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Testicles – How Do They Work? Are Mine Normal?

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Testicles are oval-shaped reproductive organs that are sometimes called balls or testes. They hang behind the penis in a sac called the scrotum. They produce sperm and testosterone. The testicles are often very sensitive. Many people get pleasure from touching or pulling them. Others may not enjoy having them touched at all.

How do the testicles work?

The testicles are full of a series of small tubes that contain sperm-producing cells. They make enough sperm to release 100 million per ejaculation! These sperm are stored in a tube called the epididymis. When a person ejaculates the sperm travel up through another tube called the vas deferens, then the urethra and out through the tip of the penis. The testicles also produce testosterone. Testosterone is a hormone that helps make sperm. It also makes the penis and testicles grow, makes hair grow on the face and body and lowers the voice pitch.

Are my testicles normal?

Every person’s testicles are going to look and feel a little different. Testicles usually start to grow between the ages of 8-13. As they grow, the skin on the scrotum will get darker and grow hair. Adult testicles are commonly about 4-7cm (2-3 inches) in length and 2.5cm (1 inch) in width. But a lot of people have one testicle that is slightly bigger than the other. You can be completely healthy and have testicles of different sizes. However, if you notice a sudden change in the size or shape of one or both testicles you may want to tell your doctor. This could be a sign of testicular cancer.

The testicles need to stay cooler than normal body temperature in order to work properly. That’s why they hang down and aren’t inside the body. If the testicles get too hot they can’t make sperm as well. Wearing loose clothing and avoiding staying in the heat too long can help prevent this. When a person is excited or when the testicles get too cold, they can also retract or “ride up”. There’s a muscle that pulls them inside the body. Some people find that this can hurt a bit. The pain often goes away after the person calms down or moves to a warmer temperature. If the pain is really bad or doesn’t go away, you may want to see a doctor.

Some people are born with an undescended testicle. This means that the testicle has not moved into its proper position in the scrotum. Most of the time the testicle moves into position on its own before the baby is 4 months old. If not, a surgeon can do it. Without surgery, an undescended testicle can cause health problems because it gets too hot.

What can cause testicle pain?

Testicles are very sensitive, and even small injuries can feel really painful for days. The pain can come from a lot of things. Even injuries or medical issues in your stomach can make your testicles hurt.

When the pain is severe, sudden and comes with swelling, it may be testicular torsion. This is when the testicle twists around and reduces its blood flow. This is a serious condition and it’s important to go to the ER right away.

A swollen but painless testicle could be a hydrocele, which is the collection of fluid in the scrotum. This often goes away on its own but can be a sign of another condition. It could also be a cyst or a bacterial infection, like an STI (sexually transmitted infection). These are commonly treated with antibiotics.  If the pain comes soon after sex, even if you orgasm, it could be vasocongestion, or “blue balls.” This will pass on its own, and painkillers will help.

When the testicular pain is sudden and really bad, it can be a sign of serious health issues and you should go to the ER right away. If pain is more dull, but it doesn’t go away for a few days, it’s a good idea to go to a CLSC. This is especially true if you notice a lump or any swelling.

How do I examine my testicles?

One way to help keep your testicles healthy is to do regular testicular self-exams. This means you check your testicles for any unusual lumps or bumps. These lumps could be an early sign of testicular cancer. Doctors recommend you do one every month to help stay familiar with how your testicles feel normally.

  1. Choose the right time to do your exam. This is usually after a bath or shower when the skin of the scrotum is most relaxed.
  2. Examine one testicle at a time. Start by gently pinching the top of your scrotum between your thumb and fingers. This will help your testicle stay put during your exam. You may feel a little tube called the spermatic cord.
  3. With your free hand, glide your thumb and fingers from top to bottom along the front, back and both sides of the testicle. Feel for any lumps or bumps. At the top on the back, you can usually feel the epididymis. This is a normal lump and may be a little tender.
  4. Examine the other testicle in the same way.

If you feel unusual hard lumps, swelling, or changes in colour it’s a good idea to see your doctor or go to a CLSC for a checkup. Just because you find a lump doesn’t necessarily mean you have cancer.

More info:

  • About Testicles

    Answers some common questions related to how testicles should look and feel, as well as common issues. 

  • One testicle worries – Scarleteen

    Information about having one testicle

  • Vasocongestion, AKA Blue Balls – Scarleteen

    This article talks about vasocongestion, commonly known as blue balls. It talks about what it is, how it can affect people with vaginas or penises, and what people can do to alleviate it.

  • Testicular Exams

    Kidshealth.org article on testicular exams with general information on possible issues and prevention.

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