If you’re experiencing testicular pain, admitting to a doctor (or even to yourself) that one or both of your testicles hurt is probably the last thing you want to do. Having pain “down there” may feel embarrassing or humiliating, and you may be tempted to put off telling your doctor because you a) don’t want to overreact; or you b) hope that if you give it some time, the pain will just go away on its own.
While both responses are completely understandable, testicular pain is not something to take lightly. While it’s true that some causes of testicular pain are ultimately nothing to worry about, some conditions are more serious or even considered medical emergencies. That’s why making an appointment to get checked out by a urologist—a doctor specializing in conditions of the male reproductive tract—should be at the top of your to-do list.
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But first: A quick anatomy lesson
However, before we dive into the possible causes and treatments for testicular pain, let’s recap with a quick anatomy lesson (after all, sixth-grade health class was a long time ago for some of us!): The testes (testicles) are two small, egg-shaped glands inside the scrotum (a thin pouch of skin that holds and protects the testicles). The testicles produce sperm and testosterone. To make sperm, the temperature of the testicles needs to be cooler than the internal temperature of the abdomen, which is why the scrotum is located outside the body. Due to their location, the testes are quite sensitive and more vulnerable to potential injury.
Testicular pain can affect men of any age, and the causes can range from going on a really long bike ride to contracting a sexually transmitted infection (STI) to developing an emergency condition called testicular torsion. That’s why it’s important to seek medical attention if you experience any type of testicular pain to ensure you receive a prompt diagnosis and treatment.
What does testicular pain feel like?
While this may seem like an obvious question with an obvious answer—if your testicles hurt, you know it!—it’s important to be mindful of possible symptoms, as the duration and intensity of the pain can vary depending on the cause. In general, testicular pain and symptoms of a testicular condition can include the following:
- A dull ache in the scrotum
- Swelling or a lump in the scrotum
- Pain in one or both testicles
- Pain that is sudden, sharp, or intense
- Pain that is either acute (comes on suddenly and leaves quickly) or chronic (comes on more gradually and sticks around)
- Bruising on the scrotum Testicular pain accompanied by a fever, nausea, and/or vomiting
- Urination problems or blood in the urine
- Pain with ejaculation
If you experience any of the above symptoms or you notice a new sensation in your testicles that doesn’t feel normal or typical for you, it’s important to get evaluated as soon as possible. If you experience sudden or severe pain, this could be the sign of a medical emergency that requires immediate treatment.
What causes testicular pain?
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Testicular pain has several possible causes, ranging from a sudden injury during physical activity to testicular cancer, the most common cancer in men ages 15-35. Here is a list of some possible causes:
- Sudden injury or trauma: Playing full-contact sports, tackling home repairs around the house, or going on a long bike ride (where the seat can cause friction if not properly adjusted) can increase your risk of injuring your testicles.
- Infection: The source of the pain may be inflammation due to an infection, such as a urinary tract infection (UTI) or a sexually transmitted infection (STI) like gonorrhea or chlamydia. Inflammation may be found in the epididymis, a structure attached to the testis that stores sperm, (called epididymitis) or in one or both testicles (called orchitis).
- Inguinal (groin) hernia: A condition in which soft tissue (typically part of the intestine) bulges through a weak spot of the lower abdominal muscles. The hernia can cause swelling in the scrotum.
- Testicular torsion (twisting): This is when a testicle rotates around the spermatic cord, blocking blood flow to the testicle. Symptoms include sudden, severe testicular pain, swelling, and possibly nausea and vomiting. This medical emergency requires immediate surgery (typically within hours of the onset of pain) to prevent decreased fertility or evenloss of a testicle.
- Testicular cancer: Symptoms associated with testicular cancer, such as dull pain or a firm lump within the testicle, typically develop gradually. Testicular cancer is usually painless.
- Varicocele: these are dilated veins above the testicle that can cause dull achy pain. Varicoceles are one of the most common causes of male infertility.
- Hydrocele: Swelling in the scrotum that occurs when fluid builds up around a testicle.
- Testicular rupture: A tear in the outer covering of a testicle, typically from an injury to the area.
- Referred pain: Pain that starts in another part of the body, like a kidney stone or a UTI, but presents in one or both testicles.
Here are some commonly asked questions about testicular pain:
Can ejaculating too much cause testicular pain?
The short answer is yes, testicular pain can occur after ejaculation, but it’s not typically a cause for concern. For example, you may experience muscle spasms in your perineal region after sex that can lead to pain, especially if your orgasm was intense. If you intentionally delay orgasm, you could experience epididymal congestion—this is when the increase in blood flow to the testicles during sex takes a while to decrease after orgasm. Testicular pain after ejaculation can also be due to trauma (due to very vigorous sexual activity) or other conditions, such as varicoceles. Typically treating post-ejaculation pain with home remedies like rest, heat/ice, and medicationslike ibuprofen are all you need. However, if the pain doesn’t subside or gets worse, or if you develop additional symptoms, seek medical attention.
