Why do your testicles feel tight? (+1 reasons)

In this article, we will discuss why you feel tightness in your balls. We will also discuss the associated symptoms and how your balls should feel like.

Why do your testicles feel tight?

You may feel tightness in your testicles due to several reasons, including:

• Testicle torsion,
• Epididymitis,
• Hydrocele, and
• Environmental factors such as cold and touch.

Tightness in a man’s ball may be a cause of concern, especially if the tightness is persistent. You must also note other associated symptoms like swelling, testicular pain, and tightening of the foreskin before going to your doctor.

Some diseases causing the ball’s tightness must be treated immediately, especially testicle torsion. A father needs to discuss groin area problems with their boys and make them comfortable to discuss anything about their private parts. Early diagnosis can prevent worsening of the condition.

Testicle torsion

Testicle torsion is a medical emergency in which the spermatic cord becomes twisted. The spermatic cord supplies blood flow to the testicles. Once the spermatic cord becomes twisted, it cuts off the blood supply to the testicles, thereby causing ball tightness, pain, and swelling (1).

Epididymitis

Epididymitis is an inflammation of the epididymis (convoluted duct behind the testis) due to bacterial infection. You are prone to get epididymitis if you have a urinary tract infection or sexually transmissible infection like gonorrhoea or chlamydia (2).

Hydrocele

Hydrocele is a condition in which the scrotum becomes filled with fluid. It may be caused in newborns, and the elderly, or occur due to epididymitis, trauma, or swelling. A hydrocele feels like a water-filled balloon and causes swelling in one or both sides of the testes (3).

You may feel tenderness around the scrotum and tightness in your balls due to increased testicular volume. Hydrocele may also cause phimosis. In phimosis, the tightening of the foreskin occurs. Phimosis and paraphimosis occur only in the uncircumcised males (3). 

Environmental factors

The cremasteric reflex causes contraction of the cremasteric muscle that causes tightness of the balls. The cremasteric reflex is often caused by cold temperatures. Sometimes touch and anxiety can also cause tightness of the balls due to the cremasteric reflex.

What does research suggest?

In a retrospective single-centre review, it was found that 104 boys (aged 0-18 years) experienced testicle torsion, tightness, and compression of the vessels of the cord. Amongst them, 94 boys suffered from scrotal swelling, pain, and abdominal discomfort (4).

In a prospective study, 134 adults were observed for other associated symptoms due to epididymitis. The patients presented with ball tightness and swelling associated with hydrocele (45.5%), orchitis (47%), and epididymal abscess (8%) (5).

What are the other associated symptoms of testicle tightness?

Tightness in the man’s balls may ignite other symptoms and discomforts, including:

• Pain and swelling in the groin area and testicles,
• Lumps and bumps in the testicular area,
• Redness and warmth in the testicular area,
• The scrotum looks or feels full of fluid but there is no arousal, and
• Difficulty in urination.

What should your testicles look and feel like?

Your balls, testes or testicles, are oval-shaped glands that sit in a pouch known as the scrotum, under the base of your penis. When you feel your balls under the scrotum, they should be smooth and no lumps/ bumps should be present.

When you squeeze your balls, they should feel firm, but not hard, to touch. It is normal if you feel that one testicle is bigger than the other one. However, they should not be abnormally small. Also, it is normal if one ball hangs slightly lower than the other one.

How to manage tightness in testicles?

If you experience tightness in your balls due to cold temperature and touch sensation, a hot compress may help relieve the symptoms. However, the scrotum tends to tighten up naturally during cold to maintain the temperature of testicles which is 2°C less than the normal body temperature.

Medication

In the case of epididymitis, antibiotics are often prescribed to treat the underlying bacterial infection. The commonly prescribed antibiotics include trimethoprim-sulphamethoxazole, levofloxacin, and doxycycline.

Your doctor may prescribe the antibiotic treatment for one or two weeks depending upon the severity of the disease. Doxycycline is known to cause severe nausea. You may take doxycycline with food to prevent the occurrence of nausea. 

If testicle tightness and epididymitis are due to gonorrhoea, your doctor may prescribe you a one-time intramuscular injection of ceftriaxone (500 mg). In the case of chlamydia, azithromycin (one dose of 1000 mg, followed by 500 mg once a day) and doxycycline (500 mg for one week) may be prescribed.

Surgery

Although hydrocele poses no danger to the patient, you may need surgery to remove hydrocele if it is affecting your daily activities or sexual life. The surgery removes the fluid from the sac under general anaesthesia. You will be discharged from hospital within a day (6).

In case of testicular torsion, your doctor might be able to untwist the spermatic cord by pushing on the scrotum. This procedure is known as manual detorsion. However, doctors rarely perform this procedure and usually opt for surgical procedures (7).

You may need to wear a scrotal support after the surgery for about 1-2 weeks. You should also avoid strenuous activities and exercise till complete healing. However, you may need to wait for about 4-6 weeks before carrying out sexual activities (7).

If you feel tightness in your balls, pain in your groin area, or swelling, immediately consult your doctor. Boys often feel reluctant to talk about their private parts, even with their parents. This may worsen the situation with time.

A doctor, parents and siblings need to provide a suitable and comfortable environment for the boys and men to talk about their private parts, especially if they have pain in their scrotum and groin area.

References