Experiencing testicular pain, especially when coughing, can cause concern. While some causes are minor, others may indicate a condition requiring medical attention.
Common Explanations
A common explanation for testicular pain during coughing is an inguinal hernia. This condition develops when a weakness in the lower abdominal wall allows a portion of the intestine or fatty tissue to protrude. When coughing, the sudden increase in intra-abdominal pressure pushes this tissue further into the weakened area, causing it to descend into the scrotum. This movement can cause sharp or aching pain exacerbated by the strain.
The discomfort is often described as a pulling or heavy sensation in the groin or scrotum, intensifying with activities like coughing, sneezing, or lifting. The pain is a direct mechanical response to the increased pressure forcing tissue into the hernia sac. Identifying and addressing an inguinal hernia typically involves a physical examination and, in many cases, surgical repair to alleviate the symptoms and prevent complications.
Another potential cause involves inflammation of the epididymis or testicle. Epididymitis refers to the inflammation of the epididymis, a coiled tube at the back of the testicle that stores and carries sperm. Orchitis, on the other hand, is the inflammation of the testicle itself. These conditions are frequently caused by bacterial infections, such as urinary tract infections or sexually transmitted infections, or by viral infections like mumps.
Coughing does not directly cause epididymitis or orchitis, but the associated physical straining and sudden changes in abdominal pressure can worsen existing inflammatory pain. The discomfort is generally constant, though any physical exertion or movement that jostles the inflamed area can intensify it. Accompanying symptoms might include swelling, redness, fever, or pain during urination, indicating a need for medical evaluation.
Other Potential Causes
Fluid accumulation around the testicle, known as a hydrocele, can contribute to discomfort. A hydrocele occurs when fluid collects in the thin sheath surrounding the testicle, leading to scrotal swelling. Similarly, a varicocele involves the enlargement of veins within the scrotum, often described as feeling like a “bag of worms.” Both conditions typically cause a dull, persistent ache or a feeling of heaviness in the scrotum.
When coughing, increased abdominal pressure might temporarily increase fluid pressure within a hydrocele or enhance blood pooling in a varicocele. This momentary change can make existing discomfort more noticeable or briefly intensify the ache. While not directly caused by coughing, the symptom can highlight the underlying presence of these conditions.
Pain originating from other areas of the body can sometimes be perceived in the testicles, a phenomenon known as referred pain. Conditions like kidney stones, which cause severe pain as they travel through the urinary tract, can radiate sensations to the groin and scrotum. Nerve compression in the lower back can also manifest as pain in the testicular region.
The physical exertion and body mechanics involved in coughing can sometimes aggravate the primary source of this referred pain. This leads to a heightened sensation in the testicular area, even though the problem lies elsewhere. Recognizing that the pain source might be distant from the perceived location is an important aspect of diagnosis.
For individuals who have undergone a vasectomy, post-vasectomy pain syndrome (PVPS) is a chronic pain condition that can develop. This syndrome can cause persistent or intermittent pain in the testicles or epididymis. Activities that increase abdominal pressure, such as coughing or straining, might temporarily intensify the discomfort or aching sensation associated with PVPS.
When to Consult a Doctor
Consult a medical professional if you experience severe or sudden onset testicular pain. Prompt medical attention is also important if the pain is accompanied by other concerning symptoms, including a fever, noticeable swelling or redness of the scrotum, or tenderness to the touch.
Additional red flags warranting immediate evaluation include:
- Nausea or vomiting.
- Blood in the urine.
- Persistent pain that does not improve over time.
- A noticeable lump in the scrotum or groin.
A medical professional can accurately diagnose the underlying cause of your symptoms and recommend the most appropriate course of treatment.