Understanding Testicular Health: What Every Man Should Know

Testicular health is an important part of reproductive, hormonal and general wellbeing. However, many people do not think about their testicles until pain, swelling or another unexpected change appears.

Most testicular symptoms are caused by conditions other than cancer. Even so, a new lump, persistent discomfort or change in the size or shape of a testicle should not be ignored.

Knowing what is normal for your body can help you notice changes and seek medical advice when needed. Sudden or severe testicular pain is different—it requires immediate emergency assessment because it may be caused by testicular torsion.

Why Testicular Health Matters

The testicles, also called the testes, sit inside the scrotum and have two main functions:

Producing sperm
Producing testosterone

Testosterone contributes to sexual development, libido, muscle and bone health, body hair and other physical functions.

A range of conditions can affect the testicles and surrounding structures, including:

Testicular torsion
Testicular cancer
Epididymitis
Orchitis
Varicocele
Hydrocele
Epididymal cysts
Inguinal hernia
Injury or trauma
Fertility-related conditions

Some conditions are mild, while others require urgent treatment. It is not always possible to identify the cause based on symptoms alone, so unexplained changes should be assessed by a healthcare professional.

What Should Healthy Testicles Feel Like?

Everyone’s anatomy is slightly different.

It is common for:

One testicle to sit lower than the other
One testicle to be slightly larger
The testicles to feel smooth and firm but not rock-hard
The position of the testicles to change with temperature
The scrotal skin to tighten when cold and relax when warm

At the back and upper area of each testicle, you may feel a softer, tube-like structure. This is the epididymis, which stores and carries sperm. It is a normal part of the reproductive system and can sometimes be mistaken for a lump.

Becoming familiar with your usual anatomy may make it easier to recognise a new or unusual change.

What Changes Should You Discuss With a Doctor?

Arrange a medical appointment if you notice:

A new lump in or around a testicle
Swelling in the testicle or scrotum
A change in the size, shape or firmness of a testicle
A feeling of heaviness in the scrotum
Persistent aching or discomfort
Pain in the lower abdomen or groin
Fluid collecting in the scrotum
Redness or warmth
Tenderness that does not improve
A testicle that appears to be sitting differently
A change that concerns you, even if it is not painful

A painless lump still needs assessment. Testicular cancer commonly causes a painless swelling or lump rather than severe pain.

These symptoms do not necessarily mean that you have cancer. Cysts, infections, enlarged veins and fluid collections can cause similar changes. A GP assessment is needed to determine the likely cause.

When Is Testicular Pain an Emergency?

Go to the nearest hospital emergency department immediately if you experience:

Sudden, severe testicular or scrotal pain
Rapid swelling
Nausea or vomiting with testicular pain
Lower abdominal pain with scrotal symptoms
One testicle sitting noticeably higher than usual
Redness and severe tenderness
Sudden pain that disappears without treatment

These symptoms may indicate testicular torsion.

What Is Testicular Torsion?

Testicular torsion occurs when a testicle twists around the spermatic cord, reducing or cutting off its blood supply.

It is most common in teenagers but can occur at any age.

Emergency surgery is usually required. The chance of saving the testicle is highest when treatment occurs within the first several hours.

Do not:

Wait to see whether the pain improves
Delay treatment while waiting for a routine GP appointment
Attempt to diagnose the cause yourself
Rely on pain-relief medication before seeking assessment
Ignore pain because it has temporarily disappeared

Pain that suddenly resolves can occur when the testicle twists and then untwists. This still requires urgent assessment because the torsion may happen again.

Call Triple Zero on 000 if symptoms are severe, you are unable to travel safely or urgent ambulance assistance is needed.

Understanding Testicular Cancer

Testicular cancer is uncommon compared with many other cancers, but it disproportionately affects younger people. In Australia, it is among the more common cancers diagnosed in younger adult males.

It can occur in anyone with testicles, including men, transgender women, non-binary people and people with intersex variations.

Testicular cancer is highly treatable. Australian data show a five-year relative survival rate of approximately 98 percent, although individual outcomes depend on the type and stage of the cancer and other personal factors.

