Aching Testicles: What It Could Mean and Possible Treatments
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Time to read 7 min
Table of contents
As any man will tell you, no pain compares to that of taking a blow below the belt.
Other than blunt force or sudden injury, testicular pain can be caused by inflammation, a sexually transmitted infection (STI), or even testicular cancer.
Aching testicles can also be a sign of an emergency condition known as testicular torsion, which needs emergency medical attention. Especially when the pain is unusually intense or lasts longer than an hour.
While not all testicular pain qualifies as a medical emergency, recognizing what does can go a long way in helping you secure your family jewels.
Oh, My Aching Testicles
There are two types of testicular pain: acute or chronic.
Acute testicle pain is sudden and short, and most commonly caused by a sudden injury. Chronic pain, on the other hand, is gradual and long-lasting, beginning as a dull ache before it increases with time or activity. Testicular pain can appear in either one or both testicles.
Aches coming from another part of your body such as the stomach or your groin, as opposed to the testicles themselves, is known as referred pain and could be a symptom of more problems down below.
A surefire way to potentially cause irreversible damage to your testicles and scrotum is to ignore testicle pain. Check 'em!
Does Age Matter?
Age doesn’t matter. There is, however, a higher risk for boys or men involved in heavy physical work, or those who play full-contact sports.
The Big "C"
There's lots of reasons your balls may hurt - and 99.9% of them aren't interesting or concerning. The most feared cause is Testicular Cancer. According to Cleveland Clinic, Testicular Cancer is the most common cancer affecting people assigned male at birth aged 15 to 35.
The most common sign to look out for is a painless lump in your testicle. If you happen to feel a testicular tumour or lump in the course of grooming your pubes or checking your balls, be sure to book a physical exam with your doctor. A medical professional should be able to help diagnose the tumour before you jump to the conclusion that it’s testicular cancer.
It’s worth noting that most cases of testicular cancer are actually painless and are, in fact, usually detected through a lump. Testicular cancer that’s diagnosed and treated early has an excellent cure rate.
We're not doctors, and we're not going to counsel you on Testicular Cancer; if you're concerned, talk to your doctor. There are, however, plenty of other common testicle issues which may cause chronic or acute ball-ache.
Three Common Causes of Testicle Pain
If your balls are hurting for some time, or if the ache is hard to bear, get help quickly. Here are some reasons why you may have aching balls, and the possible treatments.
Condition |
Risk Factors |
Treatment |
Epididymitis |
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Abdominal Issues |
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Testicular torsion |
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1. Epididymitis
The epididymis is a tightly coiled group of thin tubes that carry sperm from the testicles to the sperm duct and out of the body. Epididymitis describes the medical condition marked by inflammation or the swelling and irritation of the epididymis.
Epididymitis is caused by sexually transmitted infections such as gonorrhoea and chlamydia. It could also be the result of bacteria from a urinary tract infection (UTI) or prostate infection or a viral infection such as the mumps virus. Further causes could be from a groin injury, urine in the epididymis, and tuberculosis.
Some of the signs and symptoms of epididymitis include:
- Blood in the semen
- Discharge from the penis
- Swollen, red, or a hot-to-the-touch scrotum
- Painful urination, and an urgent need to urinate
- Discomfort and pain in the lower abdomen or pelvic area
- Testicle pain and tenderness, usually on one side, that gradually increases
A few risk factors increase the chance of contracting sexually transmitted epididymitis. They include having a history of STIs and having sex without a condom with a partner who has an STI. Practising safe sex can protect you against the STIs that lead to epididymitis.
The chances of contracting non-sexually transmitted epididymitis increase when someone has a history of prostate infections or UTIs, medical procedures—like the insertion of a urinary catheter or a scope into the penis—that affect the urinary tract, and prostate enlargement.
Other infections that cause testicle pain, can affect fertility, and might be associated with (or the result of) epididymitis include bacterial orchitis. Viral orchitis, which is commonly caused by the mumps virus, can be prevented by getting immunized against mumps.
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Treating Epididymitis
Epididymitis can be treated simply by:
- Taking prescribed antibiotics
- Resting and elevating the scrotum
- Applying ice packs to the affected area
- Drinking fluids to promote urination
2. Abdominal Issues
The nerves leading to your balls come from various places in your abdomen such as the stomach, digestive tract, and kidneys.
