PROTECT YOUR NUTS!!! Get Your Balls in Gear

There is one defensive measure that men universally master – protecting one’s nuts.

Daniel Gwartney, M.D.

After a single, excruciatingly painful and embarrassing lesson learned around the age of 10, boys develop an innate kung-fu block for any kinetic threat directed toward the groin. For a healthy man, the threatened loss of the testes (balls) conjures images of tortuous castration, emasculation, loss of social standing and sexual deprivation. Sadly, some men suffer castration through trauma, cancer or other misfortunes; others may have an inherent condition that results in severe hormonal defects, causing a functional castration rather than an anatomic absence; yet others may suffer a loss of testosterone production as a consequence of certain medications. These examples are outside the scope of this article.

Closer Look Below the Belt

The testes produce testosterone within Leydig cells, which are relatively inactive until puberty; then they begin to erratically produce testosterone in a manner that suggests a developing regulatory system. The regulation of testosterone production involves two glands located in the brain called the hypothalamus and the pituitary. The hypothalamus detects the concentration of testosterone and its metabolites, estradiol and DHT.1,2 When the concentration is low, the hypothalamus sends a signal (GnRH) to the pituitary, which responds by sending a hormonal signal (LH) to the testes to produce more testosterone. If testosterone approaches the upper limit of the “normal” range, the hypothalamus backs off its signal, as does the pituitary gland, and the testes slow down testosterone production until the level drops. This results in the pulsatile (ups and downs) pattern of circulating (blood) testosterone concentrations.

Protecting the nuts actually begins before conception, as epigenetic effects can alter the sperm, egg (ovum) and fetal physiology. Since a person cannot choose his parents, it is best to focus on factors that can be influenced. Few studies have looked at the childhood environment to determine later effect on testosterone production. One investigated the effect of swimming on later testes function, following children who swam in pools treated with chlorine (either indoors or outdoors) or a silver-based system. The intent was to see if exposure to biogenic chloramines (created when the chlorine in the water interacts with sweat or urine) or halogenated hydrocarbons (formed when chlorine interacts with “organic matter”) affected the testes. Indeed, boys who swam in indoor chlorine-treated pools (>250 hours by age 10; or >125 hours by age 7) had lower testosterone concentrations later in life; below the tenth percentile, which means less than 90 percent of their peers.3 It was proposed that the chlorinated byproducts were absorbed across the scrotal skin and injured the Leydig cells during a critical point in development. Outdoor chlorine-treated pools did not have the same effect – presumably because the urine and waste contamination was less, as they were largely privately owned pools in this study.

Possible Endocrine Disruptors

Other chemical assaults occur during all phases of life as well, possibly responsible in part for the declining age-matched testosterone concentration that has been noted over several generations. This means that at your age, your father likely had higher (natural) testosterone than you, and his father more so than your father. This population-based decline in testosterone has occurred in addition to the aging-related decline in testosterone that thankfully appears to be declining at the same rate across generations, just from a lower starting point in younger men in comparison to their elders. Though most prominently reported in the United States, this phenomenon has been described in other countries as well.4,5

The causative agents are likely legion (meaning a huge number).6 It has been grossly underreported that many chemicals interfere with the sex steroid hormone balance. These chemicals, collectively referred to as endocrine disruptors, are particularly problematic for children and infants. However, due to the bias against testosterone-related research, little is known about the extent of damage caused by the combined effect of all the endocrine disruptors in our food, beverage and even the air we breathe.