Testicle pain

Testicle pain can affect one or both testicles. It may come from the testicle itself, the coiled tube behind it called the epididymis, or another part of the groin or abdomen.

The pain may begin suddenly or build over time. It can follow an injury, infection, heavy activity, or prolonged pressure. Sometimes pain travels to the testicle from a kidney stone, hernia, back problem, or another nearby structure.

Most causes are treatable. However, sudden severe pain can be caused by testicular torsion. This means the testicle has twisted around its blood supply. Torsion requires emergency assessment because prompt treatment gives the best chance of protecting the testicle.

Testicle pain may feel like a dull ache, sharp pain, throbbing, pressure, or heaviness. Touching the testicle or moving around may make it worse. Pain can also spread into the groin, lower abdomen, or back.

Other changes can help point toward a cause:

• Swelling, warmth, or redness of the scrotum
• A testicle sitting higher or at a different angle
• A lump, enlarged vein, or change in size
• Burning when urinating or needing to urinate more often
• Discharge from the penis
• Fever, nausea, or vomiting
• Pain after exercise, sex, lifting, or an injury

Symptoms alone cannot reliably identify the cause. In particular, it may be difficult to tell torsion from infection without an urgent examination.

Minor injury or strain can cause soreness after sport, exercise, sex, cycling, or a direct knock. Pain from a mild injury usually settles, but increasing swelling or severe pain needs prompt assessment.

Epididymitis is inflammation of the epididymis, the tube behind the testicle that stores and carries sperm. It is often caused by an infection. Pain commonly develops more gradually and may occur with swelling, urinary symptoms, fever, or penile discharge. Sexually transmitted infections are one possible cause, but they are not the only cause.

Pain from elsewhere may be felt in the testicle even when the testicle is not the source. Examples include a groin muscle strain, an inguinal hernia, a kidney stone, or irritation of nerves in the back or pelvis.

Less common causes include inflammation of the testicle itself, called orchitis; fluid around the testicle, called a hydrocele; and enlarged scrotal veins, called a varicocele. Pain can also continue after groin or scrotal surgery.

Testicular cancer more often causes a painless lump or swelling than sudden pain. However, an ache, heaviness, or change in the testicle still needs a medical examination.

Testicular torsion is an urgent cause. It often causes sudden pain on one side, sometimes with swelling, nausea, vomiting, abdominal pain, or a testicle sitting unusually high. It can happen during sleep or activity and does not require an injury.

Go to an emergency department now for:

• Sudden or severe pain in one testicle
• Testicle pain with nausea, vomiting, or abdominal pain
• A testicle that appears higher, twisted, or at an unusual angle
• Severe pain or marked swelling after an injury
• Sudden pain that improves without treatment, since twisting can temporarily undo itself

Do not wait to see whether sudden severe pain settles. Torsion is time-sensitive, and an ultrasound is not always needed before treatment when the examination strongly suggests it.

Seek same-day medical care for pain with fever, increasing redness or warmth, painful urination, penile discharge, or worsening swelling. These symptoms may indicate an infection or another condition requiring treatment.

Book a routine appointment if mild pain lasts more than a few days, keeps returning, or interferes with normal activities. Arrange an examination for any new lump, persistent swelling, change in testicle size, or ongoing feeling of heaviness, even if it is not painful.

A healthcare professional will ask when the pain began, whether it was sudden or gradual, and whether there was an injury. They may also ask about urinary symptoms, fever, sexual health, previous surgery, and pain elsewhere.

The examination may include the abdomen, groin, penis, scrotum, and both testicles. This helps check for tenderness, swelling, a hernia, or a change in the testicle's position.

A urine sample may be tested for infection. Tests for sexually transmitted infections may be offered when relevant. An ultrasound can show blood flow and look for swelling, fluid, a lump, or another structural cause.

If torsion is strongly suspected, urgent surgery may be advised without waiting for tests that could delay treatment.

Treatment depends on the cause. A bacterial infection may require antibiotics like amoxicillin or doxycycline. Testicular torsion requires emergency surgery to untwist and secure the testicle; the other testicle is often secured during the same operation to reduce its future risk of twisting.

A hernia, kidney stone, varicocele, or persistent fluid collection may need its own treatment plan. A suspicious lump is assessed with imaging and specialist care rather than treated as ordinary pain.

For mild pain after a minor strain or knock, resting from aggravating activity and wearing supportive underwear may help. A cold pack wrapped in cloth can be applied for short periods. Do not place ice directly on the skin.

Over-the-counter pain relief, such as acetaminophen or ibuprofen, may help if it is safe for you. Follow the product label and ask a pharmacist if you have other health conditions, take regular medicines, or are unsure which option is suitable.

Self-care should not delay assessment of sudden, severe, worsening, or unexplained pain. Do not take leftover antibiotics, since the correct treatment depends on the cause.

Recovery time depends on the cause. Mild soreness from pressure or a small injury may improve over several days. With epididymitis, pain may start improving after treatment begins, but tenderness or swelling can take longer to settle.

Pain referred from the groin, urinary tract, or back usually improves as the underlying problem is treated. Recurrent discomfort may require further testing even if an earlier examination was normal.

After treatment, seek further advice if pain is not improving as expected, swelling increases, fever develops, or symptoms return. New sudden severe pain always needs emergency assessment, even if you have had testicle pain before.

Can sexual activity cause testicle pain?

Temporary aching can occur after prolonged arousal, sex, or minor strain. Persistent, severe, or recurring pain should not be assumed to be caused by sexual activity.

Does testicle pain mean cancer?

Usually not. Testicular cancer more often appears as a painless lump, swelling, or change in firmness. Any new lump or lasting change should still be examined promptly.

Can testicle pain affect fertility?

Many causes do not affect fertility. Fertility may be affected by severe infection, injury to both testicles, or delayed treatment of torsion. One healthy testicle can often produce enough sperm and hormones.

Should I examine the painful testicle myself?

You can notice swelling or a change in position, but repeated pressing may worsen discomfort and cannot rule out torsion. Sudden or severe pain needs professional assessment.