Best not to grow some balls

Bigger than normal testes can be a red flag. Image:

Among guys, the usual comment to “grow some balls” is an euphemism for telling you to be braver in the face of a hurdle or a dare.

It can be used as an expression of tough love by a big brother or even a form of insult to your opponent. One thing that is certain though, is that no one wants you to literally have a bigger pair of testicles.

But let’s just assume that you did take the phrase quite literally and wanted to be born with bigger testicles. How would that play out for you?

Bigger isn’t always better

Usually, the size of your testicle is measured using an Orchidometer, an instrument with beads of varying sizes on a string, used for paediatric patients.

Comparing the size of your testicle to the respective bead on the string helps establish the size-for-age of your testicle and determine whether it is smaller or larger or normal.

Upon having your testicles examined, you are told that your testicles are bigger than normal.You rejoice after learning this, thinking that you can brag about this to your friends but you are surprised when the doctor looked concerned and worried about the finding.

Red flags

The reason the doctor is concerned is because the finding of a large testicle is a red flag for what can be a sign of long-standing primary hypothyroidism, follicle stimulating hormone (FSH), secreting pituitary macroadenomas, adrenal remnants in congenital adrenal hyperplasia or local tumours.

More importantly however, it is one of the most common signs of Fragile X syndrome.

Fragile X

Fragile X syndrome (FXS) is a genetic disorder characterised by the presence of mild to moderate intellectual impairment and a number of physical features which develops over time such as:

• A large head

• A long face

• A prominent forehead and chin

• Protruding ears

• Loose joints

• Large testes

Bigger isn’t always better when it comes to testes. Image:

Motor and language delays are usually present but also become more apparent over time. Behavioural abnormalities including autistic behaviour is common.

Fragile X syndrome was traditionally thought to be X-linked dominant in terms of inheritance. What that essentially means is that regardless if you are XX (Female) or XY (Male), just one of those Xs that carries the defect is enough to give you the condition.

It is notably different from X-linked recessive form of inheritance which, in order for the disease to manifest, requires both defective X chromosomes to be present in a female while one is enough for a male since they only have one X in their sex chromosome.

As a result, boys are more likely to have Fragile X Syndrome than girls, and they have more severe symptoms.

However, studies have also found the patterns of genetic anticipation and X-inactivation in females. Some people inherit the fragile X gene without having symptoms and they are called carriers as they are able to pass the gene change to their children.

Due to that, Fragile X syndrome’s inheritance pattern does not coincide with the classical pattern of X-linked dominant inheritance, leading to suggestions of discontinuing such a label.

The gene responsible for the disease is the Fragile X mental retardation 1 (FMR1) gene on the X chromosome which produces a protein called FMRP needed for proper cell function.

A defect in this gene leads to insufficient production of FMRP required for normal development of the connection between neurons.

The syndrome got its name because some individuals with the disorder were found to have a segment of their X chromosome broken or somewhat fragile.

Later it was learned that the FMR1 gene is located precisely where the X chromosome appears to be “fragile” in affected individuals.

If you have worries or concerns regarding your child’s health, it is advised that you see the doctor immediately to get proper tests and consultation.

The Hello Health Group does not provide medical advice, diagnosis or treatment.