Pain in testicles and lower abdomen can be caused by a few different things. This area is where the male reproductive structures are as well as the urinary tract. The lower abdomen also has the large bowel and the muscles that keep the lower abdominal organs in place. Pain in this area can feel like stabbing, throbbing, aching, or like sore muscles. Let’s take a look at the different things that can cause pain in this area. Remember, this article cannot actually diagnose what may be going on so if something looks close to what you are feeling give your doctor a call.

Causes of Pain in Testicles and Lower Abdomen

1.       Epididymitis

This is an infection of the tubes that transport sperm. Infections can be caused by either viruses or bacteria, leading to inflammation and pain in the testicles and deep in the lower abdomen. It usually starts out as a bladder infection and gets transferred into the epididymis. Symptoms include:

• Pain
• Swelling in the testicles
• Fever
• Chills
• Painful ejaculation
• Urinary frequency
• Blood in urine

Treatment for epididymitis is antibiotics for a bacterial infection, rest, and increased fluids. For a viral infection, only rest and fluids will help relieve the symptoms. This infection needs to be treated fully and promptly to avoid long-term complications and pain.

2.       Testicular Torsion

The testicles are attached to cords inside the scrotum. If they become twisted, this is known as torsion and can cause severe lower abdominal pain. When the cords twist, the blood supply to the scrotum and testicles becomes cut off. Symptoms include:

• Very intense sharp pain
• Swelling of the scrotum
• Nausea
• Vomiting
• Lump in testicle
• Blood in semen

This is a medical emergency and needs medical evaluation immediately. The cut-off of the blood supply could cause the delicate tissues in the scrotum to dieoff quickly. This can lead to permanent sterility and other complications. The treatment for this condition is surgery.

3.       Inguinal Hernia

A hernia to the inguinal canal causes lower abdominal pain and groin pain. The inguinal canal is a hole in the wall of the abdomen. When the muscles in the lower abdomen become weak, the hole can get larger and tissue can slip through. This is usually caused by lifting heavy objects. There can be a lump in the groin and may even go into the scrotum. It is common in older men and men who are overweight. It can also happen with weight loss. This condition requires surgery to repair and some kind of abdominal support.

4.       Testicular Cancer

One of the less common causes of pain in testicles and lower abdomen is testicular cancer. The testicles produce hormones and sperm and cancer in this area is quite rare. It shows up as a lump in the testicle in men aging 15 to 35 years old. Self-examination of the testicles can help prevent this form of cancer. Symptoms include:

• Pain in the testicle
• Swelling
• Pea sized lump
• Dull pain in the abdomen
• Breast tenderness
• Leg swelling
• Shortness of breath
• Blood in semen

Testicular cancer is highly treatable if caught early. Treatment options include surgery, chemotherapy, and radiation. People with localized testicular cancer have a 5-year survival rate of 99%. If the cancer grows outside the testicles, the survival rate drops to 73%.

Experiences of Others

Pain in testicles and lower abdomen sounds terrible but is not uncommon. Here’s what others have been through:

“I get severe pain in my testicles and the doctor said it was coming from the tubes. They tested me for sexually transmitted disease and a hernia, which were negative. The doctor said since I have pain with touch that it is some kind of inflammation. They thought it might be epididymitis, so they put me on antibiotics and that didn’t help. I am now being referred to a neurologist. They think it might be nerve pain coming from somewhere else.” –John

“My testicles have very sensitive skin to the touch and I have pain in my lower abdomen. I lifted a heavy object at work that I had to take time off because of a bad pain in my lower back. They sent me for an MRI and found a bulging disc. When I lay on my back and lift my leg, the pain shoots down into my scrotum. They may need to do back surgery, but we are trying physical therapy first.”—Mark

“I have had a sore left testicle with swelling for about 4 months now. I cannot sit for longer than 30 minutes or my testicle gets really swollen and tight. My semen seems really thick too. They thought I had both a yeast infection and epididymitis, so I was treated with antibiotics and yeast infection pills. They tested me for STDs and was negative. I had an ultrasound and it showed I did have epididymitis. I was given more antibiotics in very high doses and it worked. I did find that one of the workout supplements I was using causes dehydration and the doctor said this may have concentrated my urine too much and caused the infection. I gave up caffeine which was further dehydrating me and I started seeing a chiropractor who gave me adjustments to my pelvic area. This helped a lot. Since this most likely started in my bladder, my doc said that at the first sign of burning with urination or pain I need to get checked out right away. Not taking care of a bladder infection can be very serious.” --Chris

Tips for Dealing with Pain in Testicles

If you have talked to your doctor and all health concerns have been evaluated, here are some helpful tips for pain in testicles and lower abdomen:

• Use an athletic support during sports or heavy lifting
• Use an icepack on your testicles
• If you don’t have an infection or swelling, try a hot bath
• Use over-the-counter pain relievers or anti-inflammatory drugs
• Always use a condom during sex if you have multiple partners and use a condom if your usual partner has a bladder, vaginal, or yeast infection.