Testicles, the scrotum, huevos, balls, nuts – the appendages men have and want the best of, but do they know how to do so? Testicles are not only important for reproduction, but also for hormone balance and sex drive.
There are many things you can do to improve and maintain the health of your testicles, including diet, exercise, and even trying a testicle massage. They require TLC like any other organ and here’s how you can care for them.
Testicles are outside the body for a reason, to stay cool. Testicles function optimally at 35C or 95F. In fact, decreased testicular volume, decreased sperm count and decreased testosterone production were observed in male rat models with induced testicular temperature of 109F for just 45minutes (think hot tub exposure!). With this small amount of heat, testicular weight decreased by 65% and sperm count decreased 29% in the rat population (1).
Broad foods for testicular health include those rich in antioxidants, such as leafy greens, berries, broccoli, bell peppers, oranges, and eggplant. The antioxidants scavenge free radicals that can damage DNA of developing spermatids and impair production of fully functional sperm. Selenium along with Vitamins C and E also provide antioxidant services, to protect and promote sperm development, increasing sperm count and testosterone levels (2).
Zinc is an even more important mineral to boost sperm count. Zinc is a natural local antimicrobial agent in the testicles and boosts testosterone production (2). Melatonin is an antioxidant as well, which can easily pass through the testicular blood-barrier. High melatonin in the testes increases spermatogenesis and strengthens sperm DNA (3). Lycopene is another antioxidant, shown to increase sperm count, viability and decrease oxidative stress particularly in men with varicocele. Lycopene can be found as a supplement, dosage recommendation is about 30mg daily. Lycopene can also be naturally found in tomatoes (4).
Most likely, yes. There is a very rare condition called triorchidism, with only about 100 reported cases (5). More likely, if you observe three masses in your scrotum, there is a varicocele, hernia or tumor. A varicocele is dilation of the veins that feed the testicles, the mechanism of testicular varicoceles is yet undefined but may be due to increased pressure in the abdomen or outflow obstruction. Outflow obstruction can occur due to the unique testicular vein anatomy. The left testicular vein is longer, the majority of which does not contain valves to prevent backflow, making left testicular varicoceles more common than right. Varicoceles can be dangerous for the testicle and the increased blood sitting next to the organ decreases both testosterone secretion and spermatogenesis via increased reactive oxygen species and heat (6).
Inguinal hernias are an outpouching of the intestine through the muscles of the pelvic floor. These hernias occur from a weakened muscle layer combined with increased intraabdominal pressure, most commonly due to obesity. Obesity increases the risk of these hernias due to abnormal stretching of the muscle wall and increased intraabdominal pressure from fat pushing the bowel down, into the pelvic floor (7). This type of hernia, similar to varicocele, can decrease fertility.
Finally, a third hard mass in the scrotum should prompt attention to obtain a physician evaluation for possible testicular cancer. Testicular cancer most often presents in young men, aged 15-35, as a painless slowly growing testicular mass (8).
Yes! Testicular massage not only feels good but is good for you! This practice can increase your sperm count by stimulating release of sperm into the epididymis to await ejaculation (9). Testicular massage also increases systemic testosterone by increasing release of testosterone during the massage (10). Furthermore, regular testicular massage can help you self-screen for testicular cancer, especially if you are under the age of 40, these can be silent cancers, which can be caught earlier in a more easily treated state if regular testicle inspection is performed.
Before beginning, you should know that the testicles can be easily injured with too much pressure or impact. When attempting a testicle massage, or "balls massage" as some call it, you should start off more gently than you think you should be, just to be safe. As you become more comfortable with massaging your testicles you can add additional techniques and pressure as needed.
How to massage your testicles: holding the penis out of the way, gently roll each testicle between your fingers and thumb. You can both perform a milking action, aiming upward and a pill-rolling action. Throughout the massage you should feel the moderately firm membrane of each testicle with the soft, squiggly epididymis sitting atop and toward to back of each testicle, accompanied by the spermatic cord running toward your pelvis.
Similar to breasts, it is common for the two testicles to be slightly different in size. If this gentle massage is painful in any way, or you observe anything over than the described above, you should seek counsel from a physician.
Low hanging balls or larger scrotum are associated with higher testosterone and sperm loads because there are more cells in each testicle to produce both. Unfortunately, there is no medically proven food or exercise to increase scrotum size. But you can improve your overall testicular health but consuming antioxidants, exercising regularly, keeping your scrotum cool, avoiding smoking both tobacco and marijuana products have been linked to an increased risk for testicular cancer, and maintaining a healthy weight (BMI <25).
All of these interventions allow for normal signaling of your testes to produce testosterone without the negative feedback of excess adipose tissue and estrogen as in obesity and maintain a healthy microenvironment to create sperm with the antioxidants and nutrient supply.
✔️ References
1. https://academic.oup.com/endo/article/141/4/1414/2988074
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483704
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015250
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677959/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017339/
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770484
7. https://www.urologyhealth.org/urology-a-z/h/hydroceles-and-inguinal-hernia
