Testicular Pain

What is testicular pain?

Testicular pain can affect anyone with testicles (testes) at any age. Your testicles are small, egg-shaped reproductive (sex) organs. They rest inside your scrotum, which is a thin pouch of skin behind your penis. Most people assigned male at birth (AMAB) have two testicles — one each on the left and right side of their scrotum.

If you have testicular pain, you may feel it in one or both testicles. However, the pain may not actually be coming from the testicles themselves. The pain may come from another part of your body, like your stomach or groin. This type of pain is referred pain.

Testicular pain can be acute or chronic. “Acute” means that it develops suddenly, rises sharply and lasts a short period. “Chronic” means that the pain gradually grows and it lasts for a long period. Your testicles contain many sensitive nerves, which can make testicular pain severe.

If you have testicular pain that lasts for more than an hour, reach out to a healthcare provider.

Go to an emergency room (ER) if you have intense testicular pain. It could be a sign of testicular torsion, which is a serious medical emergency.

Is it normal to have a testicle ache?

No, it isn’t normal to have a testicle ache.

Your testicles are sensitive, so any impact or trauma to them can cause temporary pain. But if you have consistent testicular pain that lasts more than an hour, talk to a healthcare provider. You may have a more serious condition that affects your testicles.

How do you know if testicular pain is serious?

Talk to a healthcare provider or go to the ER immediately if you have:

• Sudden, intense pain in one or both of your testicles.
• Testicular pain along with nausea and vomiting and/or abdominal (stomach) pain.
• Swelling.
• Testicular pain that lasts for more than an hour or doesn’t get better while you’re resting or lying down.

Who is most at risk of testicular pain?

Anyone with testicles at any age can get testicular pain. But you may be at a higher risk of developing testicular pain if you do heavy physical work or play contact sports (baseball, football, hockey, soccer, lacrosse, martial arts).

What is the main cause of testicle pain?

There are many common causes of testicular pain. The cause may be obvious if you have had a recent injury or accident while playing a sport or exercising. But in other cases, it may not be obvious why you have pain.

Some other common causes of testicular pain may include:

• Orchitis. Orchitis is when a bacterial or viral infection causes inflammation in one or both of your testicles. In children, the mumps virus is a common cause of orchitis. If the mumps causes orchitis, swelling usually starts four to six days after the start of your mumps symptoms.
• Inguinal (groin) hernia. An inguinal hernia occurs when part of your intestine pushes through a weak part of your abdominal muscles near your groin. It’s usually not dangerous, but in rare cases it can be painful and may require urgent surgery.
• Epididymitis. Epididymitis is inflammation that affects your epididymis. Your epididymis is a tightly coiled group of thin tubes that carry sperm from your testicles to your sperm duct and eventually out of your body when you orgasm. If you have epididymitis, your scrotum may swell and feel hot to the touch. The infection can last for weeks.
• Spermatocele. A spermatocele is a fluid-filled cyst that can form inside your epididymis near your testicle. Spermatoceles aren’t cancerous, and they usually aren’t painful, but they can grow large and become uncomfortable.
• Hydrocele. A hydrocele is when abdominal fluid builds up in your scrotum around one or both testicles. Hydroceles are common, especially in babies.
• Hematocele. A hematocele is when blood collects around one or both of your testicles. Hematoceles usually develop after an injury.
• Varicocele. A varicocele is a group of abnormally large veins in your scrotum. Varicoceles may ache or cause pain during daily activities. Pain or discomfort usually improves when you lie down.
• Testicular torsion. Testicular torsion is when the spermatic cord twists and cuts off blood flow to a testicle — usually your left testicle. It causes a sudden sharp pain. It can occur at any time. Testicular torsion is a medical emergency that requires surgery.
• Kidney stones. A kidney stone is a solid mass or crystal that develops in your urinary system. The stones can block your ureters (the tubes that drain pee from your kidney into your bladder) and cause pain in your testicles, scrotum, groin or back. You may be able to pass small stones when you pee, but larger stones may need surgery.
• Post-vasectomy pain. A vasectomy is a surgical procedure that seals the vas deferens, which are the tubes that carry sperm. It’s a type of birth control. Some people who get a vasectomy have testicular pain afterward due to higher pressure in the vas deferens or epididymis.
• Testicular cancer. Testicular cancer is the most common cancer in people AMAB between the ages of 15 and 35. It may present as a dull ache or pain in your testicles or groin.

What other symptoms may occur alongside testicular pain?

Other symptoms that may occur alongside testicular pain include:

• Bruising. Bruising may occur on your scrotum after an injury to your testicles.
• Nausea and vomiting. Feeling sick to your stomach and/or vomiting can be a symptom of many conditions that cause testicular pain, including an injury, orchitis or kidney stones.
• Swelling. Swelling or a lump may appear in your scrotum. Your scrotum may appear discolored (red, purple, brown or black) or shiny. Swelling can be a symptom of an injury or an infection.
• Fever. Fever that appears along with testicular pain is often a sign of an infection.
• Problems peeing. Kidney stones can cause you to pee a lot (frequent urination). They can also cause a burning sensation when you pee or blood in your pee (hematuria).

Can testicular pain be caused by a sexually transmitted infection?

Yes. Testicular pain is a symptom of some sexually transmitted infections (STIs). STIs can affect multiple parts of your body, including your testicles. They may cause testicular swelling or inflammation.

