Testicles (Testes): Location, Anatomy, Function and Conditions

What is a testicle?

A testicle (or testis, plural: testes) is a male reproductive gland responsible for producing sperm and the hormone testosterone. They are typically two oval-shaped organs located in the scrotum, a sac of skin that hangs below the penis. The primary functions of the testicles are:

● Sperm production (spermatogenesis):

 This enables reproduction by generating sperm cells that can fertilize a female's egg.

● Testosterone production:

 Testosterone is the main male sex hormone, which plays a key role in developing male reproductive tissues, promoting secondary sexual characteristics (like muscle mass, body hair, and deepening of the voice), and maintaining libido.

Testicles are crucial for both fertility and the overall hormonal balance in males.

What do the testicles do?

Testicles have two primary functions:

■ Sperm Production (Spermatogenesis):

 The testicles produce sperm, the male reproductive cells, in tiny structures called seminiferous tubules. Sperm is necessary for fertilizing a female egg, which is essential for reproduction.

■ Testosterone Production: 

Testicles produce testosterone, the primary male sex hormone. Testosterone is responsible for male sexual development, maintaining muscle mass, regulating libido, promoting the growth of body hair, and deepening the voice. It also plays a role in maintaining bone density and overall health.

These functions make the testicles essential for male fertility, sexual function, and overall hormonal balance.

How do the testicles make sperm?

The process by which the testicles make sperm is called spermatogenesis, and it occurs in specialized structures within the testicles known as seminiferous tubules. Here’s a breakdown of how it happens:

1. Spermatogonia (Stem Cells) Formation

● Inside the seminiferous tubules, there are special stem cells called spermatogonia. These are the starting cells for sperm production.

● The spermatogonia divide through mitosis (a form of cell division) to produce more spermatogonia or develop into primary spermatocytes, which are the first stage of sperm precursor cells.

2. Meiosis (Division of Chromosomes)

● The primary spermatocytes undergo meiosis, a type of cell division that reduces the chromosome number by half. This is important because sperm cells need to have only 23 chromosomes (instead of 46) to combine with the female egg.

● After the first division, the cells become secondary spermatocytes, which further divide to become spermatids.

3. Spermiogenesis (Maturation into Sperm)

● The spermatids undergo a process called spermiogenesis, where they transform into mature sperm cells (spermatozoa). This process includes:

     • Development of a tail (flagellum) for swimming.

     • Formation of the acrosome, a cap-like structure that helps the sperm penetrate the egg.

     • Compaction of the genetic material in the head of the sperm.

4. Final Maturation

● The newly formed sperm are released into the lumen of the seminiferous tubules, but they are not fully mature yet.

● They are transported to the epididymis, a coiled tube attached to the testicle, where they undergo further maturation, gaining the ability to swim and fertilize an egg.

The entire process of spermatogenesis takes about 64-72 days, and it is a continuous process that occurs throughout a male's reproductive life. Hormones like testosterone and follicle-stimulating hormone (FSH) play key roles in regulating and stimulating this process.

What are the hormones made by the testes?

The testes primarily produce the following hormones:

Testosterone:

■ This is the main hormone produced by the testes, specifically in the Leydig cells found between the seminiferous tubules.

■ Functions: 

Testosterone plays a crucial role in the development of male reproductive tissues (testes, prostate) and secondary sexual characteristics like muscle mass, body hair, deep voice, and bone density. It also influences libido (sex drive) and is important for overall male health, including mood regulation.

Inhibin:

■ This hormone is produced by the Sertoli cells inside the seminiferous tubules.

■ Functions: 

Inhibin helps regulate sperm production by inhibiting the release of follicle-stimulating hormone (FSH) from the pituitary gland. FSH stimulates the testes to produce sperm, and inhibin helps control this process to prevent overproduction.

Anti-Müllerian Hormone (AMH):

■ This hormone is produced by the Sertoli cells in the testes during fetal development and early childhood.

■ Functions: 

AMH plays a key role in male sexual differentiation by preventing the development of female reproductive structures (the Müllerian ducts) in the male fetus. It is less important after puberty.

These hormones are essential for regulating male reproductive function, sexual development, and overall hormonal balance.

Where are the testicles located?