Constipation
Constipation can cause testicular pain. Pressure from your unrelieved waste presses on the nerves leading to your gonads, causing pain and discomfort.
Inguinal Hernia
Inguinal hernias occur when part of the intestine pushes through a weak part of the abdominal muscles near the groin. Once the hernia pushes into the scrotum, it causes testicular pain and swelling.
While doctors can reduce or push it back into place, surgery is common. While an inguinal hernia may not usually be dangerous, urgent medical attention is required if it’s painful.
Kidney Stones
Kidney stones working through your system, upset stomachs, and hernias are other areas other than your balls that can be causes of testicular pain. These are examples of what we call referred pain. Kidney stones have a range of signs and symptoms which include:
- Nausea and vomiting
- Cloudy or foul-smelling urine
- Burning sensation when urinating
- Brown, pink or red (blood-tinged) urine
- Persistent need to urinate, in small amounts, and with increased frequency
- Sharp, cramping pain that radiates from the back to the groin
- Sharp, severe pain in the side and back, and below the ribs
- Pain that comes in waves and fluctuates in intensity
- Difficulty passing urine
Treatment for small kidney stones consists of pain relievers for mild pain, or alpha-blockers to help relax the muscles in your ureter.
For a large kidney stone that may cause bleeding or is too large to pass on its own, medical procedures include:
- Using a ureteroscope—a thin lighted tube with a camera—to break it into pieces and remove it from your ureter or kidney
- Using sound waves to break it up into tiny little pieces that can be passed in your urine in a procedure called extracorporeal shock wave lithotripsy (ESWL)
- Surgery to remove it from the kidney in a procedure known as percutaneous nephrolithotomy and is only performed if ESWL is unsuccessful
3. Testicular Torsion
Your balls are attached to the body by the spermatic cord, which carries sperm from your balls to the urethra. It’s when this cord becomes twisted and cuts off the blood flow to the testicles that the serious condition known as testicular torsion occurs.
Yup, we're talking about testicle twisting.
While testicular torsion is most common between the ages of 12 and 18, it can happen at any age. It happens spontaneously when you’re having sex, working out, or even sleeping restlessly. Unfortunately, there are no symptoms that have been pinpointed as specifically preceding testicular torsion.
Suggested symptoms include: an injury to the testicle or a condition known as “bell clapper” deformity. While most males have balls that are firmly attached to the scrotum, those with the bell clapper deformity have testes that can swing freely, which can lead to twisting.
Signs and Symptoms of Testicular Torsion
One of the sudden onset symptoms of testicular torsion is severe testicular pain. You’ll almost always feel the sudden pain in one testicle—most commonly the one on the left.
While sudden, sharp pain in your scrotum, that’s not caused by an injury or accident, might let you know that all’s not well with your balls, see a doctor immediately if you also experience symptoms such as:
- Nausea
- Swelling
- Vomiting
- Abdominal pain
- Redness or darkening of your scrotum
- A testicle in a higher than normal position or an unusual angle
Treating Testicular Torsion
The severity of cutting off blood flow to your balls requires immediate medical attention.
The stakes are high: you could lose your testicle if not treated within six hours. As your balls are responsible for making hormones and sperm, untreated testicular torsion could potentially affect your fertility potential.
When you seek treatment for your twisted testicle, a health care professional will try to manually untwist its spermatic cord. Even so, surgery is still needed to restore blood flow to the affected testicle.
Most importantly, surgery prevents future torsions by securing the testicles to the inner scrotal wall with sutures.
Summary
Your balls are important. But while it’s not always possible to prevent testicular pain, there’s a lot you can do to seek treatment.
To get your testicular pain diagnosed accurately, your doctor may have to do an ultrasound scan of the testicles and scrotal sac. S/he may also perform a urinalysis, get urine cultures from you, and examine your prostate secretions before s/he can provide medical advice and treatment.
Whenever possible, inspecting your balls makes sense. Next time you do some manscaping, spend a few moments doing a health check. You’ll be glad you did.
Tommy Buckley
Balls.co Blog Contributor
