Penile health
Testicle shrinkage: what causes it and when to get checked
Testicles naturally move and change size with temperature, but true testicle shrinkage, called testicular atrophy, is a lasting reduction in size that can affect hormones and fertility.
In short: Testicles look smaller in the cold because the scrotum tightens; this is normal. True shrinkage can be caused by anabolic steroids or testosterone use, varicocele, past infections such as mumps orchitis, injury, heavy drinking, ageing and some medicines. It can lower testosterone and sperm production, so a noticeable change in size or firmness should be checked.
Normal changes versus shrinkage
The cremaster muscle pulls the testicles closer to the body in the cold or during exercise. In warm conditions they hang lower and look larger. See why do testicles hang low. Shrinkage means they stay smaller or feel softer over time.
Common causes
Anabolic steroids and testosterone
External testosterone tells the brain to switch off the testicles. They can shrink noticeably. Read steroids and erectile dysfunction and signs of high testosterone in men.
Varicocele
Swollen veins above the testicle can raise temperature and affect its growth. See varicocele natural treatment.
Orchitis
Inflammation from mumps or other infections can damage testicular tissue.
Injury or torsion
A twisted testicle (torsion) is an emergency. Severe sudden pain needs immediate care.
Alcohol
Heavy long-term drinking can damage testicular cells and lower testosterone.
Ageing
A gradual, mild reduction can happen in later life.
Some medicines
Including some prostate and hormone treatments.
Symptoms that may come with shrinkage
- Lower sex drive and weaker erections
- Less muscle and more body fat
- Reduced facial or body hair
- Fertility problems
- Breast tissue growth
When to get checked
See an appropriately registered medical professional if you notice:
- One or both testicles getting smaller or softer
- A lump or hard area, see testicular self-exam
- Pain, swelling or heaviness
- Sudden severe pain, which is an emergency
Can it be reversed?
If caused by steroids, size and function often improve after stopping, though recovery can take months. Other causes depend on treatment.
How we can help
Our naturopaths support men with natural plans for energy, libido and sperm health, particularly during recovery from steroid use, and refer you for medical assessment when needed.
Why men choose our natural approach
Walk in or consult remotely
Walk in at Buccleuch, Sandton, with parking available, or consult by phone or video from anywhere in South Africa.
Natural and non-surgical
Herbal remedies and practical guidance, with no injections or surgery.
Faster appointments
Enquiries answered 24/7, with same-day appointments often available.
Transparent pricing
Consultations are R2,500, with any remedy costs confirmed before you commit.
Private self-check: 5 quick questions
Answer these honestly before you try anything new or book. They help you describe what is happening and get more from your first consultation.
- Do you have pain, swelling, redness or itching in the genital area?
- Have you noticed discharge, sores, a lump or blood in your urine or semen?
- Do you have a fever or feel generally unwell?
- Has this lasted more than a few days, or keep coming back?
- Is it affecting your sex life, sleep or confidence?
A yes to questions two or three, or sudden severe pain, means you should see an appropriately registered medical professional promptly. For recurring or lifestyle-related concerns, a naturopath can help with natural support alongside medical care.
What happens at your first consultation
- Walk in or book online, call +27 10 205 9855 or WhatsApp +27 81 823 1313. In Gauteng, walk in at 199 Vanessa Street, Buccleuch, Sandton, where parking is available. Outside Gauteng, choose a confidential phone or video consultation. Enquiries are answered 24/7.
- Talk privately with a naturopath about your symptoms, health history, lifestyle and goals.
- Receive a personalised natural plan, with any remedy costs confirmed upfront.
- Follow up in person or remotely so your progress is reviewed and your plan adjusted.
Your health and safety
Our naturopaths use natural remedies and lifestyle support, and always check your health history and current medicines first. If anything needs medical attention we tell you honestly and refer you to an appropriately registered medical professional. Avoid unregistered “enhancement” products sold online or at markets, as SAHPRA has warned that some contain hidden ingredients.
Seek urgent medical care for chest pain, an erection lasting more than four hours, sudden weakness or other sudden symptoms.
Consultation price
A consultation is R2,500, in person or remote, and your naturopath confirms any further costs before you go ahead. See our mens clinic prices for details.
Frequently asked questions
Why do my testicles look smaller sometimes?
Cold, exercise and stress make the scrotum tighten and pull the testicles closer, which is normal.
Can steroids shrink your testicles?
Yes. External testosterone shuts down the testicles’ own production and they can shrink.
Does testicle shrinkage affect fertility?
It can lower sperm production and testosterone, so it is worth having checked.
Can shrunken testicles go back to normal?
After stopping steroids, many men see improvement over months. Other causes depend on treatment.
How much does a consultation cost?
A consultation is R2,500, and any remedy costs are confirmed with you before you go ahead.
Book your consultation today
Walk in at our Sandton practice any time, day or night, or book ahead. Outside Gauteng? Book a remote consultation.
References and further reading
Reviewed by George Mulaudzi, Naturopath. This page is general information and does not replace a personal consultation. If you have chest pain, sudden symptoms or a medical emergency, seek urgent medical care.
