The phrase “do men’s balls drop” suggests a sudden event in adulthood, but the descent of the testicles, male reproductive glands, is a complex developmental process that primarily occurs before birth. This process is part of fetal development, preparing the male body for its reproductive functions.
The Process of Testicular Descent
Testicular descent is a biological event. The testicles initially form inside the abdominal cavity near the kidneys during fetal development. Around the seventh month of gestation, these organs migrate from the abdomen, through a passage in the groin called the inguinal canal, and into the scrotum, the sac of skin located beneath the penis.
This migration is guided by the gubernaculum, a ligament connecting the testicle to the scrotum. Hormonal influences, particularly testosterone, also play a role in enabling the testicles to traverse the inguinal canal. Most testicles complete this journey before birth, though some may descend shortly after, within the first few months of life.
Why Testicles Descend
The primary reason testicles descend into the scrotum is temperature regulation. Sperm production and viability, called spermatogenesis, requires a cooler environment than the core body temperature, ideally approximately 2 to 4 degrees Celsius (3.6 to 7.2 degrees Fahrenheit) lower than the body’s internal temperature of 37 degrees Celsius (98.6 degrees Fahrenheit). The scrotum acts as a natural cooling system, maintaining this lower temperature. If testicles remain inside the warmer abdominal cavity, the higher temperature can impair their development and ability to produce healthy sperm.
When Descent Doesn’t Happen
When one or both testicles fail to descend into the scrotum, the condition is known as cryptorchidism, or an undescended testicle. This is the most common birth defect of the male genital tract.
In many cases, an undescended testicle will spontaneously descend within the first six months of life, with most occurring within three months. If descent has not occurred by 6 months of age, it is unlikely to happen on its own.
Causes of cryptorchidism are not always clear but can include premature birth, low birth weight, hormonal imbalances, anatomical problems, genetic factors, and certain maternal health conditions or exposures during pregnancy like diabetes, alcohol use, or smoking. The condition is identified during physical examinations shortly after birth or in early infancy when a testicle cannot be felt in the scrotum.
Addressing Undescended Testicles
If left untreated, undescended testicles can lead to health concerns. The elevated body temperature can negatively impact sperm production, increasing infertility risk, especially if both testicles are affected. There is also an increased risk of testicular cancer, though surgery does not eliminate this risk entirely. Other complications include testicular torsion, a painful twisting of the spermatic cord that can cut off blood supply, and inguinal hernias.
Treatment for undescended testicles is recommended if spontaneous descent does not occur by 6 months of age. The approach is a surgical procedure called orchidopexy, where the testicle is moved into the scrotum and secured in place. This surgery is often performed when the child is between 6 and 18 months old, ideally before 2 years of age, as earlier intervention may help preserve fertility and reduce other complications.