The testicles are located in the scrotum, a sac of skin that hangs below the penis. The scrotum serves several important functions:

1. Temperature Regulation: 

Sperm production requires a temperature slightly lower than the body's core temperature. The scrotum helps regulate this by adjusting the position of the testicles. When it’s cold, the scrotum contracts to bring the testicles closer to the body for warmth. When it’s warm, the scrotum relaxes to allow the testicles to hang away from the body to stay cool.

2. Protection:

 The scrotum provides a protective environment for the testicles, helping to shield them from injury and maintain optimal conditions for sperm and hormone production.

This location outside the body cavity helps ensure that the testicles function effectively, particularly for sperm production.

What do the testicles look like?

The testicles (or testes) are oval-shaped organs that are about the size of a large olive or small egg. Each testicle typically measures about 1.5 to 2 inches (4 to 5 cm) in length and is covered by a smooth, firm membrane called the tunica albuginea. Here’s a more detailed description of their appearance:

● Shape: 

Oval or egg-shaped.

● Texture: 

Smooth but firm to the touch.

● Color: 

They are usually pale or light in color, with a slight pinkish or whitish tone.

●Position: 

They are located inside the scrotum, a loose sac of skin hanging below the penis. The testicles may not always be at the same level, with one (usually the left) hanging slightly lower than the other.

Each testicle is connected to the body by the spermatic cord, which contains blood vessels, nerves, and the vas deferens (the duct that transports sperm). The outer layer of skin (the scrotum) covers and protects the testicles while regulating their temperature.

How big are testicles?

The size of testicles can vary from person to person, but on average:

■ Length:

 1.5 to 2 inches (4 to 5 cm)

■ Width:

 About 1 inch (2.5 cm)

■ Volume:

 Typically ranges between 12 to 25 milliliters (mL)

Testicles may slightly differ in size, with the left testicle often hanging a little lower and sometimes being slightly larger than the right, which is considered normal.

What are the common conditions and disorders that affect the testicles?

Several common conditions and disorders can affect the testicles, impacting reproductive health and overall well-being. Here are some of the most frequent ones:

1. Testicular Torsion

● Description:

 This occurs when the spermatic cord, which supplies blood to the testicle, twists, cutting off blood flow.

● Symptoms:

 Sudden, severe pain and swelling in the scrotum.

● Treatment: 

Requires immediate medical attention to prevent permanent damage or loss of the testicle.

2. Epididymitis

● Description: 

Inflammation of the epididymis, the coiled tube at the back of the testicle that stores sperm, often due to infection.

● Symptoms: 

Pain, swelling, and redness in the scrotum, often accompanied by fever or pain during urination.

● Causes: 

Can be caused by sexually transmitted infections (STIs), such as chlamydia or gonorrhea, or urinary tract infections (UTIs).

● Treatment: 

Typically treated with antibiotics.

3. Hydrocele

● Description: 

A fluid-filled sac around the testicle, leading to swelling.

● Symptoms:

 Swollen scrotum, which may be painless or cause discomfort.

● Treatment:

 Often resolves on its own but can require surgery in severe cases.

4. Varicocele

● Description:

 Enlargement of the veins within the scrotum (similar to varicose veins).

● Symptoms: 

Dull ache or heaviness in the scrotum, and possibly reduced fertility.

● Treatment: 

May require surgical intervention, especially if it affects fertility.

5. Testicular Cancer

● Description: 

A rare form of cancer that usually starts as a lump or swelling in the testicle.

● Symptoms: 

A painless lump or swelling, feeling of heaviness in the scrotum, or discomfort.

● Risk Factors:

 Most common in younger men (ages 15-35).

● Treatment: 

Usually highly treatable, often with surgery, radiation, or chemotherapy.

6. Orchitis

● Description:

 Inflammation of one or both testicles, often due to viral infections such as mumps.

● Symptoms:

 Testicular pain, swelling, fever, and nausea.

● Treatment:

 Depends on the cause, but may include pain relief and treatment of the underlying infection.

7. Undescended Testicle (Cryptorchidism)

● Description:

 A condition in which one or both testicles fail to move into the scrotum before birth.

● Treatment:

 Surgery (orchiopexy) is often required to move the testicle into the scrotum to prevent future complications like infertility or increased risk of testicular cancer.

8. Spermatocele

● Description: 

A cyst that forms in the epididymis, filled with sperm.

● Symptoms:

 A painless, fluid-filled lump in the scrotum, usually not harmful.