Early assessment remains important because treatment may be simpler when the cancer has not spread.

Possible Signs of Testicular Cancer

Possible symptoms include:

A painless lump or swelling
A change in testicle size or shape
Increased firmness or hardness
A feeling of heaviness in the scrotum
A sudden collection of fluid
Persistent pain or discomfort
An ache in the lower abdomen or groin
Unexplained back pain
Breast tenderness or enlargement in uncommon cases

Testicular cancer may not cause noticeable symptoms during its early stages.

Not every lump is cancer, but every new lump should be assessed.

Who Has a Higher Risk of Testicular Cancer?

Factors associated with an increased risk include:

Having had an undescended testicle
A previous diagnosis of testicular cancer
A father or brother who has had testicular cancer
Certain differences in testicular development
Some intersex variations
Infertility
Hypospadias
HIV infection

Having a risk factor does not mean that you will develop testicular cancer. People without recognised risk factors can also be diagnosed.

There is no proven link between testicular cancer and:

Wearing tight underwear
Taking hot baths
Sporting strains
A previous testicular injury
Vasectomy

However, an injury can draw attention to an existing lump or cause symptoms that require medical assessment.

Should You Perform a Monthly Testicular Self-Examination?

There is no routine population-screening test for testicular cancer in Australia.

Formal monthly testicular self-examination is not universally recommended for everyone without symptoms because there is limited evidence that it detects cancer earlier or improves treatment outcomes.

However, it is reasonable to become familiar with the usual appearance and feel of your testicles.

The goal is not to repeatedly search for disease or cause unnecessary anxiety. It is to recognise a clear new change and seek medical advice rather than ignoring it.

People with increased risk, including those with a previous testicular cancer diagnosis, may receive more specific monitoring advice from their GP or specialist.

How to Check Your Testicles

A simple check may be easier after a warm shower or bath, when the scrotal skin is relaxed.

1. Look for Visible Changes

Stand in a comfortable position and check for:

New swelling
Redness
An obvious difference in size
A change in the position of a testicle
Changes to the scrotal skin

2. Check One Testicle at a Time

Support one testicle gently with both hands.

Roll it carefully between your fingers and thumbs without squeezing firmly.

3. Notice New or Unusual Areas

Be aware of:

A hard lump
A firm area that was not present before
A clear change in shape
New swelling
Unusual tenderness
A significant difference in size

4. Remember the Epididymis

The epididymis is a soft or rope-like structure behind the testicle. It is normal anatomy.

It may be easier to distinguish the epididymis from a new lump once you are familiar with how it usually feels.

5. Seek Advice When Unsure

Do not repeatedly press or squeeze an area in an attempt to diagnose it yourself. This can increase tenderness and anxiety.

Book an appointment if you notice something new or are unsure whether a structure is normal.

Common Causes of Testicular Pain, Swelling or Lumps

Many testicular symptoms are caused by non-cancerous conditions.

However, the symptoms can overlap, so a healthcare professional should make the diagnosis.

Epididymitis

Epididymitis is inflammation of the epididymis.

It is commonly caused by an infection, including:

A sexually transmitted infection such as chlamydia or gonorrhoea
Bacteria associated with a urinary tract infection
Other bacterial or viral infections

Possible symptoms include:

Pain that develops gradually
Swelling
Tenderness
Redness or warmth
Pain when urinating
Penile discharge
Fever
Discomfort during ejaculation

Treatment depends on the cause. Bacterial epididymitis may require antibiotics, while other causes may be managed differently.

Sudden or severe pain should still be treated as an emergency until torsion has been ruled out.

Orchitis

Orchitis is inflammation of one or both testicles.

It may be caused by:

A viral infection
A bacterial infection
An infection associated with epididymitis

Symptoms may include swelling, pain, fever and feeling unwell.

Medical assessment is needed to identify the cause and determine appropriate treatment.

Varicocele

A varicocele is an enlargement of veins within the scrotum.

It may feel like a soft collection of veins and is sometimes described as feeling similar to a “bag of worms.”

