Fragile Balls

Dear Dr G,

I am 71-years-old who is generally fit and healthy.

Of late, perhaps a few months ago, I began to realise that one of my testicles is a bit more sensitive than the other.

Having noticed such tenderness, I observed a definite change in the size of my balls, too. The sensitive side is now noticeably smaller in size compared with the other.

All right, I must clarify that I am not the sort of man who is obsessive about my genitalia.

Upon gentle pressing of the ball, I feel a bit of tenderness, but not to an extent that it gives me pain in my everyday life.

I would like to put Dr G on the spot about the mystery of my “fragile” balls.

Is it normal for such occurrence in men? What would be the causes and will it resolve with time?

I am rather worried that this can be something more serious and it requires urgent medical attention.

Your advice is most appreciated.

Looking forward to your reply.

Andrew

Testicular pain is usually experienced in or around one or both scrotums.

The intricate innervations of men’s “crown jewels” are peculiar that the sensation felt in the sac may be from its content, or even from somewhere else in the groin or the abdomen.

Such phenomenon is known as referred pain, adding layers of complexity to investigating the source of the tenderness.

Testicular pain or discomfort is overwhelmingly common. The true prevalence of such nuisance is unknown, as the vast majority of cases go unreported.

The discomfort or the tenderness in the sac can affect any man, at any age.

The truth is the vast majority of such ordeal is mild in nature, and often intermittent and transiently in nature.

Hence, when such “twitches” strikes in the groin, most men would consider it a nuisance instead of a curse, unless the ordeal is prolonged and affects the quality of life.

The common causes for testicular pain in younger men and adolescent are intermittent torsion, trauma or varicocele.

Torsion is relatively common among young men during their sexual maturation.

The increased “activities” in the groin with the combination of long spermatic cords can risk the balls twisting and causing pain.

In the event of excruciating pain, such scenario demands immediate attention, as the acute torsion may risk losing the testicle!

Trauma induced injuries to the testicles is also common among young active men, especially those in cycling.

Other sporting enthusiasts among youth may also cause the increase intra-abdominal pressure, in turn resulting in the dilation of the testicular veins.

This is a condition known as varicocele, well known to be the pain in the balls affecting men of all ages.

Contrary to common perceptions, testicular cancers present themselves as painless swelling in the sac.

The other common myths of young men would correlate testicular pain the habit of frequent masturbation.

Rest assured, there is no correlation between the frequency of sex and testicular pain.

The pain in the sac for older men can be perhaps a little bit more complex.

Diabetic patients can encounter neuropathy and vasculopathy, as the nerve and vessel damage can cause pain and shrinkage of the balls.

The enlargement of the prostate, resulting in residual urine, leading to urinary tract infections can also cause chronic orchitis that may be painful.

Apart from that, even blood vessels inflammation such as Henoch-Schonlein Purpura (HSP), is well known to affect the testicle causing mild discomfort.

Lastly, aged related problems such as hernias and hydrocele can also result in testicular pain. The crown jewel in the sac becomes more fragile and susceptible.

Although most of the causes of testicular pain and shrinkage may be alarming and puzzling, the real etiology is unidentified or resolved.

“Pretty Woman” actress Julia Roberts once said: “The older you get, the more fragile you understand life to be. I think that’s good motivation for getting out of bed joyfully each day.”

Dr G’s response is: “The older you get, the more fragile your balls are. When the tenderness is not affecting your daily life, that is definitely a motivation for getting out of bed joyfully each day!”