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Infertility and Testicular Disorders


What Is Epididymitis?

Epididymitis is inflammation of the epididymis. The epididymis is the coiled tube that lies on and around each testicle. It functions in the transport, storage, and maturation of sperm cells that are produced in the testicles. The epididymis connects the testicles with the vas deferens (the tubes that carry sperm).

What Causes Epididymitis?

Epididymitis often is caused by infection or by sexually transmitted diseases, including chlamydia and gonorrhea. In men over 40 years of age, the most common cause is due to bacteria in the urinary tract.


What Are the Symptoms of Epididymitis?

Symptoms of epididymitis include scrotal pain and swelling. Discharge from the penis, painful urination, and painful intercourse or ejaculation may also be present. In severe cases, the infection can spread to the adjacent testicle, causing fever and abscess (collection of pus).

How Is Epididymitis Treated?

Treatment for epididymitis includes antibiotics (drugs that kill the bacteria causing the infection), bed rest, ice to reduce swelling, the use of a scrotal supporter, and anti-inflammatory medicines (NSAIDS such as ibuprofen). Partners will need to be treated if the epididymitis is due to a sexually transmitted infection to prevent re-infection.

If left untreated, epididymitis can produce scar tissue, which can block the sperm from leaving the testicle. This can cause problems with fertility, especially if both testicles are involved or if the man has recurring infections.

How Can I Prevent Epididymitis?

The use of condoms during sex can help prevent epididymitis caused by chlamydia or gonorrhea.

What Is Hypogonadism?

One function of the testes is to secrete the hormone testosterone. This hormone plays an important role in the development and maintenance of many male physical characteristics. These include muscle mass and strength, fat distribution, bone mass, sperm production, and sex drive.

Hypogonadism in men is a condition that occurs when the testicles (also called gonads) do not produce enough testosterone. Primary hypogonadism occurs when there is a problem or abnormality in the testicles themselves. Secondary hypogonadism occurs when there is a problem with the pituitary gland in the brain, which sends chemical messages to the testicles to produce testosterone.

Hypogonadism can occur during fetal development, at puberty, or in adult men.

What Problems Are Associated With Hypogonadism?

When it occurs in adult men, hypogonadism may cause the following problems:

  • Erectile dysfunction (the inability to achieve or maintain an erection)
  • Infertility
  • Decreased sex drive
  • Decrease in beard and growth of body hair
  • Decrease in size or firmness of the testicles
  • Decrease in muscle mass and increase in body fat
  • Lose of bone mass (osteoporosis)
  • Enlarged male breast tissue
  • Mental and emotional symptoms similar to those of menopause in women (hot flashes, mood swings, irritability, depression, fatigue)

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