Pain in the left testicle during an erection can be concerning. While not always severe, understanding potential causes and seeking medical evaluation is important.
The Link Between Erection and Testicular Pain
An erection increases blood flow to the penis and surrounding structures, including the testicles. This engorgement makes the penis rigid and enlarged. Testicles also experience increased blood volume, causing slight swelling and a heavier sensation.
During arousal, blood flow to the genital area increases, and veins constrict to maintain the erection. If arousal is prolonged without ejaculation, this blood can pool in the testicles and scrotum, leading to pressure, discomfort, or pain.
Common Causes of Left Testicle Pain When Erect
One common cause of left testicle pain during erection is epididymal hypertension, often known as “blue balls.” This condition arises when sexual arousal leads to increased blood flow and engorgement in the testicles. Without ejaculation, blood can pool, causing temporary discomfort or aching. The pain typically resolves within minutes or hours once arousal subsides or ejaculation occurs.
A varicocele involves enlarged veins within the scrotum, similar to varicose veins. They are more common on the left side due to anatomical differences. While often asymptomatic, varicoceles can cause a dull, aching pain or heaviness, which may worsen with physical activity, prolonged standing, or during an erection due to increased blood flow.
Epididymitis, inflammation of the epididymis, can cause testicle pain exacerbated during an erection. The epididymis is a coiled tube at the back of the testicle that stores and transports sperm. This condition is often caused by bacterial infections, including sexually transmitted infections, and can result in swelling, tenderness, and acute pain.
Prostatitis, inflammation or infection of the prostate gland, can cause testicle pain, especially during sexual activity. The prostate is situated below the bladder. This condition can cause widespread pelvic pain, including discomfort in the perineum, lower back, and penis, and may lead to painful urination or ejaculation.
An inguinal hernia, where intestine or abdominal tissue protrudes through a weak spot in the abdominal wall, can refer pain to the testicle. Common in the groin, these hernias can extend into the scrotum. Pressure from the protruding tissue on the spermatic cord and testicle can cause a dull, aching, or dragging sensation, which might become more noticeable with increased abdominal pressure during an erection or other activities.
Fluid-filled sacs, such as spermatoceles or epididymal cysts, can develop near the testicle. A spermatocele is a cyst within the epididymis that contains fluid and often dead sperm cells. While usually painless and benign, if these cysts grow large, they can cause a feeling of heaviness, discomfort, or a dragging sensation in the scrotum, which could be more apparent when the area is engorged during an erection.
When to Seek Medical Care
While some causes of left testicle pain when erect are transient, certain symptoms warrant immediate medical attention. Sudden, severe pain, especially with rapid swelling, nausea, or vomiting, could indicate testicular torsion. This serious condition occurs when the spermatic cord twists, cutting off blood supply, and requires urgent treatment to prevent permanent damage or loss of the testicle.
Consult a healthcare professional if the pain is persistent, worsens, or does not resolve within a few hours. Other concerning symptoms include fever, chills, blood in the urine or semen, difficulty urinating, or a lump or noticeable change in testicle size or texture. These signs may point to infections, inflammation, or other conditions requiring timely diagnosis and management.
Steps for Diagnosis and Management
A healthcare professional typically begins the diagnostic process with a physical examination of the groin, testicles, and abdomen. They will also ask detailed questions about the pain’s nature, its onset, duration, and any associated symptoms. This initial assessment helps narrow down the potential causes and guide further investigations.
To confirm a diagnosis, several tests may be performed. A scrotal ultrasound is a common imaging technique used to visualize the testicles and surrounding structures, assess blood flow, and identify conditions like varicoceles, cysts, or signs of inflammation. Urine and blood tests can help detect infections, such as epididymitis or prostatitis, by identifying bacteria or markers of inflammation.
Management of left testicle pain when erect depends entirely on the underlying cause. For conditions like epididymal hypertension, simple measures such as ejaculation or distracting activities to reduce arousal are often sufficient. If an infection is present, antibiotics are typically prescribed. Anti-inflammatory medications and pain relievers can help manage discomfort and swelling.
In some cases, lifestyle adjustments may be recommended, such as wearing supportive underwear or applying ice packs to the scrotum to alleviate swelling and pain. For structural issues like large varicoceles or symptomatic hernias, surgical intervention might be considered to correct the problem and relieve pain. It is important to follow the guidance of a healthcare professional to ensure an accurate diagnosis and appropriate treatment plan.