Small testicles man boobs

Small Testicles And Manboobs – What Is The Link?

Hi Mark,

Is there a link between small testicles and manboobs?

I’m dealing with both right now and am wondering if there is a connection?



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Hello RJ,

This isn’t the first time I’ve been asked this question, and I’m sure it won’t be the last!

You might take some comfort in knowing that the combination of symptoms you’re experiencing isn’t unusual.

In fact, quite often a reduction in testicle size and an increase in breast tissue go hand in hand.

They are both indicative of a hormonal imbalance…

Here are some of the most common causes:

Estrogen – Androgen Imbalance

One of the primary causes of small testicles (testicular atrophy) is having elevated levels of estrogen.

Estrogen is often thought of as a female hormone.

While it’s true that levels are far higher in females, it’s still essential for men in small quantities.

A study of the hormones involved in male fertility concluded “that estrogen is an absolute necessity.” (1)

The problems start to occur when the delicate balance between testosterone and estrogen gets out of whack.

A study that injected men with estrogen discovered that the resulting hormonal imbalance caused “testicular atrophy with markedly reduced spermatogenesis after only 21 days”(2)

So as you can see, it doesn’t take long for changes to occur when estrogen levels get too high in relation to testosterone.

But shrunken testicles aren’t the only negative consequence…

It can also cause an increase in breast tissue, known as “Gynecomastia” or more commonly – “gyno”.

What is Gynecomastia?

Defined “as the benign proliferation of male breast glandular tissue, it is usually caused by increased estrogen (and) decreased testosterone activity” (3).

A study of men who had developed gyno discovered that their “mean plasma production rate of testosterone was… 20% of that found in normal men without Manboobs” (4).

A reduction in testosterone is never good news, but this wasn’t the problem in this case.

The real issue is that their estrogen production wasn’t impaired at the same rate, causing an imbalance.

The researchers concluded that if there is a “striking reduction in the ratio of testosterone to estrogen production rates, gynecomastia may result” (4).

But what can cause this imbalance to occur in the first place?

I can be caused by any of the reasons on This Page (


Drug – Steroid Use

“Drug-induced gynecomastia accounts for 20% to 25% of cases.”(6)

When most people think of steroid users they probably think of a guy with big, contoured muscles.

I’m sure far fewer people associate their use with increases in breast size!

But it’s a very real and possible side effect.

“use of anabolic steroids may stimulate glandular proliferation in male breast tissue”(5)

This is because the most commonly used recreational steroids are a synthetic form of testosterone.

But why would taking extra testosterone cause breast tissue growth?

Well, testosterone “can be peripherally aromatized to estrogen, which may result in manboob development”(6)

What is aromatization?

When an outside source of testosterone is introduced into the body, it realizes that the ratio between estrogen and testosterone is getting outside of the normal range.

As the body always wants to keep a state of balance (homeostasis), it turns some of this excess testosterone into estrogen through a process known as “aromatization”.

The result can be a spike in estrogen that causes breast tissue growth.

But that isn’t all…

Steroids and Testicular Atrophy

When your body senses there is already too much testosterone in the body, it cuts off its natural supply.

Often this will lead to the balls shrinking, as they aren’t being used to produce testosterone anymore.

“Anabolic steroids cause testicular atrophy and reduced blood levels of gonadotropins and testosterone in adult males.”(7)

Use it or lose it!

The result?

A hormonal double whammy.

Not only is the estrogen level elevated, the natural testosterone supply is cut off and the balls have shriveled as a result – creating a perfect environment for manboobs to occur.

Hyperprolactinemia – Excessive Prolactin Production

Prolactin is another essential hormone that “plays an important role in the reproductive health of both women and men”.(8)

However, it can be very harmful if the levels increase beyond the normal threshold.

This can occur for a number of reasons, most often a tumor on the pituitary gland which produces prolactin (9)

This is referred to as hyperprolactinemia, a “condition in which a person has higher-than-normal levels of the hormone prolactin in the blood”(10)

This condition, especially in the presence of increased estrogen, can cause unwanted side effects in men such as;

Breast tissue growth, milk production, water retention…

“Hold up, did you say ‘milk production’?!”


In some rare cases an elevation in prolactin, which is a state usually found in pregnant women, can cause a man to start producing breast milk:

Dr. Jack Newman, an expert on breastfeeding discovered that:

“medical disruptions involving prolactin, the hormone necessary to produce milk, have resulted in spontaneous lactation” in male subjects (11)

Imagine trying to explain that one to your partner!

“Don’t worry honey, I’ll feed the baby”…

High prolactin and reduced testosterone production

While it’s necessary to maintain low levels of prolactin for optimal sexual function, excessive levels “inhibits GnRH secretion”(12)

Why is this a bad thing?

Gonadotropin-releasing hormone (GnRH) is the hormone that starts the cascade of hormonal processes that ultimately results in testosterone being synthesized in the body.

It is so necessary for healthy sexual function that synthetic forms have been successfully used to treat sexual dysfunction

“after GnRH treatment, testosterone secretion normalized, libido and potency improved, and ejaculation returned” (13)

If GnRH is reduced, the body won’t have the raw ingredients that it needs to produce testosterone.

What happens when there is a lack of testosterone production?

Estrogen levels can get too high, testicular atrophy can occur and gynecomastia can rear its head.


As you’ve seen, hormonal imbalances can cause a whole host of symptoms, conditions, and embarrassment.

But if you’re suffering with small testicles and manboobs, you needn’t despair.

It’s often possible to reverse these conditions and get back to a normal, healthy, life.

By taking steps to bring your hormone levels back to the normal range naturally, you will start to see an improvement in your symptoms and may even see them disappear altogether.


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