore. this can be chemically caused.
-pain in left testicle, a feeling of heat at times. pain in left groin. discomfort which started a couple of weeks after it happened. pain down inside of left leg.
- the three days of intense pain 1 year ago which still hasn't been explained.
-varicocele, small hernia and two spermatoceles or cysts on left testicle - all of which have been shown to cause reduction in testosterone, and sometimes shrinkage of the testicle.
-occasional vision problems which have happened in the last year and a half at irregular intervals. consistent with effect of a microadenoma, though none was detected on MRI of pituitary. never had them before, could be unrelated.
-arms became far skinnier and less vascular, without any change in diet or routine. that happened six months after. I read of a hormone or chemical affecting vascularity, yet the endocrinologist denied its existence.
-penis while flaccid is at minimal state 99% of the time, as though I was sitting in a bucket of cold water. it was never like this before.
-scrotum contracted close to abdomen 99% of the time. again, it used to change with temperature etc normally and be loose
for the majority of the time.

So it remains a mystery, and my life isn't improving.
It would be better if the doctors took the approach of "ah, this has happened, why and how can we fix it" instead of "this can't have happened as it is improbable, let's forget about it".

If I had had scans and blood tests before any of this happened - it would have been easier to say "look, things are not right".
But no reason to before, I was healthy.

Results appearing to be normal 'enough' on the ecography or blood tests doesn't help me. It just makes things harder.
Others have suggested further tests, but that requires convincing a doctor to continue testing - which they seem incredibly reluctant to do. Despite not having resolved anything.

Is there someone who can calculate what a good balance would be in my case, between testosterone, oestrogen, prolactin and the rest? Is it possible to work out?

My prolactin has remained elevated, just above the range.
All blood tests were taken early in the morning apart from one of the 6-8 I've had, which was around lunchtime.
I would feel a lot better if only my nighttime/morning erections
were functioning, as that is essential to the health of the penile tissue.

I should mention I had a semen analysis some months ago, have yet to see a urologists to discuss it - but the sperm were 70% dead. I read 60% live was considered a good baseline.
 

fweed

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I dont think i have pelvic problems but my uro said that i should do it anyway..i think our varicocele affected our hormones for too long ..i will try again with hcg to see maybe its better this time
It could be what happened.
With the HCG if you go for that, ask the doctor about medicines which keep the oestrogen down too, maybe a combination, or a lower or higher dose is necessary.
I think now your varicocele has been fixed, the rest of you can be repaired more completely.
 

fweed

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Does anyone have any good news? Has anyone ever been cured of this.
 

Wean

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26 checking in I took hcg 5 times I was perfectly normal and like a dumb ass wanted to increase my test using hcg for fun used it 5 times then stopped goy some pretty bad estrogen affects started sweating felt sick lioe the flue maybe it was from shutting doen my natural test because i hear hcg is jusy like outside test and shuts you down anyway about 4 to 6 days later i was under alot of atress my body kicked back in and ny left testicle swelled up and hurt for like 3 days sliwly it went down but the veins stayed big went to a urologist and boom told me i had a grade 3 varicocele that it didn't affect testosterone got blood drawn my test was at 450 got another 3 months later came in at 409 since I've been depressed no libido no sex drive wtf
 

fweed

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From what I've read, having the varicocele repaired with microsurgery can increase test by up to 200 points, as well as improving fertility. There's a new study showing it also prevents/reverses prostate swelling.
Talk to some different urologists about surgery.
 

fweed

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I think that there is some commonality between these endocrine problems, stress and varicoceles that might not have been researched yet. Too many men with this problem and not enough answers as to why it is happening or how to solve it.
 

