Testicular pain, a lump or swelling can be worrying, but there are many possible causes and most testicular changes are not cancer. What matters is getting a new or persistent change assessed rather than trying to diagnose it yourself.
Some conditions affecting the testicles or surrounding structures can also affect sperm production or transport. Others have no effect on fertility. A sperm test may provide useful information about selected semen parameters, but it cannot identify the cause of pain, diagnose a lump or replace a physical examination.
Sudden, severe testicular pain is a medical emergency. Go to A&E immediately or call 999 if the pain is sudden and severe, occurs with nausea, vomiting or abdominal pain, lasts for more than an hour, or continues while you are resting.
Is it normal for testicles to feel slightly different?
It is common for one testicle to sit slightly lower than the other or to be a little different in size. Behind each testicle is a soft, coiled tube called the epididymis, which stores and carries sperm. Knowing what is usual for your body can make a new change easier to notice.
The NHS advises being familiar with how your testicles normally look and feel. Arrange a GP appointment if you notice a new lump or swelling, an increase in size, heaviness or firmness, a persistent ache, or another change that is not normal for you.
You cannot determine sperm concentration, motility or fertility by looking at or feeling the testicles. In the same way, semen appearance cannot confirm sperm health. Our guide explains why you cannot tell whether sperm are healthy by appearance alone.
Når er testikkelsmerter en nødsituasjon?
Sudden, severe pain can be caused by testicular torsion. This happens when the spermatic cord twists and restricts blood flow to the testicle. It requires emergency treatment because delay can permanently damage the testicle.
According to the NHS guidance on testicular pain, you should go to A&E immediately or call 999 if:
- the pain is sudden and severe
- the pain occurs with nausea, vomiting or abdominal pain
- the pain lasts for more than an hour
- the pain continues while you are resting
Do not wait for a fertility appointment, sperm test or routine GP appointment when these symptoms are present.
What can cause pain, lumps or swelling?
A symptom cannot identify its own cause. A clinician may need to take a medical history, examine the scrotum and arrange tests such as urine testing, STI testing or an ultrasound.
Testicular torsion
Torsion often causes sudden, severe pain and swelling, sometimes with nausea, vomiting or abdominal pain. Because it can interrupt the testicle's blood supply, it must be treated as an emergency.
Epididymitis
Epididymitis is inflammation of the epididymis, the tube behind the testicle. It can cause pain and swelling in one or both testicles. The NHS explains that epididymitis is often caused by an infection, including an STI such as chlamydia or gonorrhoea in some people, or a urinary infection.
Epididymitis usually needs medical assessment and may require antibiotics. An ExSeed test does not screen for STIs or diagnose infection.
Varicocele
A varicocele is an enlargement of veins in the scrotum. It may cause a dull ache, heaviness or visible enlarged veins, although many men have no symptoms. Some varicoceles are associated with changes in sperm concentration or motility, but having one does not mean you are infertile. Read our detailed guide to varicocele and sperm test results.
Cysts and fluid collections
Conditions such as an epididymal cyst or hydrocele can cause a lump or swelling around the testicle. They are often benign, but you cannot reliably identify one by touch alone. A GP may recommend an ultrasound to clarify what is causing the swelling.
Injury or inflammation
An injury can cause pain, bruising or swelling. Infections and inflammation, including orchitis, can also affect the testicle. Seek medical advice for significant injury, persistent pain, swelling or any change that does not settle.
Testicular cancer
Testicular cancer may present as a lump or swelling, an increase in testicle size, an ache, or a scrotum that feels heavy, firm or hard. These symptoms are common and can be caused by several other conditions, so having one does not mean you have cancer. However, the NHS advises having any new testicular change checked by a GP.
A sperm result cannot rule out testicular cancer. Do not use home testing as a reason to delay an examination.
Can testicular conditions affect fertility?
The testicles produce sperm and testosterone, while the epididymis and reproductive tract help sperm mature and travel. A condition that damages testicular tissue, affects blood flow, causes significant inflammation or blocks sperm transport may affect fertility.
Possible examples include:
- testicular torsion that restricts blood flow
- infection or inflammation affecting the testicle or epididymis
- a clinically significant varicocele
- previous undescended testicles
- significant testicular injury
- cancer or treatments such as chemotherapy and radiotherapy
The effect varies. Some men retain expected semen parameters after a testicular condition or treatment, particularly when the other testicle is healthy. Others may need semen analysis, hormone testing, imaging or specialist assessment. Our guide to urology and male fertility explains when a urologist or andrologist may become involved.
