Testicular failure

Alternative names
Primary hypogonadism - male

Testicular failure is the inability of the testicles to produce sperm or male hormones.

Causes, incidence, and risk factors

Causes of testicular failure include chromosomal abnormalities, testicular torsion, direct trauma to the testicles, diseases that affect the testicle (such as Mumps, orchitis [inflammation of the testes], and Testicular cancer), and a variety of drugs. The condition is uncommon.

Increased risk is associated with activities that may cause constant, low-level trauma to the scrotum (such as riding a motorcycle) or frequent administration of a drug known to affect testicular function (such as heavy marijuana use or taking some prescription medications). Men who had undescended testicles at birth are at higher risk.


  • Potential lack of libido (sex drive)  
  • Delay in development or absence of secondary male sexual characteristics (growth and distribution of hair, scrotal enlargement, penis enlargement, voice changes)  
  • infertility  
  • Gynecomastia  
  • Lack of muscle mass

Signs and tests
A physical examination may reveal:

  • Ambiguous genitalia (usually noted in infancy)  
  • Abnormally small testicle  
  • Tumor or mass (aggregation of cells) on or near the testicle

Hormonal levels determined through blood tests may detect low testosterone levels and high levels of gonadotropins (pituitary hormones FSH and LH).

Supplementation of male hormones may be successful in treating some forms of testicular failure. In cases that appear to be related to specific exposure or activity exposure, removal of the drug or activity may result in return of normal testicular function.

Expectations (prognosis)
Many forms of testicular failure are irreversible. However, androgen replacement is effective in reversing symptoms, though it may not restore fertility.

Testicular failure prior to the onset of puberty will prohibit normal growth, specifically the development of adult male characteristics.

Calling your health care provider
Call for an appointment with your health care provider if symptoms occur.

Avoid higher-risk activities or monitor testicular function when involved in such activities. Also, cease the activity with the initial onset of symptoms.

Johns Hopkins patient information

Last revised: December 8, 2012
by Armen E. Martirosyan, M.D.

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