Dear Nelson: Thanks for all the cutting edge info you provide. It really makes me keep an eye on postings here at thebody. I have been on testosterone for 5 years and my testicles have shrunk a lot. I miss them. Also, my wife and I (both poz) are thinking about having children. Does testosterone help in that regards? Thanks again

Thanks for your kind words. It is my goal to bring up issues seldom talked about but which are very important for most of us who are aging with HIV.

Testicular atrophy (shrinkage) while on testosterone replacement is common. Since your testicles are no longer producing testosterone while you are providing your body with external sources of testosterone, they tend to go "dormant". Fortunately, this issue can be reversed easily. However, there are no guidelines for the management of this side effect. Most doctors use human chorionic gonadotropin (HCG) at various doses with good results. The following is an excerpt from Testosterone: A Man's Guide

The Use of HCG to Increase Testicular Size and Sex Drive While on Testosterone Replacement Therapy

By the way, the use of HCG alone may not be the best way to increase sperm production and quality (sperm production also decreases dramatically on testosterone replacement). There are combination approaches that fertility physicians use to jump start your sperm production so that men on long term testosterone replacement can father children. More in the book.

I hope this helps.

Nelson