Aching Down There? Causes of Scrotal Pain and Your Medical Roadmap

A Practical Guide to Testicle Pain in Men Over 60

Experiencing scrotal or testicle pain can be uncomfortable—and understandably concerning. While many causes are minor and treatable, some require urgent medical care. If you're dealing with testicle pain in men over 60, it's especially important to understand what may be behind it and what steps to take next.

Let's walk through the common causes, warning signs, and a clear medical roadmap so you know what to do.

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First: Is It an Emergency?

Some causes of scrotal pain require immediate care. Seek urgent medical attention if you notice:

• Sudden, severe testicle pain
• Swelling that develops quickly
• Nausea or vomiting with scrotal pain
• A high fever
• Redness spreading across the scrotum
• Pain after injury
• One testicle sitting higher than the other
• Fainting or severe abdominal pain

One serious condition to rule out is testicular torsion, where the spermatic cord twists and cuts off blood supply. While more common in younger males, it can still occur in older men. If you're experiencing sudden, severe pain and aren't sure whether it requires emergency care, you can check your symptoms with a free AI symptom checker to help assess your risk level and determine next steps.

If pain is sudden and severe, do not delay—go to the emergency room immediately.

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Common Causes of Testicle Pain in Men Over 60

As men age, the causes of scrotal pain shift slightly compared to younger men. Here are the most common reasons.

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1. Epididymitis (Most Common in Older Men)

Epididymitis is inflammation of the epididymis—the coiled tube behind the testicle that stores sperm.

In men over 60, this condition is often linked to:

• Urinary tract infections (UTIs)
• Prostate enlargement (BPH)
• Recent urinary procedures
• Bladder problems causing urine backflow

Symptoms:

• Gradual onset of pain
• Swelling on one side
• Warmth and redness
• Painful urination
• Fever (sometimes)

This condition is usually treated with antibiotics. Most men improve within a few days, but full recovery can take weeks.

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2. Prostate Enlargement (BPH) Complications

Benign Prostatic Hyperplasia (BPH) is very common in men over 60. An enlarged prostate can:

• Block urine flow
• Increase risk of infections
• Cause referred pain to the testicles

If testicle pain is paired with:

• Weak urine stream
• Frequent nighttime urination
• Difficulty starting urination

Your prostate may be contributing to the discomfort.

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3. Inguinal Hernia

A hernia occurs when part of the intestine pushes through a weak spot in the abdominal wall and may extend into the scrotum.

Symptoms:

• Bulge in groin
• Aching or pressure sensation
• Pain that worsens with lifting or coughing
• Scrotal swelling

Hernias are common in older adults. They may not always require emergency surgery, but painful or enlarging hernias should be evaluated promptly.

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4. Hydrocele

A hydrocele is a fluid buildup around the testicle.

It typically causes:

• Painless or mildly uncomfortable swelling
• A feeling of heaviness
• Gradual enlargement

Hydroceles are usually harmless but should be checked to rule out infection or tumors.

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5. Varicocele

A varicocele is enlarged veins in the scrotum. Though more common in younger men, it can persist into older age.

Symptoms may include:

• Dull ache
• Heaviness
• Pain that worsens when standing

Most cases don't require treatment unless pain is persistent.

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6. Testicular Cancer (Less Common Over 60, But Possible)

Testicular cancer is less common in men over 60 compared to younger men—but it can still occur.

Warning signs include:

• A painless lump
• Firmness in one testicle
• Persistent ache
• Swelling without infection

Testicular cancer is highly treatable when caught early. Any new lump should be evaluated by a doctor as soon as possible.

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7. Kidney Stones

Pain from kidney stones can radiate into the testicles.

Signs include:

• Severe back or flank pain
• Pain that moves toward the groin
• Blood in urine
• Nausea

This pain often comes in waves and can be intense.

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8. Nerve-Related Pain

Chronic scrotal pain in older men can sometimes be due to:

• Nerve compression
• Past surgeries
• Diabetes-related nerve damage
• Spinal conditions

This pain may feel burning, tingling, or persistent without swelling.

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Why Testicle Pain in Men Over 60 Deserves Attention

As we age:

• Infection risk increases
• The immune response changes
• Cancer risk increases
• Circulation may decline
• Prostate problems become common

That doesn't mean pain equals danger—but it does mean symptoms shouldn't be ignored.

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Your Medical Roadmap: What to Do Next

Here's a practical plan if you're experiencing scrotal pain.

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Step 1: Assess Urgency

Ask yourself:

• Did it start suddenly?
• Is the pain severe?
• Do I have nausea or fever?
• Is swelling increasing quickly?

If yes to any of these—seek urgent care.

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Step 2: Perform a Gentle Self-Check

Look for:

• Swelling on one side
• Redness
• A lump
• Changes in testicle position
• Bulging in the groin

Do not squeeze firmly. A light exam is enough.

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Step 3: Track Symptoms

Note:

• When pain started
• Severity (1–10 scale)
• Urinary symptoms
• Fever
• Any recent heavy lifting
• Recent infections or procedures

This information helps your doctor diagnose quickly.

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Step 4: See Your Doctor

Your doctor may perform:

• Physical exam
• Urine test
• Blood tests
• Scrotal ultrasound (very common and painless)
• Prostate evaluation

Ultrasound is especially helpful in ruling out torsion, tumors, and infections.

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Treatment Depends on the Cause

Here's what treatment may look like:

• Antibiotics for infections
• Anti-inflammatory medication for swelling
• Surgery for torsion or hernia
• Drainage for hydrocele (if needed)
• Pain management for nerve-related causes
• Prostate medication if BPH is contributing

Most causes of testicle pain in men over 60 are treatable—and many improve quickly once properly diagnosed.

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When Pain Becomes Chronic

Chronic scrotal pain (lasting more than 3 months) is less common but can happen.

Management options may include:

• Pelvic floor physical therapy
• Nerve pain medications
• Targeted nerve blocks
• Urology referral

Persistent pain should never simply be ignored.

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A Calm but Clear Bottom Line

Testicle pain in men over 60 is:

• Often treatable
• Frequently infection-related
• Sometimes related to prostate or hernia issues
• Rarely—but possibly—linked to cancer or torsion

The key is not panic—but prompt evaluation.

If pain is severe, sudden, or accompanied by systemic symptoms, treat it as urgent.

If pain is mild but persistent, schedule a medical visit.

And if you're unsure what might be causing your symptoms or whether they need immediate attention, you can use a free symptom checker to better understand your condition before your appointment.

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Final Word: Don't Self-Diagnose Serious Pain

Online information is helpful—but it cannot replace a medical exam.

If you are experiencing:

• Severe pain
• Fever
• Swelling
• A new lump
• Ongoing discomfort

You should speak to a doctor immediately, especially if symptoms could indicate something life-threatening like torsion or infection.

Early care leads to better outcomes—and often quicker relief.

Your health is worth addressing directly and promptly.