Testicle hurts

Dear Alice,

This is a serious query about a health problem I'm having. My left testicle HURTS! I am quite concerned. It's not sharp pain but a gradual aching pain, but it's damn tender when I touch it. Is this testicular cancer, testicular torsion, a hernia, the consequence of an active sex life, or simply the result of two successive bouts of masturbation? Please help me resolve this.

— Swollen balls

Dear Swollen Balls,

Since you seem to be having new pain and are concerned about the cause, your best course of action at this point is to visit a health care provider. But while you're here, boning up on testicular particulars can't hurt: testicular cancer most commonly appears as a firm, painless swelling of one testicle. Cancerous lumps in the testes are generally not tender when they are touched. Relatively rare, testicular cancer usually occurs in men between the ages of fifteen and thirty-four years, especially if they have an undescended testicle.

Other causes of swelling and/or pain in the testes can include:

  • Hydrocele, a collection of fluid in the scrotum
  • Epididymal cyst, a fluid-filled swelling of the epididymis (the structure behind the testicle where sperm mature) which may also cause fever and discharge from the penis
  • Varicocele, varicose veins in the scrotum, which is described as feeling like "a bag of worms"
  • Bacterial infections
  • Herniated disc at the L4 and L5 vertebrae near the tailbone (the last two bones in the back and spinal column)

Torsion of the testis, another possible explanation, occurs when a testicle rotates, obstructing the tube sperm travels through and cutting off the blood supply. This most commonly occurs around puberty and causes acute severe pain and swelling of the testes. Pain in your testicle is most likely not a hernia (a protrusion of an organ or tissue through a weak area in the muscle or other tissue that normally constrains it, which commonly occurs in your abdominal area).

If during sex or masturbation you are engaging in activities that involve twisting, pulling, or squeezing of your testicles, this may be a cause of pain. Otherwise, average masturbatory or sexual techniques (even many times per day!) don't cause your testicles to swell.

Again, since you are experiencing pain and tenderness, it might be a good idea to schedule an appointment with a health care provider to discuss this problem in the context of the rest of your life, including any recent changes before your testicle started to hurt.

While you're there, you and your health care provider could discuss testicular self-exams, which can help you become familiar with your anatomy, and note if any changes occur. You can do a testicular self-exam during a shower, when the heat of the water relaxes the scrotum. Basically, you rotate each testicle between your thumb and forefinger making sure you feel a round, firm surface and look at your scrotum for any changes. Your provider can give you detailed instructions about a self-exam.

Wishing you swift resolution,

Last updated Jun 04, 2014
Originally published Apr 18, 1995

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