Testicular Size

[keith486]

Hi,

I am a 32 year old male

I recently had an ultrasound done on my testicles as I felt pain. Apparently there was an epididymal cyst so nothing to worry about there.

However, I noticed that on the report that came back it said that my testicles were relatively small with 10 ml in volume on one side and 9 ml in volume on the other. I am very worried about this and wonder why my testes are so small. Should I be worried, as they are not of adult size (What would you consider adult size too?) and I wonder how this might effect me and whether my testes will reduce in size as I age. Remember I am only 32 but I am rather worried that there is something wrong with me. Could I please get an honest answer and not just something to make me feel better. If there is something I should be concerned about I would like to know what it is.

I have always felt unmasculine too. I look like I am still a teenager, little facial hair and unmasculine body.

My penis also is only about 12 cm when erect too and wonder if there is a correlation with the size of my testes and the size of my penis.

Any help would be greatly appreciated.

[keith486]

OK.

Thanks for getting back to me.

I got some tests done as you suggested:

I had a karyotype and don't have any chromosonal abnormalities (No Kleinfelters or any other genetic problem).

My testosterone level was 11.1 nmol/L which is about 317 ng/dl. Tested in the morning.

My sperm analysis was pretty much fine except that the morphology was 3% and they consider normal to be above. What would a healthy morphology be though? (15-20%)?

My doctor told me this was normal but I don't think he knows what he is talking about. I said to him that the test is not age specific so while that level may be normal for a man who is much much older, I don't think it is normal for a 32 year old man. I have read many journal articles that suggest that less than 325 ng/dl is considered hypogonadal so I don't know. I think the GP just thinks to himself it's in that "normal range" so I am not gonna deal with it any further. I don't care if this guy is low for his age. All I care about is that it's within the "normal" range so I am covered if there is to be some sort of problem.

He also said that my testes were fine and that some people have big ones and some people have small ones but I really don't think its as simple as that. I have read that under 15ml is actually abnormal and may be a sign of hormonal problems.

I did start masturbating when I was about 10 and I remember the first time was a dry orgasm - no ***. I wonder if I had started masturbating a couple years down the track if everything would have turned out fine. Perhaps compulsive masturbating from early stages of puberty may have contributed to this? This is an honest question and something that I have wondered about.

The only sensible thing he suggested was losing some weight which I have read can help to boost testosterone levels. I am fairly overweight so I am trying to lose some to see what happens.

Do you think though that this testosterone level (11.1 / 317) is normal for someone my age? And would that level be likely to drop even further in years to come? I really want the straight truth. No ducking and weaving like my GP. Just a straight up answer would be appreciated.

[Bhupinder Kaur, MD]

Hello,
Thanks for writing back to me.

At normal temperatures a non-erect penis usually measures between 8.5cm and 10.5cm (3 to 4 inches) from tip to base. So your penis size is of normal length. The testicular size which you have mentioned is a bit less. As mentioned earlier also, it is a bit small than the normal.

You are right that small testes (1–4ml) after puberty are an indication of Klinefelter’s syndrome in most cases. As I have mentioned earlier, if the ultrasound has reported small size of testicles( it is 9 ml and 10 ml in your case which is slightly less than the normal size) and if any of the above mentioned accompanying features are present then it needs evaluation for Klinefelter’s syndrome. Some journals have reported variability in the testicular size. In studies, most of the patients of Klinefelter’s syndrome had small sized testicles but there were some reported cases having normal sized testicles, although the number of these cases were very very low.


Are you having any symptoms of erectile dysfunction, difficulty getting and maintaining an erection, any low libido or any infertility? If there are no such symptoms, then Klinefelter’s is very less likely. You have already mentioned that the erectile dysfunction in your case was psychological as diagnosed by your urologist.

Apart from Klinefelter’s syndrome, testicular size may be decreased in hypogonadism. Primary hypogonadism occurs when there is a problem or abnormality in the testicles themselves. You can get this possibility also checked out if along with the decreased testicular size you are having any low libido or infertility.


I sincerely hope that helps. Take care and regards.

[keith486]

Oh yeah,

just wanted to add that I saw a urologist almost 2 years ago as I was having ED issues and he done a full exam of my testes etc and told me everything was normal and it was all psychological. Surely, he should have picked up on small testes in a physical exam. What is the world coming to. Can't get a straight answer from anyone.

[keith486]

Hi,

Thanks for getting back to me.

I think my penis is OK (perhaps slightly smaller but nothing to worry about really) but there is no way that a penis just over 2 inches is normal. You say it's normal but then say 5.1 to 5.9 inches is normal?

So you are saying that Klinefelters is a possibility? I thought that was only if your testes were 4 ml or smaller.

What are other causes, considering this does not sound like Klinefelters given the above information? Do you really think that with the info I have given you that I may have Klinefelters? Rememeber that is characteristic of people with testes 4 ml or smaller. Please give me some more info. I did have to pay for this.

OK, so what if it is not Klinefelters which it does not sound like but for some reason you think its possible. Why else could my testes only be between 9 & 10 ml in volume.

And how come when the results come back of small testicles do the doctors not suggest further investigations? So many doctors seem so incompetent. It really is a disgrace. I know this has nothing to do with you but I have been totally stuffed around by doctors for many years and don't see why they can't just be more helpful.

What do you mean by get better soon? Do you think I am sick or something?

[Bhupinder Kaur, MD]

Hello,
Thanks for posting your query.

I can understand your concern for the testicle and penis size.

A human testicle measured with an orchidometer is typically 15 to 25 ml in volume. The size of an erect penis usually over 2 inches is normal. The normal penis size is 5.1 to 5.9 inches. Your penis size is absolutely normal. However the testicle size may be a bit small.

One condition in which the testicles size is small is Klinefelter’s syndrome. Klinefelter's syndrome (KS) is when males have an extra X chromosome and instead of being 46, XY, men or boys with KS are usually 47, XXY. It is a genetic problem that only affects boys and men.

Typically the symptoms in adult males include small size of testicles, decreased pubic and facial hair compared to a usual male, gynecomastia and a tall, thin body with disproportionately long arms and legs. One may be infertile and may also have problems getting an erection and a low libido (sex drive).If the ultrasound has reported small size of testicles and you are having these features then an evaluation by a doctor is needed.

The diagnosis can be confirmed by a test called a karyotype. A blood sample is taken and the chromosomes are studied. This test can show the extra X chromosome.

Hope that this information helps and hope that you will get better soon.

Wishing you good health.