● Treatment:

 Often doesn’t require treatment unless it causes discomfort, in which case surgery may be an option.

9. Testicular Atrophy

● Description: 

Shrinking of the testicles, often due to hormone imbalances, injury, or infection.

● Causes: 

Can be caused by mumps, certain medications, or prolonged use of anabolic steroids.

● Symptoms: 

Reduced size of one or both testicles, often leading to infertility.
10. Trauma or Injury

● Description: 

Physical injury to the testicles can cause pain, swelling, or even more serious damage like a rupture.

● Symptoms: 

Immediate pain, swelling, and bruising.

● Treatment: 

Depending on severity, treatment can range from rest and ice to surgical intervention.

When to See a Doctor:

It’s important to consult a healthcare professional if you experience any unusual symptoms, such as lumps, pain, swelling, or changes in the size or feel of the testicles, as some conditions (like testicular torsion and cancer) require prompt medical attention.

What are some common signs or symptoms of conditions related to your testes?

Common signs and symptoms of conditions related to the testicles can indicate various issues that may require medical attention. Here are the most frequent ones to watch for:

1. Pain or Discomfort

■ Sharp or sudden pain:

 Could indicate conditions like testicular torsion (a medical emergency), trauma, or an infection such as epididymitis.

■ Dull ache: 

Often associated with conditions like a varicocele or minor injury.

2. Swelling or Enlargement

■ Unilateral or bilateral swelling: 

Can be caused by infections (orchitis, epididymitis), hydrocele (fluid buildup), or testicular cancer.

■ Painless swelling: 

May indicate a hydrocele or testicular cancer.

3. Lumps or Masses

■ Painless lump: 

A common early sign of testicular cancer.

■ Cysts or fluid-filled masses: 

May indicate a spermatocele or hydrocele.

4. Changes in Size or Shape

■ Enlargement: 

Could be caused by infections, cysts, or cancer.

■ Shrinkage (atrophy): 

May result from hormonal imbalances, infections like mumps, or long-term use of anabolic steroids.

5. Heaviness or Fullness in the Scrotum

■ This sensation is often linked to conditions like a varicocele or hydrocele.

6. Discomfort or Pain in the Lower Abdomen or Groin

■ Pain may radiate from the testicles to the lower abdomen or groin area and can indicate issues like testicular torsion, hernias, or infections.

7. Redness, Warmth, or Tenderness

■ These are often signs of inflammation or infection, such as epididymitis, orchitis, or cellulitis in the scrotum.

8. Changes in Urination or Ejaculation

■ Pain during urination or ejaculation: 

May suggest a urinary tract infection (UTI), sexually transmitted infection (STI), or prostate issue that could affect the testicles.

■ Blood in semen or urine: 

Can be a sign of infection or trauma.

9. Fever and General Malaise

■ A fever accompanying scrotal pain and swelling may indicate an infection such as orchitis or epididymitis.

10. Nausea or Vomiting

■ These symptoms, combined with severe testicular pain, are often linked to testicular torsion, which requires immediate medical attention.

11. Infertility

■ Testicular disorders like varicocele, testicular atrophy, or trauma can affect sperm production, leading to infertility.

If you experience any of these signs or symptoms, it's important to see a doctor for a proper diagnosis and treatment. Some conditions, like testicular torsion or cancer, require immediate intervention.

What are some common tests to check the health of your testicles?

Several tests can be used to evaluate the health of the testicles. These tests help diagnose conditions such as infections, torsion, cancer, or fertility issues. Here are some common diagnostic tests and procedures:

1. Physical Examination

● A doctor will manually check for lumps, swelling, tenderness, or abnormalities in the testicles and scrotum. They will also assess the size, texture, and position of the testicles.

2. Ultrasound (Scrotal Ultrasound)

● Purpose: 

This is the most commonly used imaging test for diagnosing testicular issues.

● Procedure: 

A non-invasive ultrasound uses sound waves to create images of the testicles and surrounding tissues.

● Conditions Diagnosed: 

Testicular torsion, varicocele, hydrocele, epididymitis, testicular cancer, and cysts.

3. Blood Tests

● Tumor Markers: Certain proteins in the blood can indicate the presence of testicular cancer. Common tumor markers include:

     • Alpha-fetoprotein (AFP)

     • Human chorionic gonadotropin (HCG)

     • Lactate dehydrogenase (LDH)

● Hormone Levels:

 Blood tests can measure testosterone and other hormones (e.g., follicle-stimulating hormone (FSH), luteinizing hormone (LH)) to evaluate testicular function and fertility.

