What is testicular pain?

The testicles are a sensitive part of the male body. Even relatively minor injuries to them cause great pain, and many conditions can affect them.
Testicles hang from the body in a pouch of skin called the scrotum. They play a necessary role in the male reproductive system, producing sperm and testosterone, the male sex hormone.
Given their sensitivity, occasional testicular pain or discomfort is normal and usually resolves itself. However, sharp, sudden, or especially severe pains are signs of an underlying condition and possibly a medical emergency. Left untreated, severe testicular pain can lead to:
- Infertility
- Loss of one or both testicles
- Infection
- Abscesses
Signs and symptoms of testicular pain
Minor testicular pain is often caused by posture or a small injury and is easily corrected. But it is also a sign of many serious conditions. Pay attention if you feel:
Sudden, sharp pain
The appearance of sudden and severe pain is a serious warning sign you shouldn’t ignore. The pain could involve one or both testicles and may not be of equal intensity on either side. Pain of this nature could be a sign of medical emergency.
Swelling
Swelling of the scrotum or testicles can happen on either one or both sides, and at any age. Any amount of swelling in the scrotum or testicles is cause for concern, though sometimes it may only be a response to injury.
Fevers are an important immune response that act as a warning sign from your body. Testicular pain and fever together could be a sign of infection that needs evaluation by a doctor.
There are many other signs of testicular problems that you should monitor carefully, such as:
- Lumps in either testicle
- Changes in testicle size
- Burning urination
- Frequent urination
Many conditions share these symptoms, for which reason a doctor should see and evaluate you if you have testicular pain.
Causes of testicular pain
The complexity of the reproductive system can make it difficult to find the reasons behind testicular pain. Your doctor can help you assess your symptoms and pin down the exact cause. For instance, testicular pain is often caused by:
Trauma is a common cause of testicular pain. Since the testicles are external rather than internal, they are exposed to many possible injuries in daily life, some of which don’t necessarily hurt right away. Inflammation and pain in nearby body parts often accompanies testicular pain caused by trauma.
Testicular torsion is a medical emergency that occurs when the spermatic cord, the pathway of blood to the scrotum, becomes tangled or obstructed in some way. Most common in young boys and teenagers, testicular torsion almost always needs immediate surgical intervention to clear.
Epididymitis
The epididymis is the part of the scrotum that attaches to the sides of the testis, and inflammation of the epididymis is called epididymitis. While its symptoms resemble those of testicular torsion, the most common cause, though not only the only cause, of epididymitis is a sexually transmitted disease, namely gonorrhea.
In addition to these, other possible causes of testicular pain include:
- Hernias
- Testicular cancer
- Orchitis, inflammation of the testicle(s)
- Varicocele, enlargement of the veins in the scrotum
Some conditions and environmental factors may make you more prone to developing serious testicular problems. Some of these are:
- Undescended testicles
- Family history of testicular cancer
- Certain occupations like miners and gas workers
- Human Immunodeficiency Virus (HIV)
It’s very difficult to find the cause of testicular pain on your own. An accurate diagnosis by a trained physician is needed to ensure a good outcome from testicular pain.
Diagnosing testicular pain
Your doctor will perform a physical exam and ask you questions about your pain: how long you’ve felt it for, where it is located, and so on. You’ll also probably be asked some routine questions about your medical history, diet, and lifestyle.
Various tests may be ordered depending on your answers and the physical examination results. For example, epididymitis may be diagnosed through urinalysis. A testicular ultrasonography may be used to find deeper problems hiding within the testes themselves.
Treatments for testicular pain
Treating testicular pain depends on the condition that causes it. Sometimes you may be sent home only with instructions to rest with a cold pack and sometimes you may need a full course of antibiotics.
A few other therapies and surgical options for testicular conditions are:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Hormonal replacement therapy, for low testosterone
- Orchiopexy, a surgery to treat testicular torsion
- Varicocele repair, a surgical intervention for varicocele
- Hydrocelectomy, a surgical intervention for hydrocele (scrotal swelling)

SLIDESHOW
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American Family Physician: "Diagnosis and Treatment of the Acute Scrotum."
Beaumont Health: "Signs and Symptoms of Scrotal and Testicular Conditions."
Beaumont Health: "Treating Scrotal and Testicular Conditions."
Centers for Disease Control and Prevention: "Epididymitis."
Columbia University Herbert Irving Comprehensive Cancer Center: "Testicular Cancer: Risk Factors."
Mount Sinai Health System: "Scrotal swelling."
Ultrasound International Open: "Severe Acute Epididymo-Orchitis Complicated with Abscess and Testicular Necrosis — Case Report."
University of California San Francisco Department of Urology: "Testicular Pain."
University of Iowa Hospitals & Clinics: "Testicular pain."
University of Utah Health: "Chronic Testicular Pain."
Urology Care Foundation: "Testicular Torsion."
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