Last updated on July 17, 2026
Testicular pain can affect men of all ages. Whether it presents as a dull ache that comes and goes, a sudden sharp pain, or a sense of heaviness that builds throughout the day, discomfort in this area can be unsettling and should not be ignored.
There are many possible causes of testicular pain, ranging from minor issues to conditions that require prompt medical attention. One common but often overlooked cause is a varicocele, an enlargement of veins in the scrotum that can be treated with appropriate care. In this article, we explore the possible causes of testicular pain, the symptoms to look out for, and when it may be time to seek medical advice.
What Does Testicular Pain Feel Like?
Testicular pain can feel different from one person to another. For some men, it may be a sudden, sharp pain. For others, it may feel like a dull ache, a dragging sensation or heaviness in the scrotum. The discomfort may affect one testicle or both, and it can sometimes spread to the groin, lower abdomen or lower back.
The pattern of pain can sometimes provide clues about the underlying cause. Sudden or severe testicular pain should be assessed urgently, as some causes require prompt treatment. A dull ache that worsens during the day or after prolonged standing may be linked to an underlying issue, such as a varicocele.
What Are the Common Causes of Testicular Pain?
There are several possible causes of testicular pain, ranging from minor issues to conditions that require urgent medical attention. Understanding some of the more common causes can help you recognise when symptoms should be assessed, although only a medical review can confirm the underlying reason.
Varicocele
A varicocele is one of the more common causes of ongoing testicular discomfort. It occurs when the veins within the scrotum become enlarged, similar to varicose veins in the legs. This can happen when the valves inside these veins do not work properly, allowing blood to pool.
Varicoceles often cause a dull ache, a dragging sensation, or a feeling of heaviness. Symptoms may become more noticeable later in the day, after exercise or after standing for long periods, and may ease when lying down. Varicoceles are more common on the left side and may sometimes feel like a soft, ropy cluster of enlarged veins within the scrotum, particularly when standing.
Epididymitis
Epididymitis is inflammation of the epididymis, the coiled tube at the back of the testicle that stores and carries sperm. It is often caused by infection and can lead to pain, swelling and tenderness that develops gradually.
Testicular torsion
Testicular torsion is a medical emergency. It occurs when the testicle twists, cutting off its blood supply. This can cause sudden, severe testicular pain, swelling, nausea or a testicle sitting higher than usual. If you experience sudden or intense testicular pain, seek emergency medical care immediately.
Injury or trauma
A direct blow or injury to the testicles can cause significant pain, swelling or bruising. Mild discomfort may settle with time, but severe pain, persistent swelling or pain that does not improve should be assessed to rule out more serious injury.
Hydrocele or spermatocele
A hydrocele is a build-up of fluid around the testicle, while a spermatocele is a fluid-filled cyst that forms near the epididymis. These conditions are often painless, but they can sometimes cause swelling, heaviness or discomfort in the scrotum.
Inguinal hernia
An inguinal hernia occurs when tissue, often part of the bowel, pushes through a weak area in the groin. This can cause groin discomfort that may radiate into the scrotum or testicle.
Infection
Urinary tract infections and sexually transmitted infections can sometimes contribute to testicular or scrotal pain, particularly if they lead to inflammation of the epididymis or testicle. Symptoms may include pain when urinating, discharge, fever, swelling or tenderness.
Referred pain
Not all testicular pain starts in the testicle itself. Pain from another area, such as a kidney stone, groin problem, lower back issue or abdominal condition, can sometimes be felt in the testicle.
How Are the Causes of Testicular Pain Diagnosed?
Finding the cause of testicular pain usually begins with a medical history and physical examination. Your doctor may assess the testicles, scrotum and groin for swelling, tenderness, lumps or enlarged veins. If a varicocele is suspected, it may be more noticeable when standing or during gentle straining.
Imaging is often used to confirm the diagnosis and rule out other causes. A scrotal Doppler ultrasound is commonly recommended, as it can assess the testicles, surrounding structures and blood flow within the scrotum. This can help identify a varicocele, epididymitis, hydrocele, cysts or other possible causes of pain. Depending on your symptoms, further tests such as urine testing, STI screening or additional imaging may also be recommended.