Wean

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I'm meeting a varicocele specialist Friday I'm gonna ask for the surgery I'm just afraid it won't work and I'll end up on trt for life =(
 

Wean

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Gonna get it as soon as possible to..mines weird to noticed the affects on the varicocele almost instantly had good libido during the initial swelling and for about 4 to 5 days after the. Boom everything hit me no sexual desire and depression been like this for months 4 to be exact I'm hoping surgery helps of course after surgery I will give my body 3 to 6 months to see if hor.ones normal out....thats of course if the surgery works so afraid of trt at 26
 

fweed

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Try all the options you can before TRT. Think positively. Read up on foods which boost testosterone, and lifestyle changes, if you haven't already. It can make a significant difference.
You said you had flu like symptoms - then your testicle swelled up - the mumps virus is related to the flu virus, mention it to your doctor and have a blood test for it, and also the possibility of localised infection or other cause of the testicle swelling.

Don't worry too much, stress can lower test too.
 

Wean

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Well I thought originally epididimis and went to emergency room and they gave me antibiotics at first seemed to work like it helped but the swelling stayed and the veins stayed went to a urologist said it was a varicocele had all the std test done all negative I think they would see mumps if that were the case
 

Wean

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Btw it's definitely a grade 3 diagnosed doesn't hurt but I have low test and all the affects of low test
 

Wean

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Did you ever get your taken care of? I wonder what happened to the guy that got his that was posting on here he never came back it seems hope he's doing ok
 

fweed

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Haven't had mine fixed yet, I also have a small hernia. Both need good surgery.
It would be good if the other dude has recovered.
Weird that antibiotics seemed to help at first.
Some pelvic infections, prostate too, can be persistent. If there is a varicocele though, especially grade 3, it needs taking care of.
 

Wean

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Is it possible my test will return with the surgery? What do I do if I get the surgery and nothing improves?
 

Wean

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How long should I wait after surgery to see results I'm scared I keep thinking I'm gonna end up on trt
 

fweed

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Try not to worry too much about what hasn't happened. Relax and find a way to reduce your stress.
The study I read about said on average, testosterone levels increased by about 100-200 points after varicocele surgery. Fertility was significantly increased too.

They say to wait a few months after surgery to see full results, but one guy on another site was improving within 2 weeks of the surgery. He was also using other methods in combination. Special diet, with testosterone boosting foods, weight lifting, taking certain supplements, and spending time with his girlfriend.
Foods like lean red meat, dark green vegetables, nuts - especially brasil and walnuts, mushrooms, oily fish, seeds, and some others, are good for testosterone. also if you can find it, pure pomegranate juice.
Then sunlight, an hour a day if you can, for as much of your body as you can - don't burn. It can raise test by up to 120% I read.
Strength exercises and muscle building.
Make sure you eat enough protein, as that's what builds the hormones.

If things still don't improve, you can try food supplements, to raise and lower hormones depending on what you need.
 
rtmilburn

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Well I thought originally epididimis and went to emergency room and they gave me antibiotics at first seemed to work like it helped but the swelling stayed and the veins stayed went to a urologist said it was a varicocele had all the std test done all negative I think they would see mumps if that were the case
If you had the mumps you would know it. Whomever said that mumps is a possibility is and idiot. Not to mention there were only a little over 4000 cases of mumps last year and that was recorded high, since the year 2000.
 

fweed

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I said it and I had reason to, your insult comes from ignorance. There has been an outbreak of mumps in the last year, and two people I know have had it in the last six months, one of which had testicular inflammation. Mumps can occur without traditional symptoms in some people, and is from the same virus family as the flu virus. This guy said he had flu symptoms followed by testicular inflammation.
Don't be a dickhole in future.
 
rtmilburn

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I said it and I had reason to, your insult comes from ignorance. There has been an outbreak of mumps in the last year, and two people I know have had it in the last six months, one of which had testicular inflammation. Mumps can occur without traditional symptoms in some people, and is from the same virus family as the flu virus. This guy said he had flu symptoms followed by testicular inflammation.
Don't be a dickhole in future.
Haha sure. Still extremely rare. Mumps has way more symptoms on top of swollen nuts and flu symptoms. Like I said if he had mumps he would have known.
 

fweed

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Can occur without obvious symptoms in some cases, particularly in those who have been vaccinated. It's rare until you have it. In Europe this year there are a lot of cases, same with tuberculosis. He says he had a blood test so he mustn't have had it.
Funny that the doctor gave no reason for his testicular swelling.
 

