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Testicles Shrinking and Steroids: The Facts

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One of the common side effects when steroids are mentioned is whether or not they will shrink your balls.

The purpose of this article isn’t to poke fun at steroid users, it is to provide you with an objective view of the research and links between steroid use and testicular shrinkage.

If you are concerned that steroid cycles may have adverse effects, or are just wanting to weigh up the risks – this is the article you need to read.

In this article you will learn:

  • What is testicular atrophy?
  • Steroids and testosterone
  • Case reports – will anabolic steroids shrink your balls?
  • Other side effects
  • Will your testes recover after using steroids?
  • Better alternatives

What is testicular atrophy?

Testicular atrophy – the proper term for your balls shrinking. It’s a pathological condition where the testicles start off healthy, but gradually reduce in size. This condition could be caused by age, injury, inguinal hernia or medical condition such as autoimmune illness. It is usually accompanied by a loss of function. 

It is a common side effect reported in the research, with many bodybuilders having smaller testes comparable to ‘pre-pubertal boys’ [1].

The testicles are made up of mostly two cell types – Leydig cells and germ cells. The function of the Leydig cell is to produce testosterone, and the germ cell produces sperm. If cell production from these sites is even, then the testes remain full, firm and round. When cell production decreases – in either cell type – testicular atrophy can occur.

shrunken balls on steroids


Key Point: Testicular atrophy is when your testicles shrink in size and lose firmness and overall shape.


Anabolic steroid use and testosterone

In order to get the most from this section you’ll need to know a few bits of terminology – we presume that you’re familiar with the actions and mechanisms of steroids, but if you’re not then we suggest you read about them here.

The use of steroids, or Androgenic-anabolic Steroids (AAS), is commonplace and widespread in both amateur and professional athletes [2]. It is not without side effects.

One of the side effects which is often reported anecdotally and in the research is that of smaller testes through prolonged steroid use.

The way that testosterone production is regulated in the body is via the hypothalamic-pituitary-gonodal axis (HPG). This aspect of the reproductive system is made up of the hypothalamus and the pituitary glands – located in the brain, and the testes.

The HPG system works on a ‘feedback loop’ – what that means is that if your body isn’t producing enough T then the hypothalamus stimulates you to produce more, and likewise if you produce too much it suppresses production. When you take steroids you’re levels of T are so high that the hypothalamus sends signals to the testicles telling them you need to produce your own anymore. 

By dumping so much exogenous T into your body – as occurs with AAS use, your testicles respond by essentially becoming dormant – and this can result in a number of side effects including loss of libido, loss of erection and of course – smaller testes.


Studies and case reports – will steroids shrink your balls?

Most of the data on bodybuilders, steroids and testicular atrophy comes from case reports rather than longitudinal or cohort studies.

For example, a case report of a 30 year-old competitive bodybuilder [3] who died after collapsing at home hours after a weight training session, found a number of side effects of prolonged steroid use – abnormal muscle development, liver issues, and testicular atrophy. He had been using AAS for 6 months.

…and it’s not just individual case reports either – there are a number of larger reports that show adverse effects:

One study [4] recruited 100 steroid using athletes in order to identify via questionnaire, their regimens and side effects. Out of all volunteers, 88% reported experiencing steroid related side effects – with 40% reporting testicular atrophy as a subjective side effect. This was one of the most reported side effects, second only to acne.

Similarly, in a large study of 207 bodybuilders with a history of steroid use [5], numerous adverse side effects were reported – including acne, gynecomastia, abnormal hair growth and increased blood pressure. 8% of those questioned reported testicular atrophy – that’s 17 people out of the 207.


Steroids-and-Testicular-Atrophy


Key Point: Research shows that anabolic steroids shrink the testes due to decreased T production by the Leydig cells


Other side effects

According to the journal Urology [1], Exogenous testosterone typically results in atrophy of the germinal cells in normal men with varying degrees of suppression of spermatogenesis. 

When higher doses of AAS are taken you can expect your semen levels (quality and quantity) to take a nose dive, and this may lead to infertility in later life [6].

As T levels plummet and testes shrink, you can also expect that your ability to get an erection and your overall libido can also fall. 

For example, a report on high-dose steroid use in 30 bodybuilders in the journal Life Sciences [6], found that only 17.7% of the volunteers had normal sperm levels.


Will your testes grow back in size?

It is worth noting that in most cases, shrunken balls are temporary – when you’re HPG feedback system realizes that you’re not flooding your body with AAS anymore it will start to produce its own again, allowing the testes to become firmer and larger once again.

It is worth noting however that the time taken for full recover could be as long as a few months and whilst the changes in these hormones are reversible after discontinued use, the long-term effects on the hypothalamus-pituitary-testicular axis are still unknown [6].

It is very much a process of ‘the bigger the dose, the longer the recovery’. If you’ve been taking massive doses of AAS for a prolonged period of time however, you might never recover fully.

One way to speed up your recovery process is to use post-cycle therapy by taking a T booster such as TestoFuel which contains D-Aspartic acid (DAA) – a compound clinically proven to increase T production by on average 30-60%. It stimulates your testes to produce more T, as well as boost your and seminal count by up to 100% [7] and as an amino acid, has no side effects.

Summary – Steroids and testicular shrinkage

The proper term for shrunken balls is testicular atrophy, it’s a pathological condition where the testes start off healthy, but gradually reduce in size.

High levels of T from anabolic steroids lead to the Leydig cells decreasing natural testosterone release- this leads to a loss of size, firmness and shape of your testes.

As well as testicular atrophy you’ll more than likely also see a loss of libido, erection and seminal quality and quantity.

Fortunately, for most people the side effects are short-term, with a full recovery seen within a few months. However, id high levels of steroids have been taken for a prolonged period of time then the atrophy may be irreversible.


References

  1. Coward, RM et al.  Vasectomy Reversal Outcomes in Men Previously on Testosterone Supplementation Therapy. Urology. 2014; 84: 1335-1341
  2. Delbeke FT, Desmet N, Debackere M (1995) The abuse of doping agents in competing body builders in Flanders (1988– 1993). Int J Sports Med 16:66–70
  3. Fineschi, V et al. Sudden cardiac death during anabolic steroid abuse: morphologic and toxicologic findings in two fatal cases of bodybuilders. Int J Legal Med (2007) 121: 48–53
  4. Evans, NA. Gym and tonic: a prfile of 100 male steroid users. BrJ Sports Med 1997; 31: 54-58
  5. Perry, P et al. Anabolic steroid use in weightlifters and body builders. Clin J Sports Med. 2005
  6. Torres-Calleja J, Gonzalez-Unzaga M, DeCelis-Carrillo R, et al. Effect of androgenic anabolic steroids on sperm quality and serum hormone levels in adult male bodybuilders. Life Sci. 2001; 68: 1769-74
  7. D’Aniello, G et al. D-aspartate, a key element for the improvement of sperm quality. Adv. Sex. Med. 2012; 2: 47–53