What are the common causes of pain between the testicle and anus?

Reviewed by Yoshinori Abe, MD

Internal Medicine

Pain between the testicles and anus (the perineum) is often caused by pelvic floor muscle trigger points, erectile dysfunction, or a history of anorectal conditions such as an imperforate anus. Other common causes include prostatitis, nerve irritation (pudendal neuralgia), infection, or injury to the area.

Because these causes range from muscular tension to nerve or prostate issues, symptoms can overlap and be difficult to identify on your own. Delaying evaluation may allow treatable conditions to worsen. Taking a free, instant, online symptom check can help you quickly narrow down possible causes, understand how urgent your symptoms are, and guide your next steps with confidence.

Reviewed for medical accuracy: 07/15/2026

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Explanation

Pain in the area between the testicle and anus, often referred to as the perineum, can have several causes.

Myofascial Trigger Points: These are sensitive spots in the muscles that can cause pain. They are common in men with pelvic pain and can be found in the muscles around the pelvis and perineum.
Anocavernosal Erectile Dysfunction Syndrome: This condition involves problems with erectile function that are linked to pain in the anal area. This can lead to discomfort in the perineum.
Past Anorectal Issues: Sometimes, if a person had a condition like an imperforate anus, where the anus did not open properly at birth, it can lead to chronic pain in the testicular and perineal area later in life.

Understanding these causes can help in identifying the source of the pain and seeking appropriate treatment. If you are experiencing such pain, you can start by using Ubie's free AI-powered symptom checker to better understand your symptoms before consulting with a healthcare provider for a proper diagnosis and management.

(References)

Anderson RU, Sawyer T, Wise D, Morey A, & Nathanson BH. (2009). Painful myofascial trigger points and pain sites in men with .... The Journal of urology, 19837420.
Shafik A, & El-Sibai O. (2000). The anocavernosal erectile dysfunction syndrome. II Anal .... International journal of impotence research, 11424966.
Negri L, Albani E, Di Rocco M, & Levi-Setti PE. (2002). Aspermia and chronic testicular pain after imperforate anus .... Human reproduction (Oxford, England), 12407052.

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