Wean

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I had to go to 3 urologist just to get an ultra sound in the USA meanwhile my nut was huge lol umm I think I was just seeing the wrong doc/uro when I finally went to a specialist and a reputable uro group the guy diagnosed me on the spot got me a ultrasound and set me up with a good uro/surgeon who specializes in microsurgical repair I'm also looking into flying out to California for a varicocele specialist just sucks because I'm east coast it's across the country but I have insurance is only have to pay for plane and hotel and I may just do it he's the best in the world and get my follow ups back home. Fweed 100 to 200 would be nice lol puts me in the 500 to 600 range which is better than 400 so let's be hopeful even 100 would be nice I could work out and do other things to get another 100 I hope idk at this point I'm just focusing on these 2 surgeons and figuring that put next comes surgery then I'll deal with what comes next....if in the end trt is what happens it is wht it is I've heard it's not that bad after all it's supposed to help you
 

Wean

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And thx for the advice fweed but after surgery idk if I'll be able to work out hard for a while I was go. A recover for a month like just walking and yoga light yoga then when I get an all clear do full pose yoga and light weight then after second month hit some light weights and continue... we will see I'm not to scared anymore the advances in trt for men are just getting better and better like i said of course its a last resort and making your own test is best till you need it but life doesnt always go your way as long as I can workout have a good life and get a good boner...(lol) I'm not worried
 

fweed

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Good attitude. What is the name of the doctor/surgery in Canada?
I think you are right, helping the body produce testosterone naturally is the best, so do all you can for that first. Diet, lifestyle, exercise.
Yoga sounds useful as I've heard stretches help, and can free up trapped bloodflow.
I've heard from some who after surgery were told to wait a few months for full results, while the blood flow redirects.
Give yourself a good amount of time, and track your progress before you think about trt.
You're young and your body is likely to heal.
 

Wean

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I hope so man just from what I read most guys don't bounce back it scares me...i mean if I was normal test Luke 500 to 700 if this varicocele dropped me to 400 don't you think the damage is done? And i ment the surgeon is in california his nane is dr turek at the turek clinic
 

fweed

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The study was pretty solid and showed testosterone raising by 100-200 on average, that's significant. It is because your balls are producing it, but it is slow to move around your body, the bloodflow isn't carrying it away from your testicles as well as it should. Another study showed 30 times normal levels of testosterone in the prostate - because the blood was pooling in the groin, so all that useful testosterone was going into the prostate instead of in the rest of the body.
Microsurgery fixed that and testosterone levels returned to normal in the prostate afterwards, and levels increased in the body in general.
It might not be perfect afterwards, but it will be better, and a step in the right direction.
Plus, people have greatly increased their total testosterone with diet, lifestyle and exercise.
As in hundreds of points more.
Make sure they test both your balls before surgery, as sometimes the vein problems are bilateral, with one varicocele being smaller than the other, usually the right one being much smaller.
 

Wean

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K... your hope gives me hope....but like I said read allot of guys got no increase =(
 

fweed

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http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410x.1999.00353.x/full

Search for "testosterone increase microsurgical varicocelectomy" and you should find plenty of reports similar to this one.
The old fashioned view is that varicocele is a harmless and cosmetic problem, the modern view - following research, is that it affects sperm quality as well as testosterone levels.
Importantly, it makes for a healthier prostate, as the high doses of testosterone pooling there can cause hyperplasia, swelling of the prostate which can lead to various other problems. The surgery was shown to reverse that.
I haven't found any side effects to the surgery so far.
 