A varicocele may cause:

A dull ache
Heaviness
Discomfort after prolonged standing
A difference in testicle size
Fertility problems in some people

Many varicoceles do not require treatment. Referral may be recommended when there is persistent pain, reduced testicle size or a fertility concern.

Hydrocele

A hydrocele is a collection of fluid around a testicle.

It usually causes painless swelling, although a large hydrocele may feel heavy or uncomfortable.

Hydroceles are generally benign, but new scrotal swelling should be assessed to confirm the diagnosis and rule out other causes.

Epididymal Cyst or Spermatocele

These are fluid-filled cysts that develop near the epididymis.

They are usually:

Smooth
Separate from the testicle
Painless
Benign

Treatment is not always necessary unless the cyst becomes large or uncomfortable.

A new lump should still be examined rather than assumed to be a cyst.

Inguinal Hernia

An inguinal hernia occurs when tissue pushes through a weakened area in the groin.

It may cause:

A lump in the groin or scrotum
Heaviness
Discomfort when lifting or coughing
A bulge that changes with position

A painful lump that cannot be pushed back, particularly with vomiting or abdominal pain, requires urgent medical assessment.

Injury or Trauma

A blow to the testicles can cause pain, swelling, bruising or internal injury.

Seek urgent assessment if there is:

Severe or persistent pain
Significant swelling
Nausea or vomiting
Extensive bruising
Blood in the urine
An abnormal testicle position
A penetrating injury

Wearing appropriate protective equipment during contact sports may help reduce the risk of serious injury.

What Happens During a Testicular Health Check?

A GP consultation is usually straightforward and confidential.

Medical History

Your GP may ask about:

When the symptom began
Whether the pain was sudden or gradual
Recent injury
Urinary symptoms
Sexual history and possible STI exposure
Fever or other symptoms
Previous testicular conditions
Fertility concerns
Family history of testicular cancer
A history of undescended testicles

These questions help determine which conditions are most likely.

Physical Examination

Your doctor may examine:

Both testicles
The epididymis
The spermatic cords
The scrotal skin
The groin
The abdomen
Nearby lymph nodes where appropriate

Tell the doctor if you feel uncomfortable or would like an explanation before the examination.

You may ask for a chaperone to be present, subject to clinic availability.

Further Tests

Depending on your symptoms, the doctor may arrange:

A scrotal ultrasound
Urine testing
STI tests
Blood tests
Tumour-marker blood tests
Referral to a urologist
Immediate hospital assessment

An ultrasound can help determine whether a lump is inside the testicle or in a surrounding structure and whether it appears solid or fluid-filled.

If cancer is strongly suspected, specialist assessment is required. A routine needle biopsy through the scrotum is generally not used to diagnose suspected testicular cancer because of concerns about disrupting or spreading cancer cells.

How Is Testicular Cancer Treated?

Treatment depends on the cancer type, stage and individual circumstances.

It may include:

Surgery to remove the affected testicle
Active surveillance after surgery
Chemotherapy
Radiotherapy for selected cancers
Further surgery in some cases

Removing one testicle does not usually prevent erections, sexual activity or testosterone production when the remaining testicle is healthy.

Fertility may be affected by the cancer itself or by chemotherapy, radiotherapy and some surgical treatments.

Anyone who may want children in the future should discuss fertility preservation, including sperm banking, before starting treatment when possible.

Can Testicular Conditions Affect Fertility?

Some testicular conditions may affect sperm production or fertility, including:

Testicular cancer
Cancer treatment
Severe infection
Significant varicocele
Testicular torsion
Undescended testicles
Serious trauma
Hormonal conditions
Some genetic conditions

Having one healthy testicle is often enough to maintain testosterone and sperm production. However, fertility varies between individuals.

Speak with your GP if you have been trying to conceive without success or are concerned about:

Previous testicular surgery
A difference in testicle size
A history of undescended testicles
Previous chemotherapy or radiotherapy
Low libido or erectile concerns
Reduced body hair or muscle strength
Other possible signs of low testosterone

Testing may include blood tests, semen analysis or specialist referral.

How Can You Support Testicular and Reproductive Health?

Not every testicular condition can be prevented, but several habits can support reproductive and general health.

Seek Early Assessment

Do not delay medical care because of embarrassment.