When Should You See a Doctor About Testicular Pain?
While not all testicular pain is serious, some symptoms require urgent medical attention. You should seek emergency care if you experience sudden or severe testicular pain, pain with nausea or vomiting, sudden swelling, or a testicle that appears to sit higher than usual. These may be signs of testicular torsion, which requires prompt assessment and treatment.
For pain that is persistent, recurring or affecting your daily life, it is important to arrange a medical assessment, even if it does not feel like an emergency. A dull ache, dragging sensation or heaviness that worsens during the day or after standing for long periods may be linked to a varicocele. Any new lump, swelling, change in testicle size or unexplained discomfort should also be checked by a doctor.
Varicocele Treatment at Vein Doctors Sydney
Treatment for a varicocele depends on your symptoms, examination findings, ultrasound results and whether fertility is a concern. Not every varicocele requires treatment, but if it is causing ongoing pain, heaviness or fertility concerns, treatment may be considered.
Varicocele Embolisation
Varicocele embolisation is a minimally invasive, image-guided procedure. A small catheter is inserted through a vein, usually in the groin or neck, and guided to the affected veins. Tiny coils or embolic agents are then placed to redirect blood flow away from the varicocele.
This procedure is usually performed as a day procedure and typically does not require general anaesthesia. At Vein Doctors Sydney, Dr McConnell can assess whether varicocele embolisation may be suitable for your symptoms and circumstances.
Surgical Varicocele Repair
Surgical repair, also known as varicocelectomy, is another treatment option for varicoceles. It involves tying off or sealing the enlarged veins so blood can be redirected through healthier veins.
A common surgical option is microscopic varicocelectomy. This is usually performed through a small incision, often in the groin, using magnification to help the surgeon identify and treat the affected veins.
Other surgical approaches may also be considered depending on the individual case. Your doctor will discuss the benefits, risks and alternatives of each treatment option so you can make an informed decision about your care.
Book an Appointment with Vein Doctors Sydney
If ongoing testicular pain, heaviness or scrotal discomfort is affecting your quality of life, it may be time to arrange a medical assessment. These symptoms should not be dismissed, particularly when a varicocele may be one possible underlying cause.
At Vein Doctors Sydney, we are committed to providing detailed consultations and support for patients seeking varicocele treatment. For more information on our services or to schedule a consultation at our clinic, please contact our staff by calling us on (02) 9023 9970, via our online form or by sending us an email.
Frequently Asked Questions
Is testicular pain always serious?
Testicular pain is not always serious, but it should not be ignored. Some causes may be minor and settle with time, while others, such as testicular torsion, require urgent medical attention. Sudden or severe pain should be assessed immediately, while persistent or recurring pain should be reviewed to determine the cause.
Can a varicocele go away on its own?
A varicocele does not usually resolve on its own. Some varicoceles are small and cause no symptoms, meaning monitoring may be appropriate. However, if a varicocele is causing ongoing pain, heaviness or fertility concerns, treatment may be considered.
Is a varicocele dangerous?
A varicocele is not usually dangerous, but it can cause discomfort and may be associated with fertility issues in some men. An assessment can help determine whether the varicocele is likely to be contributing to your symptoms and whether treatment may be appropriate.
How do I know my testicular pain is caused by a varicocele?
The only way to confirm whether a varicocele is contributing to your testicular pain is through a medical assessment. This may include a physical examination and a scrotal Doppler ultrasound to assess the veins, testicles and blood flow within the scrotum.
Can testicular pain be caused by something outside the testicle?
Yes, testicular pain can sometimes be referred from other areas of the body, such as the groin, abdomen, kidneys, or lower back. Conditions such as kidney stones, hernias, or nerve irritation may cause pain in the testicle, which is why persistent or unexplained pain should be properly assessed.
This information is not intended to be used for diagnosis or treatment. It is aimed at presenting a perspective only and is not a substitute for a prescription. Anyone experiencing a medical condition should consult their doctor.
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