Wean

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Well talked to two uros today said the most of an increase I'd see would be 100 to 150 but it's possible I won't see anything. both did say worry stress will lead to depression which would lead to anxiety which could impact my sleep and libido and testosterone they said 400 is a little low but not dangerous they did say yes a typical guy my age sits at 700 but 400 isn't super dangerous and if I increase it put me to 500 to 550 minus the stress and it could go higher the uro did say after the surgery give it 3 months they will retest and if worse comes to worse the would do Clomid and hcg for a while and see if I can recharge and get out of the rut both did say it's a proven fact stress would impact sex drive libido and testosterone that being said both said get it fixed just do it I see the surgery uro tomorrow
 

Wean

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500 to 700 is normal average he also said do it for fertility purposes Any way he also issued me an Mr I. Just to check my brain and another standing ultra sound to make sure I don't have a right one
 

Wean

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I read ypur article and I guess I don't understand it it says it increases free testosterone in one sentence then in the next says it showed no significant increase...
 

fweed

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The prostate information was from another study, which was the relation between varicoceles and prostate enlargement. The veins exiting the scrotum connect with the blood supply of the prostate - and when the veins above this are dilated, the blood flows more easily into those of the prostate.
This can result in the testosterone passing from the testicles into the prostate in a much higher volume than normal. They said up to 30 times the normal levels, which can cause the cells of the prostate to increase in number, and thereby enlarge the gland.
The study showed that when the surgery was performed, the testosterone levels in the prostate returned to normal, and the prostate reduced in size.

This may have been a study involving only men with enlarged prostates and varicoceles, but I would guess that misdirected testosterone would end up in the rest of the body where it belongs.
As for the other study, have a read of other ones and see if information correllates.
 

Wean

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Well I saw the uro today and I'm gonna schedule surgery in September so it will be getting fixed 5 months after occurance and im 26 so we will see if it increases my test if it doesnt then they will try clomid either way I think alot of my problems come from stress i need to work on that....and force myself to get back in the gym.
 

fweed

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Hey Wean, how did your surgery go, and have you noticed improvement since?
 

LG36

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Just read through the whole 8 pages of this thread and it seems very similar to my situation. I’m a man of 21 and I woke up one day about 1.5 years ago without morning wood and haven’t achieved it properly since. Few days after this my testicles seemed to shrink which was incredibly scary. Tests from doctors all came back as normal and was put down as a psychological problem. I don’t have difficulty obtaining erections during sex but it’s always 70% and never as hard as I used to get - libido is down and I hardly ever get spontaneous erections anymore. Been doing kegels and taking l-arginine and Maca root for a few weeks with little improvement. Have developed insomnia because of this too. Sucks so bad.
 

fweed

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Can you post blood results, because what doctors seem to call normal just means "within normal human ranges", meaning a man from ages 18-80 in any level of physical fitness.
What was the day before you woke up with it like? Did you have the exhausted feeling?
My sleep hasn't been the same either, mostly that I can't sleep for long periods of uninterrupted sleep.
 

fweed

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Also, have you had ecographies of your testicles? Did they check you with the valsalvar maneuver to see if you had a varicocele and/or hernia?
The more info, the better, maybe we can find a common cause.
One urologist said to me quite early on "I've been stressed a lot in my life, and my testicles have never shrunk". Also, from everything I've heard from docs and that I've read, lack of morning and nighttime erections mean it isn't psychological, as that is an automatic process.
 

LG36

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I stupidly didnt get a copy of my blood tests when I went for them - at that stage I believed the doctor when he said I was 'normal'. Will ring up tomorrow and see if i can get them as it'd be good to know. I have a stage 2/3 variocele on my left testicle and it feels like another is forming on my right.

Just under a year ago I had variocele embolisation on the left one, and while it hasnt really reduced it in size it has illeviated some of the pain. I wish I got surgery though, apparently its much more effective and its annoying that its still lingering.

Cant properly remember how I felt before the initial shrink but i'm certain my morning woods stopped and libido dropped before I saw them reduce in size.

It's rough, I have good days and bad days - I feel blessed that I can still get it up and have sex etc but I should be peaking at my age, not worrying or having only 70% erections. Hope we can find a common cause and common cure.
 

fweed

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They should print out all the blood tests if you ask for them, they keep them on the computers.
Have you noticed any change in your urine stream, is it slightly weaker? Embolisation can be effective too, if you haven't had an ecography in a year then have them scan again, and tell them to check the right carefully too. If anything shows up, you could have microsurgery on left and right if necessary.
Apparently, zinc, magnesium, boron and B vitamins are good. They might help you sleep too.
 

