What Is Testicular Pain?
Testicular pain is pain you feel in one or both of your testicles. Your testicles are the two soft, round structures inside your scrotum, the sac of skin underneath your penis. Testicles make sperm and the sex hormone testosterone.
Testicles are a very sensitive part of your body. Many things can cause discomfort and pain in your testicles, including pain that comes from nearby body parts. While pain in your testicles can be common due to a mild injury, pain that lasts for an hour or more needs to be checked by your doctor.
Causes of Testicular Pain
If you’ve had a blow or injury to your groin, the cause of your testicular pain may be obvious. But sometimes it’s not clear why you’re feeling pain in your testicles.
Common causes of testicular pain
Sometimes, a simple action like sitting for too long can cause pain in your testicles. But lasting or severe testicular pain may mean you have medical issues that need treatment. Some of the most common reasons you may be feeling pain in your testicles include:
- Diabetic neuropathy. One possible complication from diabetes is nerve damage. If the nerves near your testicles are affected, you may feel pain.
- Epididymitis. Epididymitis is inflammation in your epididymis, the coiled tubes that store and carry sperm to your testicles. Most often, this inflammation happens because of a bacterial infection such as gonorrhea or chlamydia. Along with pain, you may get swelling in your scrotum, and it may feel hot to the touch.
- Epididymal hypertension. The slang term you may hear for this condition is “blue balls.” Your testicles can ache if you are sexually aroused and blood rushes to the area, but you don’t orgasm. It’s not dangerous, and it goes away on its own.
- Hematocele. “Cele” means a swelling or hernia, and “hema” relates to blood. When blood collects around one or both of your testicles, you can get a hematocele, or a blood cyst. This usually happens after you get an injury to the testicles.
- Hydrocele. A hydrocele is when fluid from your belly area builds up around one or both testicles in your scrotum. Hydroceles are especially common in babies.
- Orchitis. Sometimes one or both testicles swell because of a bacterial or viral infection such as mumps. Orchitis from mumps is common in children. Often orchitis and epididymitis are related. If they happen at the same time, it’s called epididymo-orchitis.
- Pain after a vasectomy. A vasectomy is a surgery that seals the vas deferens, which are the tubes that carry sperm. It’s a procedure people get as birth control. After the surgery, some people have testicular pain because of higher pressure in their vas deferens or epididymis.
- Spermatocele. Sometimes, dead sperm cells collect and form a fluid-filled cyst inside the epididymis near your testicle. Usually, a spermatocele isn’t painful, but if it grows large enough, it can become uncomfortable.
- Testicular cancer. Testicular cancer is typically painless, but a lump can be a symptom. Sometimes you may feel a dull ache or mild pain in your testicles or groin. It’s the most common type of cancer in people assigned male at birth (AMAB) between the ages of 15 and 35.
- Testicular torsion. If a testicle rotates, it can twist the blood vessels that lead to it and cut off the blood supply. This happens more often to the left testicle than the right one. It can happen at any time, and it’s most common in people ages 12 to 18. You’ll feel a sudden, sharp pain when this happens. Testicular torsion is a medical emergency, and you need surgery to treat it.
- Varicocele. A group of abnormally large veins in your scrotum is called a varicocele. They can ache during activity, and they may feel better when you rest.
Sometimes, testicular pain happens because of issues in other places in your body.
- Inguinal (groin) hernia. If you have a weak section in your belly muscles, part of your intestines can push through. When this happens near your groin, it’s called an inguinal hernia. Inguinal hernias aren’t typically dangerous, but you may need surgery.
- Prostatitis. This inflammation of your prostate, a small gland below your bladder that helps with making semen, may make your groin area ache.
Testicular pain after ejaculation
Typically, pain after ejaculation (orgasm) happens in the penis, but sometimes it may affect your testicles. Some possible causes include:
- Prostatitis
- Nerve and muscle pain
- Stones blocking the ejaculatory duct
- The effects of surgery or radiation
- Some sexually transmitted infections
- Taking antidepressants
Testicular pain and back pain
Sometimes, pain that starts in the back can radiate into the testicles or come with testicle pain. Two common causes of back pain that can also cause testicular pain include:
- Kidney stones. Kidney stones are hard mineral deposits that form inside your kidneys. When they block your ureter (the tube that carries urine from your kidneys to your bladder), you may feel pain in your testicles, scrotum, groin, or back.
- Urinary tract infection (UTI). An infection in your urinary tract, including your kidneys, ureters, bladder, or urethra, may cause pain in your back as well as your testicles.
