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Why Do My Testicles Hurt? Causes and Treatment of Testicular Pain

Life throws its fair share of aches and pains. Muscle pain, back pain, sports injuries, stomach issues – you name it. But when it comes to your nether regions, it’s a whole different ball game.

Testicular pain (also known as scrotal pain) may feel embarrassing to discuss with your health care provider but it isn’t something you should ignore. There are very normal explanations for the ache, but there are also some serious reasons why you should get checked out.

What are the common causes of pain in the testicle?

The testicles, also known as testes, are housed within a protective pouch of skin called the scrotum. 

“The scrotum or scrotal sac not only contains the testicles, which are important to the reproductive system, but also includes many nerves, veins and arteries,” said Thomas Sirrine, PA, a family medicine physician assistant with Banner Health. 

While the scrotum provides some protection, its location is sensitive to injuries, infections and other conditions. 

Trauma or injury

One of the most common reasons for testicular pain is physical trauma or injury to the testicles. Accidents, sports-related injuries or direct blows to your groin can result in swelling and pain. 

Treatment: See your provider for medical care if you are experiencing severe pain and swelling. Mild pain can be treated with rest, icing and pain medications.

Testicular twisting (torsion)

Have you ever felt a sudden, intense pain in your groin? It could be your groin muscle or twisting of the testicle.

“Testicular torsion happens when part of the testicle wraps around itself, cutting off blood supply to the testicle,” Sirrine said. “It can cause intense pain, swelling and possibly nausea and vomiting.”

Treatment: If you think your testicles are twisted, you should have someone take you to the emergency room (ER) to confirm the diagnosis as testicular torsion is an urgent concern that requires treatment. Surgery may be needed to reposition your testicle and prevent future problems like infertility. 

Epididymal hypertension 

“Blue balls” is the slang term you may be more familiar with regarding this condition. It happens when you have prolonged arousal, but you don’t ejaculate. This causes sperm to build up in the epididymitis, a structure within your testes.

Treatment: “While epididymal hypertension can be painful, it is not dangerous,” Sirrine said. “It usually gets better on its own without treatment.” 

Infections

Infections like urinary tract infections (UTIs) and sexually transmitted infections (STIs) like chlamydia and gonorrhea can cause your testicles to swell or become inflamed. They can also cause inflammation of the epididymitis as well. You may notice discharge, pain when you go pee and blood in your semen. 

Treatment: If the pain is due to an infection, your provider may prescribe antibiotics or medications to treat the underlying issue. It is important to notify any sexual partners if you have been diagnosed with an STI, so they can get tested and treated as well.

Varicocele

A varicocele is a group of abnormally large veins in your scrotum. It occurs most often in the left teste but can affect the right or both. Varicocele can cause a dull ache or pain.

Treatment: Often, varicoceles are not treated. If it causes discomfort, wearing snug underwear, icing and taking pain medication may help. If you have continued pain or the varicocele is affecting your testicles, your provider may recommend surgery. 

“Varicocele is one the most common causes of male infertility,” Sirrine said. “It may require a small surgery to bypass the affected veins and make the blood flow through healthy ones.”

Other possible causes for your testicular pain:

Could my testicular pain be a sign of cancer?

Testicular cancer rarely causes pain. Men are at highest risk for testicular cancer between the ages of 15 to 40. That said, it’s important not to ignore any pain, swelling or changes in your testicle size or lumps.

Treatment: “Testicular cancer is rare, but it is quite treatable when caught early,” Sirrine said.

Ways you maintain good testicular health

Your testicular health requires a lifelong commitment. While some causes of pain can’t be prevented, there are things you can do to reduce your chances and keep things running smoothly below the belt.

  • Wear an athletic supporter or protective cups when playing sports to prevent injury.
  • Practice safe sex, including the use of condoms.
  • Don’t wait to go pee. Empty your bladder completely when you feel the urge.
  • Wear loose-fitting underwear and pants to allow your testicles to hang naturally from your body. This will keep their temperature low for proper sperm production. 
  • Don’t smoke.
  • Do monthly testicular self-exams. 

“Self-testicle exams are an easy way to learn how your testicles normally look and feel, so you are more likely to notice changes,” Sirrine said. “It can be completed in less than 10 seconds and should be done once a month.”

How to perform the 10-second testicular self-exam:

  • Place your right hand on your right teste.
  • Gently roll it around between your fingers and thumb. It should feel like a hardboiled egg.
  • Repeat with your left teste.
  • If you notice any lumps or bumps, let your provider know.

Takeaway

Testicles shouldn’t be painful unless something is going on. Don’t hesitate to check with your health care provider or a Banner Health specialist for pain or discomfort. Most causes of testicle pain can be treated, getting you back on top of your A-game. 

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