Can emotional issues like anxiety cause testicular pain?
Again, the short answer is yes. Just like how anxiety can manifest as a racing heart or sweaty palms, it can also show up as testicular pain. You may hold tension or stress in your groin area, or you may notice pain down there when you’re going through a rough patch in your relationship or tackling performance issues in the bedroom. Getting checked out by a doctor is the best way to confirm that anxiety is at the root of your testicular pain and identify healthy ways to manage it.
Can tight pants cause testicular pain?
Yes! The arrival of skinny jeans and tight pants on the fashion scene has increased testicular pain among men who wear them. Tight pants restrict movement in the groin area, which can cause testicular torsion (twisting of the testicles) or other testicular pain. If your clothing choices have you experiencing testicular pain that is acute, severe, or long-lasting, it’s best to make an appointment with a urologist ASAP to get evaluated.
Can sitting too long at work cause testicular pain?
Not exactly—it’s not so much the sitting that’s the problem; it’s the inactivity. Sitting too long can sometimes lead to low back pain, which can sometimes radiate to the testes. . Men with larger testicles or scrotums that hang low may also experience testicular pain after sitting too long. Getting up more often and incorporating more movement throughout the day may help alleviate the testicular pain (and low back pain, if you have that too). And as before, if the testicular pain is acute, severe, or long-lasting, it’s best to get checked out.
Can the COVID-19 vaccine cause testicular pain?
No. Current research indicates that the COVID-19 vaccine has not been known to cause testicular pain or swelling. So, if you’ve gotten jabbed, you can cross the vaccine off your list of potential culprits.
When should you see a doctor for testicular pain?
While a bout of testicular pain may be nothing to worry about, it’s important to rule out conditions like testicular cancer or a medical emergency like testicular torsion. Since it can be difficult to self-diagnose or determine if your testicular pain is serious or not, it’s always best to err on the side of caution and seek medical attention any time you experience testicular pain.
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However, call your doctor immediately or head straight to the ER if:
- The pain is sudden and severe
- The pain lasts longer than an hour
- The pain worsens over time
- The pain is in only one testicle
- You have swelling or feel a hard mass or lump on your scrotum
- You also have nausea or vomiting
- There is blood in your urine
If you have sudden testicular pain that goes away after a while, do you still need to see a urologist?
Yes! For a medical emergency like testicular torsion, the pain can be intermittent (when the testicle twists and then untwists on its own), but the torsion may reoccur. If left untreated, testicular torsion can lead to decreased or blocked blood flow to the testicle, which can cause irreversible damage or the potential loss of the testicle. Testicular torsion requires immediate surgery to protect fertility and preserve the testicle, so when it doubt, get checked out!
What type of doctor should you see for testicular pain?
When experiencing testicular pain, a urologist is your go-to healthcare professional. These clinicians specialize in the male reproductive system, including the testicles and scrotum. They will perform a physical exam and ask you questions about your pain and other symptoms. They may order blood or urine tests or imaging exams (like an ultrasound) to help diagnose your pain and develop a treatment plan if needed.
Treatment for testicular pain
Minor testicular pain can often be treated at home. Still, if the pain is more severe, long-lasting, or accompanied by other symptoms, you may need additional medical treatment to feel better.
At-home remedies:
For minor pain, you can try at-home remedies such as:
- Ice: Applying ice packs (or a bag of frozen peas) to the groin area for a few minutes at a time can help reduce pain and swelling.
- Take a time out: Take a break from vigorous exercise or strength training.
- Support the scrotum: Wear an athletic supporter, switch to briefs to help restrict movement, and use a folded towel to support your scrotum when lying down.
- OTC meds: Try non-prescription pain relievers such as ibuprofen and acetaminophen.
Medical treatments:
If you’re still feeling pain or discomfort, your pain has increased, or new symptoms appear, it’s still best to visit a urologist. Depending on your symptoms and diagnosis, your doctor may prescribe the following, typically starting with the least-invasive option:
- Prescription medication: Your doctor may prescribe stronger pain medication, an anti-inflammatory, or medication to treat nerve pain.
- Antibiotics: If you have an infection, a course of antibiotics will help clear it up.
- Surgery: While surgery isn’t typically needed to resolve testicular pain, if you have testicular torsion, testicular cancer, or an inguinal hernia, you may need surgery. Sometimes a surgery called a microsurgical denervation of the spermatic cord is warranted to help resolve chronic testicular pain.
The bottom line?
Testicular pain is always something to take seriously. When you’re experiencing testicular pain, monitor your symptoms and remember: When in doubt, get checked out!
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