When to seek care for testicular pain

Overview

Testicular pain is discomfort or pain in one or both testicles (the male reproductive glands in the scrotum). It can be sharp, dull, constant, or come and go. While some causes are minor, others need urgent medical attention.

Testicular pain is fairly common, especially in younger men and teenagers. Many cases are caused by minor injuries or infections and resolve on their own or with simple treatment.

It can affect males of any age, from infants to older adults. Testicular torsion is most common in teenagers and young men under 25. Infections like epididymitis often occur in sexually active men or older adults with urinary problems.

Symptoms

Common symptoms

• Sudden, severe pain in one testicle
• Swelling or redness of the scrotum
• A dull ache that lasts for hours or days
• Feeling sick or vomiting (especially with torsion)
• Pain that spreads to the lower belly or groin

Symptoms in children

• They may cry, hold their scrotum, or refuse to walk
• Unexpected fussiness or vomiting
• Not wanting to be touched or diapered in the groin area

Symptoms in older adults

• Pain may be less intense but more constant
• Often linked to an enlarged prostate or urinary tract infections
• Possible fever or chills if infection is present

Causes

Main causes

• Testicular torsion – the spermatic cord twists, cutting off blood flow (emergency)
• Epididymitis – infection of the tube that stores and carries sperm
• Orchitis – infection or swelling of the testicle itself (often from mumps or STIs)
• Injury – a blow, kick, or accident to the groin area
• Inguinal hernia – part of the intestine pushes into the scrotum
• Varicocele – enlarged veins in the scrotum (like a varicose vein)
• Kidney stones – pain can travel to the testicles

Risk factors

• Age 10–25: higher risk for testicular torsion
• Sexual activity without a condom: higher risk for STIs that cause infection
• Enlarged prostate or urinary tract infection: risk for epididymitis in older men
• Previous testicular injury or torsion in the past

When to see a doctor

See a doctor urgently if:

• Sudden, severe pain in the testicle or scrotum – go to the emergency department or call your local emergency number right away
• Pain with vomiting, high fever, or fainting
• Swelling that comes on fast or feels hard and tender

Book a routine appointment if:

• Mild pain that lasts more than a day or two
• Pain that comes and goes but is not severe
• A lump, swelling, or change in the size of a testicle
• Pain during sex or when urinating

Diagnosis

A doctor will ask about your symptoms, when they started, and any recent injuries or sexual activity. They will examine your testicles and scrotum, sometimes checking how the testicle sits or if it can be moved easily.

Tests that may be done

• Urine test – to check for infection
• Ultrasound with Doppler – uses sound waves to look at blood flow in the testicle (helps diagnose torsion vs. infection)
• Blood tests – if infection is suspected or to rule out other causes

What to expect at your appointment

The exam may feel uncomfortable but should not be painful. The doctor will be gentle and explain what they are doing. If torsion is possible, they will act quickly—sometimes even taking you to surgery without waiting for tests.

Treatment

Treatment depends on the cause of the pain. Some minor problems get better on their own with home care. Others need medicine or surgery. The goal is to relieve pain, treat the underlying condition, and avoid long-term damage.

Self-care at home

• Rest and avoid heavy lifting or sports for a few days
• Apply a cold pack wrapped in a towel to the scrotum for 10–15 minutes at a time
• Wear supportive underwear or an athletic supporter
• Take over-the-counter pain relievers like ibuprofen or paracetamol (follow the label instructions)

Medical treatments

For infections, doctors may prescribe antibiotics. For pain, they may recommend anti-inflammatory medicines. For testicular torsion, immediate surgery is needed to untwist the cord and restore blood flow. Other treatments depend on the diagnosis—for example, if a hernia is causing pain, surgery may fix it.

When is surgery considered?

Surgery is often needed for testicular torsion and for hernias that cause pain. Sometimes a small procedure can drain fluid or remove a cyst. Your doctor will explain the risks and benefits if surgery is recommended.

Living with this condition

Most people recover fully from testicular pain. After treatment, you can gradually return to normal activities. Avoid contact sports until your doctor says it is safe.

Lifestyle tips

• Practice safer sex – use condoms to reduce the risk of STIs that can cause infection
• Wear protective gear during sports to prevent injury
• Do regular testicular self-exams to notice any changes early
• See a doctor promptly if you have any new or worsening symptoms

Diet and exercise

There is no special diet for testicular pain. A healthy, balanced diet supports overall health. Gentle activities like walking are fine once you feel better. Avoid heavy lifting or strenuous exercise until you are cleared by your doctor.

Mental health and emotional wellbeing

Pain in the genital area can cause anxiety, embarrassment, or fear about serious conditions. It is normal to feel worried. Talk to your healthcare provider about your concerns – they have heard it all before. If anxiety persists, consider speaking to a mental health professional.

Prevention

Not all cases can be prevented, but you can lower your risk. Use condoms to prevent STIs that cause infections. Wear a protective cup during sports or activities where you might be hit in the groin. If you have had torsion before, your doctor may discuss preventive surgery for the other testicle.

Vaccines

Getting vaccinated against mumps (MMR vaccine) can prevent orchitis caused by mumps, which is a rare but possible cause of testicular swelling and pain.

Screening programmes

Routine screening is not recommended for the general public. However, doing regular testicular self-exams (once a month) can help you notice changes early and seek care sooner.

Complications

If left untreated

• Testicular torsion left untreated for more than 6 hours can cause permanent damage and loss of the testicle
• Untreated infection can spread to the other testicle or to the bloodstream (sepsis)
• Chronic pain that lasts for months or years
• Fertility problems if one testicle is damaged or removed

Long-term outlook

With prompt, proper care, most people make a full recovery. Even if a testicle is lost, the remaining testicle can usually produce enough sperm and hormones for normal function and fertility. The key is to seek help early – do not delay.

Find support

International organisations

• International Society for Sexual Medicine (ISSM)

Local organisations

• NHS (UK) – Testicular Pain · United Kingdom

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