Prikkel

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I have similar problem... no bucks to go see doctors though... anybody found a solution yet? Was worse at one point been taking vitamins and ate plenty of raw garlic which seemed to help... but still not what it used to be like... mine also started suddenly... after period of extreme stress... had one really nice boner one night... never had the same ever again... ?
 

fweed

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Do you have morning wood, and did you have it regularly before? That's one helpful signifier. Did you have any sensitivity of the nipples? Have your testicles reduced in size?
 

Prikkel

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This is gonna sound too good to be true and may not help everybody but i read up on net a bit and made some minor lifestyle adjustments and can already see great improvement after just couple of days. I cut sugar almost completely from my diet, went back to loose fit boxer shorts, give myself testicle massages �� and being little bit more active... seems to be helping lots... feel better in general...
 
trtdoc

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You would think a urologist could dx and take care of this issue... my goodness!

I hate seeing posts like this, the reason we have specialists is to be able to dig in and really figure out the root cause and cure. I mean c'mon!

Hopefully you are doing better now my friend

Dr B
 

fweed

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That's good to hear Prikkel, I hope things continue to improve for you. Post back here when you can, I don't often hear from people who have improved, so any info is good.
 

fweed

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You would think a urologist could dx and take care of this issue... my goodness!

I hate seeing posts like this, the reason we have specialists is to be able to dig in and really figure out the root cause and cure. I mean c'mon!

Hopefully you are doing better now my friend

Dr B
I saw perhaps a dozen specialists in all, and nothing has come from it. I think part of the problem is they are too busy to be able to focus on one patient and work out what is wrong. The other problem is that I never saw the same one twice, neither I nor they have any choice about that, it is just the system.
Last one is, it seems to be an unusual problem, whatever the causes are, and not much research has been done on it, so it depends on a very curious doctor, or one with experience with the same problem.
 

Rogainestudy

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My story is I took Rogaine and lost my libido and sex drive, then noticed my balls shrunk, found out I had varicocele (sounds crazy) but I’m sure Rogaine was the cause of it. Had my varicocele fixed but not much has changed. My left testicle used to be much larger and feel kinda bumpy and weird to be honest now it’s small and normal. Here’s a link of everyone else who has suffered of this..... let me know if you know of anything that could help plz
 

kelcy

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Just experience something similar.
At first, Right testicle has pain, follow by some aching pain. I can feel thick veins at the back and top of the testicle. But I can't feel the swollen veins and no more pain now.
Symptoms are: sudden lost of libido, no sensation of penis, testicles seem to be smaller, shrinking of penis.

So far only done the urine test,which show normal results. It's long wait to get appointment for an urologist.
Dunno what's happened in about a week.
 

fweed

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hi Rogaine, the link was removed it looks like, can you post some keywords so it can be found with a search engine?
I would think Rogaine has an effect on the hormones, which I've read in finasteride for example can lead to testicle atrophy like this. Maybe look into a short term hormone therapy, or 'restart' of your hormonal system. I don't know what exactly, but some people have used HCG and others clomid, and other hormone therapies. Talk with an endocrinologist and also do some research yourself.
When you say your ball was lumpy, was that all over, or just on the back? Did they give you a scrotal ecography before your varicocele surgery? If you haven't had an ecography, it is worth doing to check your testicles.
kelcy, you'll know more once you've had a blood test to see your hormone levels. How extreme was the pain? Did the doctor examine your testicles, in case there was a torsion or partial torsion? Ecography would help too to see what is going on, but the urologist should suggest what to do.
I'd like to know if anyone has fixed this, permanently. I have a feeling that if anyone solves it they don't post about it anywhere, as it isn't on their mind when the problem has gone.
 

Rogainestudy

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Google “askapatient rogaine” it’s the 2nd link after ad..... that is true that people who support solve the problem don’t want to even think about it, I have emailed hundreds and it takes people who have cured so long to respond to emails but would respond in minutes when they were suffering.... email me [email protected] I’ll share some emails with you..... and endos are no help, I’ve even talked to the leading endo that helped sue Propecia and he was no help either
 

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