Testicular Pain Symptoms
Depending on what’s causing your testicular pain, it can be:
- Acute (coming on suddenly, rising sharply, and over after a short period)
- Chronic (growing over time and lasting a long time)
- Severe
- Dull
Along with your pain, you may also have:
- Bruising on your scrotum (if your pain is from an injury)
- Nausea and vomiting
- Swelling
- Abnormal coloring (red, purple, brown, or black)
- A lump
- Fever
- Problems peeing (going more often or a burning sensation when you go)
Testicular Pain Diagnosis
You can see your primary care doctor for testicular pain. Sometimes, it may be necessary to see a urologist for a more specific examination, or a nephrologist if the cause of your pain involves your kidneys.
Your doctor will give you an exam and ask you about your symptoms and medical history. They’ll ask how long your pain has been going on, what kind of pain it is and where, if certain activities (such as sex) are more difficult, and whether anything relieves the pain.
They may also need to do some tests to get more information. You may have:
- A blood test to look for signs of infection
- A urinalysis (pee test) to look for signs of infection
- An ultrasound to look closer at any lumps you may have to test for cancer
- Tests of prostate fluids to look for infection or other problems
Testicular Pain Treatment
The treatment you need for testicular pain depends on what’s causing it. Some causes of testicular pain will go away on their own, without treatment. Others need treatment with medication or surgery.
Some medications that can treat testicular pain include:
- Antibiotics. If your pain is coming from a bacterial infection, an antibiotic can help it go away. Antibiotics can’t treat viral infections.
- Antidepressants. Tricyclic antidepressants can treat nerve pain.
Some types of testicular pain need surgery to get better. A surgeon may perform:
Testicular de-torsion. If your pain is from testicular torsion, that’s an emergency that needs surgery right away to untwist your testicles and get blood flowing to the area again. Your surgeon can also stitch your testicles to the inner wall of your scrotum so they won’t twist again.
Hernia repair surgery. A surgeon can repair an inguinal hernia by pushing your intestines back into your belly area and stitching the opening closed.
Epididymectomy. Rarely, pain in the epididymis may keep happening over a long period of time. If no other treatment works to treat it, a surgeon may remove it.
Shock wave lithotripsy. This is a minimally invasive surgery that can break up kidney stones using high-energy shock (pressure) waves.
Microdenervation of the spermatic cord (MDSC). When you have nerve pain (neuralgia), your surgeon may cut the nerves that run to your testicles.
Orchiectomy. In certain cases, it may be necessary to remove one or both of your testicles. This is typically only if you have cancer in your testicles, or other medications and procedures haven’t solved the issue.
Managing Testicular Pain
There are steps you can take at home to relieve discomfort when your testicles hurt.
These include:
- Support your scrotum and give it rest with an athletic supporter (jock strap) or by lying down and placing a folded towel underneath it.
- Wrap ice in a towel or cloth and hold it on your scrotum.
- Soak in a warm bath.
- Take over-the-counter pain relievers such as acetaminophen or ibuprofen.
If your pain lasts longer than an hour, contact your doctor.
Testicular Pain Complications
If you leave testicular pain unchecked, you could have complications.
Testicular cancer or other conditions that require a surgeon to remove a testicle will lower your sperm count. Your body may also make antibodies that change the way your sperm moves and make it harder to fertilize an egg.
Bottom line: Don’t ignore testicular pain, especially if it lasts more than an hour.
Takeaways
Testicular pain is pain that affects one or both of your testicles or scrotum. Causes include injury, inflammation, infections, fluid buildup, a mass, or a medical emergency. Your doctor or specialist can help diagnose the cause and treat the problem with medication or surgery.
Testicular Pain FAQs
When should I worry about testicle pain?
If you have sudden, severe testicle pain, or you also have nausea, fever, chills, or blood in your urine, you should see your doctor right away. This could be a sign of testicular torsion, or a twisted testicle, which can cut off blood supply to the area. You should also talk to a doctor if you feel a lump in your testicle or have swelling in the area.
How can I make testicle pain go away?
For mild testicle pain, you can take an over-the-counter pain reliever such as aspirin, ibuprofen, or acetaminophen. You can also try supporting your testicles while lying down with a folded towel or cold relief with an ice pack. Consult a doctor if these methods don’t help.
What does a urologist do for testicular pain?
A urologist is a doctor who specializes in the urinary tract and reproductive system. They can help find the cause of your testicular pain and make a treatment plan.
What causes testicular pain?
Sometimes, doctors can’t find the cause of testicle pain. This is called idiopathic testicular pain. Your doctor may look for problems in other parts of your body that could be causing your pain, such as a hernia or kidney stones.
What’s mistaken for testicular pain?
Several conditions can cause pain in your testicles, even though the root cause isn’t in your testicles. These include hernias, kidney stones, some lower back pain, and pelvic floor dysfunction.
Can sperm buildup cause testicular pain?
If one of the tubes carrying sperm from your epididymis to your scrotum gets blocked, sperm can build up and cause a cyst called a spermatocele. These cysts can be painful.
