Scrotal Size

A scrotum can look smaller because the scrotum itself is tighter or more retracted, because one or both testicles inside it have lost volume, or because the scrotal skin has changed as collagen and elastin decline. Changes in hormones, weight, aging, illness, cancer treatment, or surgery can also affect the area.

Some men notice a change over time. Others have always had a smaller or tighter scrotum and simply want more volume, weight, movement, or visual presence.

The scrotum naturally tightens and relaxes throughout the day. Cold, stress, exercise, touch, and sexual activity can temporarily pull the testicles closer to the body. When the change is persistent, however, it is best to explore why this change is happening instead of waiting for it to get worse.

Retraction and natural anatomy

Some men naturally have a higher, tighter, or less substantial scrotum. In others, the muscles around the scrotum keep it pulled upward more of the time. The testicles may be completely normal in size even when the scrotum looks smaller, tighter, or more retracted than the man wants.

Testicular volume, testosterone, and anabolic steroids

The testicles provide much of the natural fullness inside the scrotum. When the testicles actually become smaller, it is called testicular atrophy. It can happen because of hormone changes, illness, infection, injury, cancer treatment, surgery, reduced blood supply, or anabolic-steroid use.

Testosterone can reduce the signals that tell the testicles to make their own testosterone and sperm, which can lead to smaller testicles or fertility changes. Who is prescribing and monitoring testosterone matters. Properly prescribed testosterone replacement therapy should be individualized and monitored with appropriate blood work, symptoms, fertility goals, and dosing in mind.

That is very different from testosterone or anabolic steroids bought online, obtained on the black market, or handed over by “that guy at the gym.” Products from unregulated sources may not contain the amount of testosterone claimed—or even the substance listed on the label—and may contain other drugs, additives, or contaminants. They may also be used at much higher doses, combined with other hormones, or taken without proper medical monitoring. In one study, 56% of male anabolic-steroid users reported testicular atrophy. [3]

Aging, skin changes, weight, cancer treatment, and surgery

The scrotum itself changes with age. Loss of collagen and elastin can change the thickness, elasticity, texture, and overall appearance of the scrotal skin. Aging can also affect muscle tone, hormones, body composition, and testicular volume.

Weight gain can crowd the genital area and change proportion, while significant weight loss can make the scrotum look looser or less full. Testicular or prostate cancer treatment, chemotherapy, radiation, androgen-deprivation therapy, and surgery can also affect size, symmetry, sensation, fertility, hormones, and appearance.

Yes. The scrotum changes the visual balance of the entire genital area. Size, fullness, hang, symmetry, movement, and proportion with the penis can all affect how the entire package looks and feels during intimacy.

Men notice these changes too. In one study, 59% of men said having a normal-looking scrotum was important or extremely important to their self-esteem. [1] Some men want to restore fullness they have lost. Others have always wanted a larger, heavier, lower, or more substantial appearance.

Scrotal size does not determine erections, testosterone, fertility, stamina, orgasm, or sexual skill. But appearance, proportion, movement, physical contact, and how a man feels about the entire area can still matter.

Some men want penile enlargement alone. Others want greater scrotal fullness, more weight and visual presence, a lower hang, or smoother movement. BawaBig® can be customized for penile enlargement, scrotal enlargement, or both, and BawaTox® can be incorporated into the treatment plan to create a lower, smoother, less retracted scrotum.

Together, BawaBig® and BawaTox® allow Dr. Bawa to address size, fullness, weight, position, movement, and overall proportion as part of a comprehensive treatment protocol for the entire area.

Treatment depends on whether a man wants more scrotal volume and fullness, a lower and less retracted position, or both. Through the Bawa Method, Dr. Bawa can combine treatments to improve the size, weight, position, movement, and overall appearance of the scrotum.

BawaBig® Scrotal Enlargement adds volume, fullness, weight, and visual presence.

BawaTox® relaxes the muscles that pull the scrotum upward, creating a lower, smoother, less retracted appearance while also reducing sweating.

DSF.me® Supplements support male sexual wellness from the inside out. Enhance® supports nitric oxide and blood flow, Renew® supports the body’s natural testosterone production rather than supplying exogenous testosterone, and Passion® supports libido, stamina, and overall sexual vitality.

• BawaBig® Scrotal Enlargement
• BawaTox®
• DSF.me® Supplements

1. Ramos SA, Pinheiro AM, Barcelos AP, Cardoso AP, Varregoso J. Satisfaction with Testicular Prosthesis: A Portuguese Questionnaire-Based Study in Testicular Cancer Survivors. Revista Internacional de Andrología. 2022;20(2):110-115. doi:10.1016/j.androl.2020.10.006.

2. Canguven O, Al Saeedi A, Al Kubaisi K, Majzoub A, Elbardisi H. Scrotal Size Index: a novel anatomical classification of scrotal morphology in inflatable penile prosthesis surgery. Sexual Medicine. 2026;14(5):qfag067. doi:10.1093/sexmed/qfag067.

3. Korkia P, Stimson GV. Indications of prevalence, practice and effects of anabolic steroid use in Great Britain. International Journal of Sports Medicine. 1997;18(7):557-562. doi:10.1055/s-2007-972681.

4. Pang KH, Randhawa K, Tang S, et al. Complications and outcomes following injection of foreign material into the male external genitalia for augmentation: a single-centre experience and systematic review. International Journal of Impotence Research. 2024;36(5):498-508. doi:10.1038/s41443-023-00675-8.

5. Ramelli E, Brault N, Tierny C, Atlan M, Cristofari S. Intrascrotal Injection of Botulinum Toxin A, a Male Genital Aesthetic Demand: Technique and Limits. Progrès en Urologie. 2020;30(6):312-317. doi:10.1016/j.purol.2020.04.016.

6. Prause N, Park J, Leung S, Miller G. Women’s Preferences for Penis Size: A New Research Method Using Selection Among 3D Models. PLOS ONE. 2015;10(9):e0133079. doi:10.1371/journal.pone.0133079.

7. Cao Y, Li F, Li S, Zhou Y, Li Q. A Preliminary Observational Study on the Vascular, Nerve, and Lymphatic Anatomy and Histology of the Labia Minora From Cadaveric and Surgical Samples. International Urogynecology Journal. 2021;32(5):1169-1176. doi:10.1007/s00192-020-04551-7.

8. Summers JA. A complication of an unusual sexual practice. Southern Medical Journal. 2003;96(7):716-717. doi:10.1097/01.SMJ.0000078368.00806.A7.

9. Davis JE, D’Souza PA. Young Man With Scrotal Swelling and Pain. Annals of Emergency Medicine. 2017;69(1):150-153. doi:10.1016/j.annemergmed.2016.06.005.