Living with one testicle, a condition known as monorchism, is a reality for some individuals. Many people are born with only one testicle, while others may have one removed due to medical reasons. A single healthy testicle often compensates for the absence of the other, allowing individuals to lead full and healthy lives.
Reasons for Having One Testicle
Individuals may have one testicle due to congenital factors or acquired conditions. Congenital monorchism occurs when a person is born with only one testicle, sometimes because the testicle never formed or did not descend into the scrotum during fetal development, a condition called cryptorchidism. If an undescended testicle does not move into the scrotum, it may gradually shrink and require surgical removal.
Acquired reasons typically involve the surgical removal of a testicle, known as an orchiectomy. This procedure is often performed to treat testicular cancer. Other medical necessities for orchiectomy include severe injury to the scrotum or testicle, or serious infections that do not respond to other treatments. Testicular torsion, a medical emergency where the spermatic cord twists, can also lead to the loss of a testicle if not treated promptly.
Hormonal Function
A single healthy testicle is generally sufficient to produce adequate levels of testosterone, the primary male hormone, for normal bodily functions. The testicles are the main source of testosterone in men, which influences libido, muscle mass, bone density, and mood. When one testicle is absent or removed, the remaining testicle often increases its activity to maintain hormonal balance.
Studies have shown that testosterone levels in individuals with one testicle can be nearly identical to those with two. However, the body may exhibit higher levels of certain pituitary hormones, like follicle-stimulating hormone (FSH) and luteinizing hormone (LH), as it works harder to stimulate the remaining testicle. If testosterone levels become insufficient, symptoms such as fatigue or a reduced sex drive may occur. In such cases, hormone replacement therapy (HRT) is an available option to restore normal levels.
Fertility Considerations
One healthy testicle can typically produce enough sperm for successful fertility. The remaining testicle often compensates by increasing sperm production to maintain adequate levels. While the removal of one testicle can lead to a decrease in overall sperm count, many individuals with a single testicle can still father children.
Fertility can be influenced by the underlying reason for having one testicle. For instance, if the remaining testicle was affected by the same issue that necessitated the removal of the other, its function might be compromised. Testicular torsion, even when treated, can sometimes impact the fertility potential of the remaining testicle. If future fertility is a concern, options like sperm banking can be discussed with a healthcare provider prior to a testicle removal procedure.
Daily Life and Well-being
Most individuals with one testicle lead active and fulfilling lives without significant physical limitations. Physical activity, including sports, is generally not restricted, though precautions to protect the remaining testicle may be advised. Sexual health and performance are usually not impacted, as a single testicle can produce enough testosterone for sex drive, erections, and ejaculation.
Body image and self-esteem can be personal considerations for some individuals. While some adjust quickly, others may experience feelings of self-consciousness or a change in self-perception. Open communication with partners and seeking support from mental health professionals can be beneficial for those navigating these feelings. For cosmetic purposes, a testicular prosthesis, an artificial implant, can be surgically placed in the scrotum to restore appearance. These prostheses are typically made of silicone and are designed to feel natural.
Ongoing Medical Care
Regular medical check-ups are important for individuals with one testicle to monitor overall health and the function of the remaining testicle. Self-examinations are an important practice to help identify any changes or abnormalities in the testicle. These self-exams should be performed monthly, ideally after a warm shower, to become familiar with the normal feel and detect any lumps or changes in size or shape.
Professional medical examinations should also be conducted regularly, especially for the remaining testicle, to screen for any potential issues. This is particularly relevant for individuals who had an undescended testicle or a history of testicular cancer, as these factors can increase the risk of cancer in the remaining testicle. Follow-up care may also involve blood tests to monitor hormone levels and ensure they remain within a healthy range.