Testicles FAQ

Testicles, also called testes or balls, are oval-shaped organs that sit in a sac that hangs behind the penis.

Is One Testicle Bigger Than the Other Normal?

Not only is it normal to have one testicle that is bigger than the other, but it’s also common to have one that hangs a bit lower. However, asymmetrical testicles that develop suddenly and are accompanied by pain and other symptoms are a reason to call your healthcare provider.

This article covers the anatomy of testicles and why they can be of different sizes. It also goes over conditions that can affect testicles, how to do a testicular self-exam, and when to see a healthcare provider.

Normal Testicle Characteristics

How testicles look and feel can vary from person to person, but normal testicles tend to have some specific characteristics.

• Adult testicles are roughly 2 to 3 inches long and 1 inch wide.
• Testicles can be different in size but will usually be of the same or similar shape.
• Each testicle feels like a firm, smooth egg.
• Pain can be felt in the testicles if they are hit or roughly handled, but should not be felt when the testicles are touched or examined.

Asymmetrical testicles are not uncommon and are usually not a problem. In some cases, the testicles are different sizes because the right testicle of a fetus finishes developing before the left one.

Testicle asymmetry is also possible during puberty when one testicle might develop a little faster than the other. The smaller testicle may “catch up” and the testicles will be closer in size by the end of puberty. However, in some cases, the testicles stay different sizes into adulthood.

At the other end of the aging spectrum, the testicles tend to decrease in size as a person gets older (atrophy). This shrinkage usually happens on both sides (bilateral). However, similar to the way in which one testicle might grow a little faster than the other during puberty, it’s possible that one testicle (unilateral) might appear to shrink a little faster than the other in older age.

Abnormal Testicle Characteristics

Having one testicle that is bigger than the other does not necessarily mean there’s a problem. However, if you also have these signs and symptoms, you should tell your provider.

Signs of a possible testicle-related health concern include:

• Changes in testicle size
• Changes in the shape of a testicle
• Pain, tenderness, or swelling
• A lump or growth on a testicle, with or without pain
• Sudden retraction (pulling in toward the body) of one testicle but not the other

Conditions That Can Cause Testicle Changes

There are some common conditions that can cause lumps, pain, or swelling of the testicles. These conditions are usually not serious or life-threatening but they do need to be looked at by a provider.

There are some different exams and tests that providers can use to figure out what’s causing a problem with a testicle. Possible conditions a provider will look for include:

• Hydrocele: In this condition, there is swelling of the sac of skin beneath the penis ( scrotum ) due to fluid buildup. Hydrocele is common in newborns and usually goes away without treatment. In late life, it can develop if there is inflammation or injury.
• Varicocele: In this condition, the vein that transports blood from the testicles gets bigger (enlargement). A varicocele occurs when blood pools in the veins rather than circulating as it should.
• Orchitis: This condition is the inflammation of a testicle, usually caused by an infection.
• Epididymitis: This condition is the inflammation of the small coiled tube behind each testicle that collects and stores sperm (epididymis). Infection usually causes this condition.
• Inguinal hernia: This condition happens when part of the intestines pushes through muscles in the groin and protrudes into the scrotum.
• Testicular trauma: This can happen during contact sports or after being struck in the groin. Testicular injuries can lead to swelling, pain, bruising, and blood in the urine.
• Testicular cancer: This type of cancer typically occurs between the ages of 15 and 45. Testicular cancer can cause heaviness in the scrotum along with a painless lump, asymmetrical swelling, and hydroceles.
• Testicular torsion: This condition is a medical emergency that’s caused by the twisting of the spermatic cord, a bundle of nerves, ducts, and blood vessels that connect the testicles to the abdominal cavity.

When to Call 911

Testicular torsion is an emergency. It can cut off (strangulate) blood flow to a testicle, which can lead to the loss of the testicle. Get emergency medical attention if you have these signs and symptoms:

• Sudden, severe scrotum pain
• Swelling of the scrotum
• A testicle that is suddenly positioned higher or at an unusual angle
• Abdominal pain
• Nausea and vomiting
• Frequent urination
• Fever

Testicular Self-Examination

A testicular self-exam is a method to check yourself for lumps, pain, or other unusual changes in your testicles. A self-check is commonly used as a preventive tool for testicular cancer.

Verywell / JR Bee

To do a testicular self-exam:

1. Shower or bathe to make sure your scrotum is relaxed and warm.
2. Stand in front of a mirror if it helps you see your scrotum better.
3. Use the fingers and thumbs on both your hands to gently roll your testicle, checking for lumps or any painful areas.
4. Feel along the underneath and back of the scrotum to locate the epididymis (it should feel like a bundle of tightly coiled tubes).
5. Repeat on the other testicle.