Healthcare professionals routinely discuss and examine genital-health concerns.

Practise Safer Sex

Condoms and appropriate STI testing can reduce the likelihood of infections that may lead to epididymitis or orchitis.

Arrange testing if:

You have symptoms
A partner has been diagnosed with an STI
You have had a possible exposure
You have a new sexual partner
You would like routine screening

Use Protective Equipment

Wear an appropriate athletic cup or guard during sports or activities where there is a risk of groin injury.

Avoid Smoking and Recreational Drug Use

Smoking and some recreational drugs may affect overall health, sexual function and fertility.

Speak with your GP if you would like support to reduce or stop use.

Discuss Fertility Concerns Early

Seek advice before fertility becomes an urgent issue, particularly if you have a medical condition or are about to begin treatment that may affect sperm production.

Attend Recommended Follow-Up

Follow your specialist’s monitoring plan if you have:

Previously had testicular cancer
Undescended testicles
Testicular surgery
A known varicocele
An ongoing fertility condition
Another diagnosed testicular disorder

Frequently Asked Questions

Is Every Testicular Lump Cancer?

No.

Many lumps are caused by benign conditions such as cysts, hydroceles and varicoceles.

However, a new lump cannot be safely diagnosed at home and should be assessed by a GP.

Can Testicular Cancer Be Painful?

Yes, although the most common presentation is a painless lump or swelling.

Some people experience discomfort, aching or pain in the testicle, scrotum, lower abdomen or groin.

How Often Should I Check My Testicles?

There is no universally recommended monthly schedule for people at average risk.

Be familiar with what is normal for you and arrange a medical assessment if you notice a new change.

Follow any specific monitoring plan recommended by your doctor.

Is It Normal for One Testicle to Hang Lower?

Yes.

It is common for one testicle to sit slightly lower than the other. One may also be slightly larger.

A sudden or significant change should be assessed.

What Does a Concerning Lump Feel Like?

A cancerous lump may feel firm or hard and may appear to be part of the testicle itself.

However, it is not possible to reliably distinguish cancer from a benign condition by touch alone.

Any new lump requires medical assessment.

Can Testicular Torsion Resolve on Its Own?

The testicle can occasionally twist and then untwist, causing sudden pain that later disappears.

This does not mean that the problem is resolved. Urgent medical assessment is still needed because the torsion may recur and permanently damage the testicle.

Can Tight Underwear Cause Testicular Cancer?

There is no established evidence that tight underwear causes testicular cancer.

However, clothing that is uncomfortable may contribute to irritation or make existing discomfort more noticeable.

Can an Injury Cause Testicular Cancer?

There is no known evidence that a testicular injury causes cancer.

An injury may lead someone to examine the area and discover a lump that was already present.

Persistent pain, swelling or a lump after an injury should be assessed.

Should I See a GP About Mild Testicular Pain?

Arrange an appointment if the pain:

Persists
Keeps returning
Is associated with swelling
Is accompanied by urinary symptoms
Is linked with a new lump
Has no clear explanation
Causes concern

Sudden or severe pain requires immediate emergency assessment rather than a routine appointment.

Can I Request a Male Doctor?

You can ask whether a male GP is available when booking. You can also request a chaperone for an examination.

Do not delay urgent care while waiting for a clinician of a particular gender.

The Bottom Line

Looking after your testicular health means knowing what is normal for you, recognising meaningful changes and seeking appropriate medical care.

A new lump, persistent swelling or unexplained discomfort should be assessed by a GP. Sudden or severe testicular pain requires immediate emergency care because testicular torsion can permanently damage the testicle within hours.

Most testicular changes are not caused by cancer. However, testicular cancer is highly treatable, and early assessment can provide reassurance or allow treatment to begin promptly.

If you have noticed a lump, pain, swelling or another change, book an appointment with Cranbourne West Medical Centre. Its men’s health services include confidential GP assessments, appropriate testing and specialist referrals when required.

This article provides general information and is not a substitute for personalised medical advice. Go to a hospital emergency department immediately if you develop sudden or severe testicular pain, rapid swelling, nausea or vomiting.