Testicular Atrophy in Cirrhosis

[Gringo8675]

Has anyone experienced this with alcoholic cirrhosis? I have not been diagnosed with cirrhosis however my testicles have atrophied, I have no sex drive, definitely have developed breasts, and have erectile dysfunction. I've seen a hepatologist and had all diagnostic testing done short of a biopsy come back clear. I am 28 years old and still suspect liver disease, as I have multiple other symptoms in addition to the testicular issues.

[Gemma68]

What has your GP said about this so far?

[Gringo8675]

Unfortunately, I mentioned the symptoms but not the atrophy. Also my endocrine labs all came back ok...though upon further inspection they are low for my age. I was sure that imaging and all of the testing would pick something up so was too embarrassed to bring it up. I am planning to make a followup appointment for it soon.

[freddie76]

Cirrhosis can cause this. Small testicle (he lost the other one at 17) was one of the first things that was spotted by a consultant when they were trying to find what was wrong with my husband. Those sort of symptoms need to be investigated by an "ENDOCRINEOLOGIST". They check all sorts of hormone levels. It was ours that finally found he had cirrhosis, not alcohol related.

Good Luck,

[Hidden]

Are you taking spironolactone for fluid build up or anything ( you didn’t mention)?

[Gringo8675 in reply to Hidden]

No, not diagnosed with Cirrhosis. Had multiple fibroscans and fibrotest plus saw a hep, all came back clear with two borderline F-2 fibroscans and one completely normal.

I do have what I suspect is mild ascites and have blue/green veins suddenly showing up on the sides of my stomach and in my groin area...hepatologist didn't look too thoroughly and just said I was fine.

[Shirts1]

I have had similar symptoms that lasted about 6 months after my diagnosis (my diagnosis came after acute onset alcoholic chronic liver failure). What was explained to me was that my liver wasn't producing testosterone. My clinician did talk to me about HRT at some point in the future but wanted a good amount of time to see what the liver could regenerate by itself. I am nearly back to normal - mostly through diet - increasing foods that help boost testosterone and decreasing sugars and refined carbs which encourage oestrogen. Mostly it was patience though. I was on Spironolactone for months which gave me sensitive nipples which didn't help with the man-breasts. Patience is probably going to be the key but well worth bringing up the hormone angle and asking what the options are

[Gringo8675 in reply to Shirts1]

Thanks Shirts, that certainly gives me hope. I'm at a loss because the Hepatologist basically wrote me off because all testing has come back clear. Getting an appointment with an Endocrinologist unfortunately will take another couple of months. May I ask what foods you ate which boosted testosterone?

[Gringo8675 in reply to Gringo8675]

Did you also have testicular atrophy? That's the symptom which is most concerning to me at the moment.

[Shirts1 in reply to Gringo8675]

Hi I didn't have atrophy no, but I did have all of the other symptoms (which along with atrophy indicate testosterone. Also had mood swings). Aside from actual liver disease, alcohol on its own can cause a decline in testosterone. I foused on proteins that are high in vitamin D and Zinc (both of which I was chronocally short of) - Tuna, beans, brassicas, mushrooms, eggs, red grapes, green tea and as importantly cut out the oestrogen boosting foods such as sugar, soy and refined flours. I did keep a balanced diet as I have to do with my liver in this state but I amde sure I did slant it as above. But please don't rely on this as the answer - use it as something to start a conversation with a health professional. We're all different and this is worrying you

[Hidden]

Testicular atrophy and gynecomastia are both known symptoms of hemochromatosis, so I'd want to make sure to rule this out. A "ferritin" blood lab is a dirt cheap test that will rule out this possibility. If ferritin is high, a full iron lab including transferrin saturation will confirm iron overload if it is there.

Hemochromatosis often becomes symptomatic in males in their late 20s to early 30s. This is not a diagnosis you want to miss! It's easy to treat when found, so ask your doc about a ferritin test and see if this might be what's causing your troubles.

[Gringo8675 in reply to Hidden]

My Iron levels were checked and found to be normal, I'll definitely look more into this though. I should have mentioned in my post that my concerns are due to Alcohol.

[Lynnylynster]

Can I Just ask, do you have a diet high in soya? Ie, vegetarian vegan or soya yoghurt and milk? I only ask because when my Stepson was eating lots of soya because his Mum was vegan, he too developed breasts(with breast glands), testicular atrophy and dysfunction. It turns out that the soya' s high estrogen content disrupted his own testosterone levels, needless to say, he no longer eats soya. He has now returned to normally thankfully.

Just another thought for you other than Liver 😊

GP should obviously do full blood work up and liver scan

[Gringo8675 in reply to Lynnylynster]

I am vegetarian, however I don't really consume too much soya. Reading about it online, soya may bump estrogen negligibly so I was never too concerned about this.

[ReturnofthePhoenix]

Thats hard to say. I mean the anxiety and depression alone of fearing liver disease can wipe sex drive off the map on its own. But not sure how you know they atrophied aside of feeling them. But definitely suggest seeing the hepatologist again over a gp. Gps arent educated much in this