Testicular pain is a relatively common affliction that can cause a disproportionate amount of worry to men of all ages. We examine the common causes to put your mind (and your nuts) at rest.
Why do my balls hurt?
Like the organs themselves, testicular pain is a sensitive subject. Men’s feelings of masculinity and virility are inextricably tied to these oval-shaped sex organs, which sit inside the scrotum on either side of the penis and produce sperm and the testosterone, both key to male sexual development.
Pain or a feeling of vulnerability in this area can therefore feel particularly acute, both physically and psychologically. However, if you know the potential causes of discomfort and what symptoms to look out for, it can put your mind at rest.
Do I have testicular cancer?
Let’s tackle that issue first. Testicular cancer accounts for just one percent of all cancers in men. ‘It’s rare,’ says men’s health specialist Dr Jeff Foster.
However, that does not mean that men should be complacent about checking themselves regularly for abnormalities.
How to perform self testicle check
Perform this routine testicle check at home once a month to ensure your balls are healthy:
- Check your testicles after a warm bath/shower, since heat relaxes the scrotal skin.
- It is normal for one testicle to be larger than the other, and sit differently – one is normally lower.
- There is a rubbery cord like structure behind each testicle that stores and moves sperm and is normal, as well the cord above.
- Examine one testicle at a time using both hands and roll it between your thumb and fingers.
- Start at one end and work up or down.
- If you feel a pea-sized lump or something like a piece of gravel, you should contact your doctor. Most are cysts, but it is better to be checked.
What to look out for
The most common symptom of cancer is a painless lump or swelling the size of a pea (or larger) in one of the testicles. Other symptoms can include a dull ache or feeling of heaviness in the scrotum.
‘I probably have a man come to me once a week complaining of testicular pain, often because they are worried about testicular cancer,’ says GP Dr Roger Henderson. ‘However, that is very rarely the cause. Testicular cancer usually manifests itself as a very dull low ache rather than a sharp pain.’
What is testicular torsion?
Torsion is a potentially serious condition that occurs when the spermatic cord twists, restricting blood flow to the testes, and is more frequent in young males between the ages of 10 and 20.
‘Infection, trauma and small epididymal cysts are common causes of testicular pain,’ says Dr Henderson. ‘In addition, testicular torsion can be responsible, which is rare but causes nasty pain.’
Testicle pain causes and symptoms
The following can cause testicle pain:
- Epididymitis: Inflammation brought on by sexually transmitted infections like chlamydia.
- Spermatocele: Fluid in the testicles can cause pain or discomfort, as can a varicocele, the term given to a group of enlarged veins in the testicle. Your doctor will be able to distinguish quite quickly between swollen veins and the normal underlying organ through a routine examination.
- Orchitis: Exposure to a bacterial or viral infection such as the mumps virus may result in orchitis, which also causes the testicles to become inflamed. The conditions often occur together, known as epididymo-orchitis, and all three cause pain in the area of the testicle, which is tender, swollen and hot to touch.
- Hydroceles: The epididymis or sperm collecting apparatus at the rear of the testicle can sometimes form cysts that may become enlarged and painful. In addition to causing that dull, nauseating pain that most men unfortunately know (and never forget), a direct injury may result in a bag of clear fluid known as a hydrocele to collects in a sac around the testicle. Hydroceles can also occur spontaneously.
Other causes of pain include an inguinal hernia, kidney stones or an undescended testicle. Different types of pain can be indicative of different types of condition. If you are concerned, consult your GP.
Treatments for testicular pain
Once the cause of the testicular pain has been diagnosed, treatments are varied and effective:
- Testicular torsion: This can be resolved through surgery if carried out quickly enough. An operation called a herniorrhaphy can be required to correct the underlying muscle weakness that causes a hernia.
- Bacterial infections: These will normally respond to a course of broad-spectrum antibiotics. Corticosteroid medication is sometimes prescribed to minimise the inflammation resulting from mumps orchitis.
- Cysts: Small cysts may disappear without treatment; larger ones may require surgical removal. Similarly, hydroceles often disappear of their own accord, but can be drained and the remaining sac removed.
- Direct injury: Supportive underwear, painkillers and warm baths can help reduce bruising and swelling.