STIs that may cause testicular pain include:

• Gonorrhea.
• Syphilis.
• Chlamydia.

How is testicular pain diagnosed?

A healthcare provider will review your medical history and perform a physical examination. They’ll examine your testicles as you’re standing up and lying down. During the physical exam, they may ask the following questions:

• When did your pain start?
• How long have your testicles hurt?
• Where exactly do you have pain?
• Have you had a recent injury to your abdomen or groin?
• Do any activities improve your pain or make it worse, like going to the bathroom, exercising, masturbating, having sexual intercourse or sitting?

They may also ask about your sexual history.

The provider may order the following tests:

• Blood test. A blood test can help rule out an infection as a possible cause of testicular pain.
• Urinalysis (pee test). A urinalysis can also help rule out an infection.
• Ultrasound. If the provider feels a lump in your testicle, they may order an ultrasound to help diagnose testicular cancer.

How is testicular pain treated?

You may be able to ease your testicular pain at home. Some remedies may include:

• Apply a cold compress or an ice pack to the area. Wrap the ice or cold pack in a towel and apply it intermittently throughout the day for no more than 15 minutes at a time.
• Place a rolled-up towel under your scrotum while lying down on your back.
• Take a warm bath.
• Take nonsteroidal anti-inflammatory drugs (NSAIDs). Not everyone can take NSAIDs, so it’s a good idea to talk to a provider first.

If home remedies don’t work, talk to a healthcare provider. They can prescribe medications that help reduce pain, including:

• Antibiotics or anti-infective medications. These medications can treat a bacterial or viral infection.
• Tricyclic antidepressants (TCAs). Some antidepressants — including amitriptyline — can treat nerve pain.

Can testicle pain go away on its own?

Testicular pain may or may not last, depending on whether it’s acute or chronic. If a simple injury — like a sudden hit or fall — causes pain, it should only hurt for about an hour. If your pain lasts longer than that or worsens, seek medical attention immediately.

Who treats testicular pain?

A primary care physician (PCP) can help treat testicular pain and diagnose underlying conditions. If they suspect you have a more serious condition, they may refer you to a specialist, including:

• Urologist. A urologist is a healthcare provider who specializes in conditions that affect your urinary tract and reproductive system.
• Nephrologist. A nephrologist is a healthcare provider who specializes in conditions that affect your kidneys.

Is surgery needed for testicular pain?

It depends on what’s causing testicular pain. If you have an emergency condition like testicular torsion or testicular cancer, you need surgery.

Types of surgery for testicular pain may include:

• Testicular de-torsion. This is an emergency surgery to untwist the spermatic cord and restore blood flow to one or both of your testicles. They’ll then use stitches to secure your testicles to the inner wall of your scrotum to prevent testicular torsion from happening again.
• Hernia repair surgery. This procedure pushes your hernia back into your abdomen and reinforces your abdominal wall with stitches or synthetic mesh.
• Epididymectomy. If you have chronic pain in your epididymis, a surgeon may remove it. This isn’t a common procedure. A provider will only recommend it if you don’t respond to other treatment options.
• Vasectomy reversal. If you have chronic testicular pain after a vasectomy, a surgeon may reverse the vasectomy to relieve pressure in your vas deferens or epididymis. A vasectomy reversal is rarely necessary to treat testicular pain.
• Shock wave lithotripsy. This minimally invasive procedure uses high-energy shock (pressure) waves to break up kidney stones.
• Microdenervation of the spermatic cord (MDSC). A surgeon cuts the nerves that pass through your spermatic cord to relieve testicular pain.
• Orchiectomy. If you have testicular cancer or medications or less invasive procedures don’t relieve testicular pain, a surgeon may remove one or both of your testicles.

Can testicular pain be prevented?

The following tips may help prevent testicular pain:

• Treat any conditions that may cause testicular pain.
• Wear an athletic cup to protect your testicles if you play sports or participate in rigorous activities.

When should testicular pain be treated by a doctor or healthcare provider?

You should immediately call a healthcare provider if you have testicular pain or swelling, especially if the pain gets worse or if you feel sick. If you have testicular torsion symptoms, make sure to get to an emergency room as soon as possible.

Should I ignore testicular pain?

No, you shouldn’t ignore testicular pain. If you have testicular pain for more than an hour or if it worsens, seek medical care immediately.

Can I still have children after losing a testicle?

In many cases, one healthy testicle can make enough sperm for you to have biological children. You should still be able to have and maintain erections normally. Your testosterone levels should stay the same too.

If you have surgery to correct testicular torsion, you may have a lower sperm count. You might also have antibodies in your system that affect how your sperm move. If you had testicular torsion as a child, you might also have a lower sperm count. In that case, it’s a good idea to have a semen analysis if you’re having any difficulties achieving pregnancy.

Can sitting for long periods cause testicular pain?

Yes, repeatedly sitting for long periods can cause testicular pain. Crossing your legs can also cause pain. Many people can decrease testicular pain by standing or moving more and sitting less.

A note from Cleveland Clinic

Testicular pain can develop suddenly and only last a short time, and you may be able to treat it at home. It can also gradually get worse and last for a long period, especially if it’s a symptom of a more serious condition. As a general rule, if you have severe, sudden testicular pain or if the pain doesn’t go away after an hour, talk to a healthcare provider. You may feel self-conscious talking about such a sensitive part of your body, but pain is your body’s way of telling you that something is wrong. Getting medical attention is crucial to increasing your chances of the best possible outcome.