The problem is that there are some serious conditions that can cause testicular pain. This article looks at five such conditions, including one this is considered a true medical emergency.
Epididymitis
Epididymitis is the inflammation of the epididymis (the long, coiled tube that transports sperm from the testicle).
Symptoms of epididymitis include:
Pain that often improved when lifting the testicleSwelling of the testicleBurning with urinationFrequent urination
Epididymitis is usually caused by an infection. In sexually active people, the sexually transmitted diseases (STDs) gonorrhea and chlamydia are common causes. In older adults, bacterial infections (often transmitted during anal sex) can also lead to epididymitis.
Epididymitis is typically treated with antibiotics. Over-the-counter (OTC) pain relievers may be prescribed along with elevation of the testicle to help minimize the pain.
If left untreated, epididymitis can lead to chronic pain or infertility.
Orchitis
Orchitis is inflammation of the testicles. The suffix “-itis” simply means inflammation, while “orches” means testicle.
Symptoms of orchitis include:
Testicular pain Testicular swelling Blood in urine Blood in semen Swollen lymph nodes in the groin
Orchitis is frequently related to an epididymis infection that has spread to the testicle. Orchitis can occur during adolescence due to the mumps virus. In sexually active adults, gonorrhea and chlamydia are common culprits.
The treatment often involves oral antibiotics. Mumps infections generally resolves on their own within a week or two, although OTC painkillers may be used to relieve pain.
Infertility and chronic pain are also possible complications of orchitis.
Epididymal Hypertension (Blue Balls)
“Blue balls” is slang for epididymal hypertension. This is a situation in which the testicles feel uncomfortable and even painful after a long period of arousal without ejaculation.
Symptoms of blue balls include:
Heaviness in the testicle An aching sensationTesticular pain (usually mild)A slight bluish tinge in the testicles
Blue balls is rarely serious and can often be resolved by ejaculating. Other people find relief using the Valsalva maneuver in which you pinch your nose and lips while forcefully expelling air.
Even without treatment, blue balls will usually resolve on its own within several hours.
Inguinal Hernia
A hernia occurs when a weak spot in muscle ruptures, allowing internal tissues or organs to protrude through the opening. When it occurs in the groin, it is called an inguinal hernia.
An inguinal hernia often starts with a visible bulging in the groin, particularly when coughing, straining, or standing up. There may also be discomfort or pain at the site of the hernia extending to the adjacent testicle. The tissue can often be pushed back through the opening in the groin.
As the hernia progresses, the bulge may be harder to push back in and the pain may become more severe. If the intestines bulge through the opening, it can cause intestinal blockage.
An inguinal hernia can become a medical emergency it becomes “stuck.” This can lead to vascular strangulation in which the hernia becomes starved of adequate blood flow.
An inguinal hernia will not go away on its own and requires surgical repair.
Testicular Torsion
Testicular torsion occurs when the spermatic cord (from which the testicle is suspended) suddenly twists, cutting off the blood supply to the testicle. It is a true medical emergency that requires immediate surgery.
Symptoms of testicular torsion include:
Sudden, severe testicular painPain in the groin or lower abdomenWorsening pain when the testicle is liftedTesticular warmth and rednessNausea and vomiting
The testicle may also lie higher in the scrotum due to the twisting of the spermatic cord.
People with testicular torsion often have no underlying medical condition. It can affect both adults and children but is most common between the ages of 10 and 20.
If testicular torsion is not treated immediately, the testicle may become strangulated and lost.
Summary
Testicular pain is something you should never ignore. The cause is not always serious, but the majority of cases require treatment by a healthcare provider.
Five common causes of testicular pain are:
Epididymal hypertension: Mild testicular pain or discomfort caused by prolonged sexual arousal without ejaculationEpididymitis: The inflammation of the epididymis usually caused by gonorrhea, chlamydia, or other bacterial infectionsOrchitis: The inflammation of the testicle commonly caused by mump in adolescents or gonorrhea or chlamydia in adultsInguinal hernia: The bulging of tissues or organs through an abnormal opening in the muscles of the groinTesticular torsion: A true medical emergency in which the spermatic cord becomes twisted, cutting off blood flow to the testicle
Call your healthcare provider if the pain is accompanied by a fever or lump in the scrotum, or if the scrotum is warm, red, or tender to the touch.
Epididymitis is inflammation of the long, coiled tube that transports sperm from the testicles. Orchitis is an inflammation of the testicles. Both conditions can potentially lead to infertility and should be treated promptly.
