What should I do if my testicles are small?

The testes are vital male reproductive organs responsible for producing semen. They are the site of sperm production, and their size can serve as an indicator of overall health. So, what should one do if the testes are unusually small? Let’s explore this further.

What to Do If Testes Are Small

Management of small testes depends on the patient’s age. In adolescents, a color Doppler ultrasound of the testes and epididymis should be performed at a hospital to assess whether testicular development is impaired. If necessary, a cranial MRI may be conducted to evaluate pituitary function, followed by appropriate pituitary-targeted treatment. Androgen therapy—such as dihydrotestosterone—may be considered, along with dietary adjustments (e.g., increased intake of animal testes, such as bull penis). In adults, evaluation should include serum sex hormone assays, scrotal color Doppler ultrasound, routine semen analysis, and assessment of sexual function. Treatment is primarily symptom- and cause-directed. If semen analysis shows normal sperm motility and sexual function remains intact, no specific intervention may be required. However, if test results are abnormal—suggesting testicular atrophy—the underlying cause must be identified to guide appropriate management.

Knowledge Expansion: What Is the Normal Size of Testes?

In healthy adult males, each testis typically measures 3.5–6 cm in length, 2.3–4 cm in width, and 2–2.8 cm in thickness, weighing approximately 16–67 g—roughly the size of a walnut. A slightly smaller testis—comparable to a small walnut—is generally not clinically concerning. However, if a testis shrinks to the size of a broad bean or peanut, this warrants attention, as it may indicate testicular atrophy.

How to Measure Testicular Volume

Testicular volume is measured using standardized, ellipsoid-shaped plastic or wooden “orchidometers,” numbered 1 through 25, each representing a specific volume. During measurement, the scrotal skin is gently stretched taut, and the orchidometer sizes are compared sequentially with the testis until the closest match is found; the corresponding number indicates the testicular volume. If both testes were previously similar in size but one suddenly enlarges significantly over a short period, prompt medical evaluation is advised. Enlargement accompanied by fever and localized pain may suggest epididymitis or orchitis. Conversely, painless testicular enlargement raises concern for testicular tumor and requires urgent investigation—never dismiss it lightly.

The above provides an overview of this topic. We hope this information is helpful to you.