Recommendations

The American Society of Clinical Oncologists recommends monthly self-exams between the ages of 15 and 55 to detect any changes that could enable the early diagnosis of testicular cancer.

How Are Testicle Conditions Treated?

The different conditions that can affect the testicles have different treatments—and some do not need much treatment at all. For example, orchitis is usually just managed with rest and possibly antibiotics if bacteria is the cause.

In some cases, the cause of a problem with the testicles is an emergency that requires medical treatment like surgery right away. There are also some conditions, like a varicocele or hernia, that may need surgery but not immediately—for example, it can be done as a planned surgery and you may not need to be admitted to the hospital.

Cancer of the testicles often involves a combination of treatments like chemotherapy, radiation, and surgery.

Summary

Having one testicle that is always slightly larger than the other is often normal. However, swelling, pain, lumps, or sudden changes in the size or position of a testicle are not.

Doing monthly self-exams is a good way to watch for changes that could be a sign of a serious medical problem, including testicular cancer.

Having regular medical check-ups is also important, but do not wait to call your provider if you notice changes in your testicles that are worrying you.

24 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. NHS (UK). What should my testicles look and feel like?.
2. Nemours. Is it normal for one testicle to be bigger?.
3. American Cancer Society. Do I have testicular cancer?.
4. Victoria State Government. Testicular self examination.
5. Soto ÁL, González JLM, Martínez MV, et al. Sonographic evaluation of fetal scrotum, testes and epididymis. Obstet Gynecol Sci. 2021;64(5):393-406. doi:10.5468/ogs.21040
6. Vaganée D, Daems F, Aerts W, et al. Testicular asymmetry in healthy adolescent boys. BJU Int. 2018;122(4):654-666. doi:10.1111/bju.14174
7. PJ. Lourdaux, Vaganée D, Christiaan Leysen, Stefan De Wachter, Gunter De Win. Evolution of testicular asymmetry during puberty in adolescents without and with a left varicocele. BJUI. 2022;131(3):348-356. doi:10.1111/bju.15914
8. Poon SA, Gjertson CK, Mercado MA, Raimondi PM, Kozakowski KA, Glassberg KI. Testicular asymmetry and adolescent varicoceles managed expectantly. J Urol. 2010;183(2):731-734. doi:10.1016/j.juro.2009.10.028
9. MedlinePlus. Aging changes in male reproductive system.
10. Emin Özbek. Testicular atrophy.
11. MedlinePlus. Testicular disorders.
12. Gordhan CG, Sadeght-Nejad H. Scrotal pain: evaluation and management. Korean J Urol. 2015;56(1):3–11. doi:10.4111/kju.2015.56.1.3
13. MedlinePlus. Hydrocele.
14. MedlinePlus. Varicocele.
15. MedlinePlus. Orchitis.
16. MedlinePlus. Epididymitis.
17. NIH. Inguinal hernia.
18. Nemours TeensHealth. Testicular injuries.
19. Nemours KidsHealth. Testicular torsion.
20. MedlinePlus. Testicular self-exam.
21. American Society of Clinical Oncologists. Testicular cancer: screening.
22. Urology Care Foundation. What are ependymitis and orchitis?.
23. UCLA. Varicocele.
24. National Cancer Institute. Testicular cancer.

By Sherry Christiansen
Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer’s research.

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Testicles FAQ

Testicles, also called testes or balls, are oval-shaped organs that sit in a sac that hangs behind the penis.

The main job of testicles is to make sperm and produce testosterone. Testosterone is the male hormone that’s responsible for the changes that occur during puberty. Puberty is the time in life when your body begins to change and you start to look more and more like an adult.

After puberty is finished, the testicles will produce millions of sperm a day. Sperm mixes with a white, milky substance to make semen. Semen is what’s released from the penis when you ejaculate.

Guys become fertile between the ages of 11 and 17, meaning they are able to ejaculate semen and get a girl pregnant.

When will my testicles begin to grow?

Your testicles will grow in the early stages of puberty, between the ages of 10 to 13. As your testicles grow, the skin around the scrotum — the sac that holds the testicles — will darken, hang down, and begin to develop hair.

How big are testicles?

On average, testicles grow to be about 2 to 3 inches in length and 1 inch in width.

Is it normal to have one testicle that’s bigger than the other?

Yes. It is common for guys to have slightly different size testicles. Usually, the right testicle is larger than the left. Also, one testicle (usually the left) often hangs lower than the other.

