Testicle Pain

On This Page: Causes | Concerns | Diagnosis | Treatment | Prevention

What Is Testicle Pain?

Testicle pain is pain in one or both testicles, the male sex glands that make and store sperm and produce testosterone. Testicle pain can be temporary or constant and may vary between a dull ache, a sharp pain, soreness, or vague discomfort. The pain may come from different sources, including the testicle itself, the supporting tissue behind the testicle (called the epididymis), or somewhere else in the groin or abdomen. Testicular pain can also be accompanied by testicle swelling in the scrotum (the sac under the penis that contains the testicles).

The testicles are very sensitive to even minor injury, and there are many possible causes of pain, including infection by sexually transmitted diseases (STDs) like chlamydia and gonorrhea. Sometimes, testicle pain can be a medical emergency.

Causes of Testicular Pain

The following are common causes are testicular pain:

• Epididymitis – An inflammation of the coiled tube at the back of the testicles which stores and carries sperm. According to the CDC, chlamydia and gonorrhea are the most common causes for men 35 and under.¹
• Orchitis – An inflammation of the testicles. It can be caused by viral or bacterial infections, such as an STD or the mumps virus. It may occur along with other infections of the prostate or epididymis.²
• Injury –  Because the testicles hang outside the body in the scrotum, they can be vulnerable to accidents and injury. While many typical injuries are minor and temporary, if you get hit hard enough or if the scrotum is penetrated, it can cause serious damage and require medical attention.³
• Testicular torsion – A testicle twists on the spermatic cord, cutting off blood to the scrotum. This causes sudden and often severe pain and requires immediate medical attention. Testicular torsion may lead to serious damage or loss of the testicle.⁴
• Kidney stones – Hard, pebble-like deposits that form inside your kidneys when there are high levels of certain minerals in your urine.  When men with kidney stones have a stone that gets close to passing, the pain may radiate to the testicle(s).⁵
• Inguinal hernia – When part of the intestines bulges through a weak spot in the abdominal wall. If a hernia becomes stuck, it can cut off blood flow to the tissue that’s trapped and be life-threatening. An inguinal hernia may look like a mass or lump in the scrotum or higher up in the groin.⁶
• Varicocele – When veins inside your scrotum become enlarged, like a varicose vein, it can lower sperm production and impact fertility and testosterone production. The appearance is often described as “a bag of worms.”⁷
• Hydrocele – A buildup of fluid around one or both testicles inside the scrotum. Although hydroceles usually aren’t painful or harmful, they can cause discomfort and may be associated with conditions such as an infection or injury.⁸
• Spermatocele – A cyst that occurs close to a testicle, in the epididymis (a coiled tube at the back of the testicle). It is a fluid-filled mass that is usually benign (not cancerous) and may contain dead sperm. Although spermatoceles are often painless, they can cause discomfort or pain in the testicle if the cyst grows too large.⁹
• Testicular cancer – When malignant (cancer) cells form in the testicles. Testicular cancer may cause a painless lump or swelling in either testicle, changes in how the testicle feels, or pain/discomfort in the testicle or scrotum. Although it’s fairly rare, testicular cancer is the most common cancer in men 20 to 35 years old.¹⁰

Should You Be Concerned?

Pain in the scrotum or testicles is concerning and should be evaluated. Certain medical conditions that cause testicle pain are very serious and require immediate treatment. Ignoring testicular torsion or an untreated infection such as chlamydia or gonorrhea can result in permanent damage to your testicles that can affect your ability to father children. To avoid complications and protect regular testicular function, it’s important to get examined by a doctor and be tested and treated as necessary.

You should seek medical attention if you:

• Experience testicular pain that is sudden or severe
• Feel pain along with other symptoms like nausea and vomiting
• Have an injury that causes pain or swelling for longer than an hour
• Feel a lump in your scrotum

Diagnosis for Testicle Pain

To diagnose what is causing your testicular pain, a doctor examines the scrotum and testicles. They may ask questions about the pain, including when it started, where it’s located, and how severe it is, in addition to questions about your sexual and medical history. They may perform a physical exam, order blood or urine tests to check for an infection, or order other tests such as imaging or swabbing.

If you are concerned that a sexually transmitted infection may be the source of your pain, you can directly order blood and urine testing through STDcheck.com to get tested quickly and easily at one of our local labs.

Treatment

The treatment options for testicular pain depend on the underlying problem. Certain conditions may require medication, or in more serious cases, surgery.

If you test positive for an STD through our service, our doctors offer a consultation and can prescribe antibiotic medication to cure chlamydia, gonorrhea, and trichomoniasis and antiviral medication to treat herpes.

Prevention

Testicle pain isn’t always preventable, but taking certain steps can help protect you. These steps include:

• Use condoms every time you have oral, vaginal, or anal sex
• Examine your testicles once a month for suspicious lumps
• Stay hydrated
• Empty your bladder when you pee, and avoid holding it in when you feel the urge
• Wear a jockstrap when playing sports, including a well-fitting protective cup
• Use caution when near machinery that could snag your clothing or skin, and follow all safety rules

Medically Reviewed by Joshua Hwang, MD on February 25, 2023