4. Semen Analysis

● Purpose: 

This test assesses sperm health and is commonly used to evaluate fertility.

● Procedure: 

A semen sample is collected and analyzed for sperm count, motility (movement), morphology (shape), and volume.

● Conditions Diagnosed:

 Infertility, testicular dysfunction, or blockages in the reproductive tract.

5. Testicular Biopsy

● Purpose: 

A small sample of testicular tissue is removed and examined under a microscope.

● Procedure:

 This is usually performed when evaluating infertility or diagnosing conditions like testicular cancer.

● Conditions Diagnosed:

 Infertility, cancer, or other structural issues in the testicles.

6. Urine Test (Urinalysis)

● Purpose: 

A urine sample is analyzed to check for signs of infection or blood.

● Conditions Diagnosed:

 Urinary tract infections (UTIs), sexually transmitted infections (STIs), or other infections that may impact the testicles, such as epididymitis or orchitis.

7. Transillumination

● Purpose:

 A simple test used to evaluate swellings or masses in the scrotum.

● Procedure:

 A light is shone through the scrotum to see whether the swelling is solid (which may suggest a tumor) or fluid-filled (which may indicate a hydrocele).

● Conditions Diagnosed:

 Hydrocele, spermatocele, or other fluid-filled masses.

8. Magnetic Resonance Imaging (MRI)

● Purpose: 

MRI can provide detailed images of the testicles and surrounding tissues.

● Procedure:

 Used less frequently than ultrasound but may be employed for more complex or unclear cases.

● Conditions Diagnosed: 

Testicular tumors or other abnormalities not clearly visible on ultrasound.

9. Testicular Self-Examination (TSE)

● Purpose:

 A routine self-exam to detect lumps or changes in the testicles.

● Procedure: 

Men are advised to regularly check their testicles by gently rolling each testicle between the fingers and thumb to detect lumps, changes in size, or other abnormalities.

● Conditions Diagnosed: 

Early signs of testicular cancer.

10. Genetic Testing

● Purpose:

 Used to detect any genetic causes of testicular problems, particularly for infertility or undescended testicles (cryptorchidism).

● Conditions Diagnosed: 

Genetic disorders like Klinefelter syndrome, which can affect testicular development and function.

These tests are used to assess testicular health and diagnose a range of conditions, from fertility issues to cancer. Depending on the symptoms, doctors may order one or more of these tests for a thorough evaluation.

What are some common treatments for testes-related conditions?

Treatment for testicular conditions varies depending on the specific diagnosis. Here are some common treatments for various testicular issues:

1. Testicular Torsion

■ Emergency Surgery: 

Immediate surgical intervention is required to untwist the spermatic cord and restore blood flow. The testicle may be anchored (orchidopexy) to prevent recurrence.

2. Epididymitis

■ Antibiotics:

 To treat bacterial infections or sexually transmitted infections (STIs).

■ Pain Relief:

 Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

■ Supportive Care: 

Rest, scrotal elevation, and ice packs to reduce swelling.

3. Hydrocele

■ Observation:

 Small, asymptomatic hydroceles may not require treatment and may resolve on their own.

■ Surgery:

 For larger or symptomatic hydroceles, a procedure called hydrocelectomy may be performed to remove the fluid and repair the sac.

4. Varicocele

■ Observation: 

Small varicoceles that are asymptomatic may not need treatment.

■ Surgery: 

Varicocelectomy is a surgical procedure to remove or repair the enlarged veins to relieve symptoms and improve fertility if affected.

5. Testicular Cancer

■ Surgery: 

Orchiectomy, the removal of the affected testicle, is often the first step.

■ Chemotherapy: 

Used to kill cancer cells that may have spread beyond the testicle.

■ Radiation Therapy: 

Sometimes used, particularly for certain types of testicular cancer.

6. Orchitis

■ Antiviral or Antibiotic Medication: 

Depending on the underlying cause (viral or bacterial).

■ Pain Relief: 

NSAIDs and scrotal elevation to reduce pain and swelling.

■ Rest: 

Essential for recovery.

7. Spermatocele

■ Observation: 

Many spermatoceles do not require treatment if asymptomatic.