Why does my scrotum shrink when I get cold?

For your testicles to produce sperm, they must be kept at just the right temperature. As a result, the scrotum will change size to make sure the testicles stay at that right temperature. This happens without you even thinking about it. So, when you are cold, your body sends a message to the scrotum to shrivel and preserve heat.

Why do my testicles hang down?

Just as your body directs your scrotum to shrivel when it is cold, your body tells the scrotum to loosen up when you are too warm. Your scrotum will become larger and more floppy to release extra heat.

What if I have painful or swollen testicles?

Many things can cause painful or swollen testicles, including:

• Fluid collecting in an area surrounding a testicle, a condition known as a hydrocele.
• Infection, such as from a virus or a sexually transmitted disease (STD) like chlamydia
• Inguinal hernia. That’s a condition in which a part of the intestines pushes into the groin or scrotum through an abnormal opening or a weak spot in the abdominal wall.
• Injury to the testicles, such as from being kicked, hit, or crushed.
• Swelling in a vein that drains blood away from a testicle, a condition called varicocele.
• Testicular cancer.
• Testicular torsion, an extremely painful condition that occurs when a testicle gets twisted.

If you think you have testicular torsion, see a doctor right away. This is a serious medical emergency.

If you notice any pain or swelling in or around your testicles, tell a parent and have it examined by a doctor as soon as possible. Many different types of testicle problems are linked to pain and swelling in the testicles. It’s not always easy to tell which episode could lead to more serious problems if ignored. Play it safe and get checked.

Could I have testicular cancer?

Testicular cancer occurs when cells in the testicle divide abnormally and form a tumor. You may think you’re too young to worry about it. But you’re not, especially if you’re over the age of 14. Testicular cancer typically affects males between the ages of 14 and 35. And it’s the most common cancer in this age group.

Testicular cancer is not very common. There are about 8,300 new cases a year. And about 500 men die each year from this cancer. But while some men are more likely to get it than others, it’s possible for any young man to get the disease.

The most common symptom of testicular cancer is a painless lump on a testicle. Other symptoms may include:

• An enlarged or swollen testicle, with or without pain
• A heavy, aching feeling in the lower stomach, low back, or groin

Should I give myself a monthly testicular self-exam?

Unless you have certain risk factors, such as a brother or father who has or had testicular cancer, the American Cancer Society (ACS) says there aren’t enough studies to make monthly exams a recommendation.

But, because the cancer is so easy to treat when found early, some doctors recommend the exam. Besides finding cancer early, the exam can help you find other problems that may need to be treated.

How do I do a testicular exam?

Some doctors recommend that boys start doing monthly exams as early as 14. At this age, it’s unlikely that you’ll find anything to be concerned about. However, a self-exam will give you the chance to get to know your body so that you can detect changes more easily in the future.

The best time to do an exam is right after a shower or bath. That’s when the skin of the scrotum will be most relaxed and the exam will be easier to do. You should do the exam standing in front of a mirror. If you are nervous about touching yourself, don’t be. This is how you get to know what your testicles and scrotum should feel like.

• Start by standing in front of the mirror and checking for any swelling in the scrotum. Cup the scrotum in one hand to see if it feels normal.
• Hold your penis out of the way and examine one testicle at a time.
• Roll the testicle gently between the fingers and thumb. You should not feel any pain.
• The testicle may be about the size of a golf ball, and it should feel smooth.
• Feel for any bumps or changes in size or consistency.
• After checking one testicle, check the other the same way. One testicle may be slightly larger or smaller; this is normal.
• Lumps should be checked by a doctor.

You may notice bumps on the skin of your scrotum. These are often caused by an ingrown hair or by a rash. They are usually not a cause for concern. You may also feel small, squishy lumps of tubes. These tubes are the sperm tubes that connect your testicles to the rest of your body. These small bumps are normal. But anything that feels different than usual should be checked by a doctor.

When should I call a doctor?

If you find any lumps on your testicles when you do a self-exam, see a doctor right away. Also see a doctor if you notice any of these changes:

• One testicle has gotten noticeably larger or smaller.
• You have a dull ache in the lower abdomen or groin.
• You have a feeling of heaviness in the scrotum.
• You feel pain or discomfort in the scrotum or a testicle.
• You notice an enlargement or tenderness in your breasts.

Any of these could be a warning sign of cancer or something else, such as an infection. Only your doctor can diagnose what the problem is and decide on the proper treatment. Remember, the earlier a problem is found, whether it’s cancer or something else, the more options there are for treating it and the easier it will be to treat.