If cancer treatment could affect fertility, the healthcare team may discuss sperm banking before treatment. The NHS testicular cancer guidance explains that chemotherapy and some other treatments can affect fertility, while removing one testicle does not usually affect fertility when the remaining testicle is healthy.
When can a sperm test be useful?
A semen assessment may be useful after a diagnosed testicular condition, significant injury or treatment when you want to understand your sperm health or are planning a pregnancy. It may also form part of a wider fertility assessment if you and your partner are having difficulty conceiving.
A full laboratory semen analysis can assess semen volume, sperm concentration, motility and morphology, with other parameters included according to the laboratory and clinical situation. Different tests provide different levels of information, so compare the parameters, process and limitations before choosing one. Our guide reviews male fertility test types, costs and reliability.
The ExSeed Home Sperm Test measures semen volume, sperm concentration and progressive motility, and calculates total motile sperm count. It can provide a private first look at these parameters and allow results to be tracked over time.
However, an at-home sperm test cannot:
- diagnose torsion, cancer, infection, a cyst or varicocele
- examine a lump, swelling or physical change
- test for STIs
- measure testosterone or other reproductive hormones
- identify the medical cause of an unexpected result
- provide a complete fertility diagnosis
Can a result within the expected range rule out a testicular problem?
No. A result within the expected range is reassuring only for the parameters measured in that sample. It cannot rule out a physical condition, infection, hormonal issue or cancer.
Equally, a lower result does not show which condition caused it or mean that natural conception is impossible. Semen parameters naturally vary, and clinical interpretation may require repeat testing under appropriate conditions. Learn more about how male fertility is assessed and why one result is not a verdict.
If you have a physical symptom, seek medical assessment regardless of your sperm result.
What happens when you see your GP?
Your GP may ask when the symptom began, whether the pain was sudden or gradual, whether you have urinary or sexual-health symptoms, and about previous injuries, infections, surgery or fertility concerns.
They may examine the testicles and scrotum. Depending on the findings, they may arrange or refer you for:
- an urgent hospital assessment
- a scrotal ultrasound
- urine or STI testing
- treatment for infection
- a semen analysis
- blood tests or specialist urology assessment
The examination should be explained to you, and you can ask questions or request a chaperone.
What should you do next?
- For sudden, severe pain: go to A&E immediately or call 999.
- For a new lump, swelling, persistent ache or change: arrange a GP appointment.
- For possible infection or STI symptoms: seek clinical or sexual-health assessment.
- For fertility concerns without urgent symptoms: discuss semen testing and the appropriate referral route with your GP.
- For an at-home result that remains concerning: prepare the full report and testing details for a healthcare professional.
Understanding sperm health can be useful, but symptoms and semen parameters answer different questions. Check what you can at home and seek the right professional assessment for what a home test cannot tell you.
Ofte stilte spørsmål
Is a testicular lump always cancer?
No. Testicular lumps and swellings can have several causes, and many are not cancer. However, any new lump or change should be examined by a GP because you cannot reliably diagnose it yourself.
Can testicular pain reduce sperm count?
Pain itself does not measure sperm health. The condition causing the pain may sometimes affect sperm production, blood flow or sperm transport. A clinician needs to assess the cause before deciding whether semen testing is appropriate.
Should I take a sperm test before seeing my GP?
Not when you have sudden, severe pain or a new physical change that needs assessment. A sperm test can be considered separately when you want information about semen parameters, but it should never delay medical care.
Can a normal sperm result rule out testicular cancer?
No. A sperm test does not diagnose or rule out cancer. A new lump, swelling, change in size or persistent ache should be assessed by a GP regardless of the result.
Can one healthy testicle be enough for fertility?
Often, yes. One healthy testicle can usually produce enough sperm and testosterone, but individual circumstances and treatments vary. Ask your specialist about fertility testing or sperm banking when a condition or planned treatment could affect the remaining testicular function.
When should I see a urologist?
Your GP may refer you when a lump, swelling, persistent pain, repeated semen results or medical history needs specialist assessment. Urgent symptoms should be assessed immediately rather than waiting for a routine referral.
Denne artikkelen gir generell informasjon og er ikke en erstatning for individuell medisinsk rådgivning, diagnose eller behandling. Søk akutt medisinsk hjelp ved plutselige, sterke testikkelsmerter.