■ Surgery: 

Surgical removal (spermatoclectomy) may be performed if the spermatocele causes discomfort or other issues.

8. Undescended Testicle (Cryptorchidism)

■ Surgery:

 Orchiopexy is performed to move the undescended testicle into the scrotum and secure it. This is usually done before the child is 1 year old to prevent complications.

9. Testicular Atrophy

■ Treatment of Underlying Causes: 

Addressing hormonal imbalances, stopping harmful medications, or treating infections can help.

■ Hormone Replacement Therapy: 

For cases due to hormonal deficiencies.

10. Trauma or Injury

■ Supportive Care: 

Rest, ice packs, and pain relief.

■ Surgery: 

Required if there is significant damage or rupture.

11. Genetic Disorders

■ Hormone Therapy:

 For conditions like Klinefelter syndrome to address hormonal imbalances.

■ Assisted Reproductive Technologies (ART):

 May be considered for infertility.

General Care:

■ Regular Monitoring:

 For conditions like hydrocele or varicocele, periodic follow-ups may be necessary to monitor the condition.

■ Lifestyle Changes: 

Avoiding activities that exacerbate symptoms and maintaining good overall health.

The specific treatment plan is tailored to the individual based on the condition’s severity, the patient's overall health, and other factors. Consulting a healthcare provider is essential for determining the appropriate treatment.

How do I keep my testicles healthy?

Maintaining the health of your testicles involves a combination of good habits and regular medical care. Here are some tips to help keep your testicles healthy:

1. Practice Good Hygiene

● Regular Washing: 

Clean your scrotum and testicles daily with mild soap and water to prevent infections and maintain cleanliness.

2. Perform Testicular Self-Exams

● Regular Checks: 

Examine your testicles monthly for any lumps, changes in size, or abnormalities. This can help detect issues like testicular cancer early.

3. Wear Supportive Clothing

● Comfortable, Supportive Underwear:

 Use properly fitting underwear or athletic support to reduce discomfort and protect the testicles during physical activities.

4. Avoid Trauma

● Protective Gear: 

Wear a protective cup during contact sports or activities that could result in injury to the testicles.

5. Maintain a Healthy Lifestyle

● Balanced Diet: 

Eat a diet rich in fruits, vegetables, whole grains, and lean proteins.

● Regular Exercise: 

Engage in regular physical activity to support overall health and improve blood circulation.

6. Manage Stress

● Stress Reduction: 

Practice stress-reducing techniques such as meditation, exercise, or hobbies to maintain hormonal balance and overall well-being.

7. Avoid Harmful Substances

● Limit Alcohol and Avoid Drugs: 

Excessive alcohol consumption and drug use can negatively affect testicular health and hormone levels.

8. Be Cautious with Medications

● Consult Your Doctor:

 Some medications, especially anabolic steroids, can impact testicular function. Always use medications as prescribed and consult your healthcare provider if you have concerns.

9. Regular Medical Check-Ups

● Routine Exams: 

Schedule regular check-ups with your healthcare provider for general health evaluations and to discuss any concerns about your testicles.

10. Protect Against STIs

● Safe Sex Practices: 

Use condoms and practice safe sex to prevent sexually transmitted infections, which can affect testicular health.

11. Seek Prompt Medical Attention

● Address Symptoms Early: 

If you experience pain, swelling, lumps, or any changes in your testicles, seek medical advice promptly to address potential issues before they become serious.

By following these practices, you can help maintain testicular health and reduce the risk of developing related conditions.

Can a person without a testicle make another person pregnant?

Yes, a person who has only one testicle can still father a child. The remaining testicle can produce sperm and testosterone, which are necessary for fertility and reproductive health. Here are a few key points to consider:

1. Sperm Production:

 As long as the remaining testicle is healthy, it can produce sufficient sperm for fertilization.

2. Hormone Production:

 The remaining testicle can also produce enough testosterone to support sexual function and other bodily functions.

3. Fertility Assessment: 

If there are concerns about fertility, a semen analysis can be performed to evaluate sperm count, motility, and overall reproductive health.

4. Medical Consultation:

 If someone is concerned about their fertility or reproductive health, consulting a healthcare provider or a fertility specialist can provide personalized guidance and assessments.

Overall, having one testicle does not necessarily impede the ability to conceive, as long as the remaining testicle is functioning properly.