What Causes Testicular Pain?

Those with testes know that being hit in the groin area is not a pleasant feeling.

Since the testes are so sensitive, a direct hit can cause serious pain.

Paired organs located inside of the scrotum, testes are responsible for sperm and testosterone production.

This article will discuss the possible causes of testicular pain and how to diagnose and treat it.

What Is Testicular Pain?

Testicular pain is discomfort in one or both testes.

Pain may be spread to different regions, including the groin, penis, or leg.

In some cases, testicular pain can result in permanent damage to the area. 

There are a few situations in which immediate medical attention may be required when one experiences testicular pain, which can either be acute or chronic and can often be severe, since the testes have sensitive nerves.

Who Is Most at Risk?

People of all ages with testes can experience testicular pain.

Those who perform heavy physical work, play full-contact sports, or have experienced testicular pain before may be at a higher risk.

Possible Causes

Epididymitis

Epididymitis refers to inflammation of the epididymis, which is the tube at the back of the testicle that carries sperm to the sperm duct and out of the body. 

Epididymitis can be caused by a sexually transmitted infection (STI) or bacteria, and sometimes occurs when urine flows backward into the epididymis.

Symptoms include:

• Scrotum pain that can often spread to the rest of the groin
• Swelling and redness of the testicle
• Blood in the semen
• Fever and chills
• Painful urination

Kidney Stones

Kidney stones are irregularly-shaped masses in the kidney that are often extremely painful. 

You can have a kidney stone for years and not even realize it’s there if it remains in place.

Pain typically occurs when the stone begins to move out of your kidney.

About 10% of people will get a kidney stone in their lifetime. Symptoms include:

• Pain in your back or side
• Blood in your urine 
• Painful urination
• Nausea/vomiting in addition to pain
• Testicular pain, or pain in the lower abdomen or other areas of the groin

Orchitis

Orchitis is the inflammation of one or both testes that is most often caused by an STI or another type of bacterial infection.

It can be associated with epididymitis. In this case, it’s called epididymo-orchitis. Symptoms include:

• Swelling in one or both testes
• Mild to severe testicular pain
• Fever
• Nausea and vomiting
• General feeling of discomfort or pain (malaise)

Hernias

An inguinal hernia occurs when the intestines or abdominal fat pushes through the lower abdomen wall into the groin area.

Hernias are a common condition and can occur in various areas of the body including around the belly, through a scar from surgery, or in the diaphragm. 

About 25% of people with penises experience inguinal hernias in their lifetime, compared to just 2% of those with vaginas.

It’s possible for inguinal hernias to cause no symptoms, but potential symptoms include:

• A bulge on one or both sides of the groin
• Groin pain
• Weakness, heaviness, or burning in the groin area
• Swollen scrotum

Varicoceles

Varicoceles are enlargements of veins in the scrotum that occur when blood collects in the veins rather than exiting from the scrotum.

The enlargement typically forms during puberty and develops over time, causing poor development of the testicle. This can result in low sperm production and other infertility issues. 

A varicocele usually occurs on the left side of the scrotum. It’s possible to cause no symptoms, but possible symptoms may include:

• Testicular pain or discomfort when standing or late in the day
• A mass in the scrotum
• Testes that are noticeably different sizes
• Infertility

Trauma/Injury

Testicular pain can be a result of trauma or injury.

A hematocele, which occurs when blood surrounds the testicle, can result from an injury such as a direct blow to the testicle. 

A hydrocele, which is when fluid pools in the thin sheath surrounding the testicle and causes the scrotum to swell, can occur due to inflammation or injury to the scrotum.

Cancerous Tumors

Testicular cancer is the most common cancer in people with penises aged 15-35.

A cancerous tumor in the testicle can cause swelling or a hard nodule, aching or pain in the groin or testes, and aching in the lower abdomen or scrotum.

Testicular tumors can be treated if caught early by using imaging methods for examination. 

Testicular Torsion

Testicular torsion refers to when the testicle gets twisted inside the scrotum and loses blood.

When this happens, the testes’ blood vessels become twisted and blood supply gets cut off.

Pain from testicular torsion is sudden and can involve nausea and vomiting.

Other symptoms include sudden severe pain in one testicle, visible swelling on one side of the scrotum, and a visible lump in the testicle.

Seek medical attention right away if you experience testicular torsion.

Emergency surgery must be done to save the testicle from further blood loss.

Other Causes

Post-vasectomy pain syndrome is testicular pain that can be a result of a vasectomy, caused by increased pressure in the tubes that carry sperm (vas deferens) or epididymis.

Infections, such as the mumps or STIs, are also causes of testicular pain.

Diagnosing the Cause

If you have testicular pain or have had recent high-risk sex, consider seeking medical attention.

The doctor will examine you as you’re standing up and lying down.

They’ll ask you questions about:

• Your pain and how long you’ve had it
• The severity of your pain
• Where exactly you’re experiencing the pain
• Sexual, medical, and surgical history

Blood and urine tests can help rule out infections as a cause for testicular pain.

An ultrasound will be able to check for cancer. If you’re diagnosed early, testicular cancer has a high cure rate. 

If you think you have an STI and are experiencing mild to severe testicular pain, consider getting tested for chlamydia and other infections.

You might not experience symptoms of an STI right away, but they can often occur weeks after infection.

Treating Testicular Pain

There are many ways to treat testicular pain, including both at-home remedies, over-the-counter medications, and medications that your healthcare provider may prescribe.

Here are some options you can employ yourself:

• Apply ice to the groin area
• Lie down and place a rolled up towel under your scrotum
• Wear a cup or athletic supporter
• Take warm baths
• Take non-prescription pain relievers
• Have regular checkups to examine health and development of the testes 

Orchitis and epididymitis caused by a bacterial infection should be treated with antibiotics.

Surgery isn’t usually required to treat testicular pain, but you may need surgery if you have an emergency condition. If you’re diagnosed with testicular cancer, you’ll likely require surgery to remove one or both of your testes. 

Types of surgeries include:

• Testicular detorsion: A procedure used to treat testicular torsion
• Hernia repair surgery: A procedure to treat a hernia
• Epididymectomy: A procedure used to remove the epididymis
• Vasovasostomy: A procedure used to reverse a vasectomy
• Shockwave lithotripsy: A procedure to treat kidney stones

When to Seek Medical Attention

Children should have annual checkups to monitor the health of their testes and to ensure that various testicular issues don’t occur. 

Adult should seek medical attention if you’re experiencing any of the following:

• If you have pain or swelling in your scrotum, especially if the pain occurs suddenly
• If you suspect you have an inguinal hernia, see a doctor before it develops into a serious condition
• If you see scrotal swelling
• If you have any pain associated with trauma that’s sudden and severe (consistent with testicular torsion), or that’s associated with a nodule inside the testicle