Testicle Pain Explained: When It’s an STD vs When It’s Not

When It Hurts But Nothing Happened (That You Know Of)

Let’s start with what confuses most people: testicle pain that seemingly comes out of nowhere. You didn’t get hit. You didn’t twist anything. You haven’t been benching your max. But there it is, that steady ache, pulling at your focus all day. This is exactly what happened to DeShawn, 27, a former college athlete who now works remote and hadn’t had sex in months. When the left side of his scrotum started throbbing, he assumed he’d pinched something while sleeping. He iced it, stretched, even took ibuprofen. Nothing helped.

By day three, the pain was worse, and now he felt a weird heaviness every time he peed. What he didn’t know is that epididymitis, a common inflammation of the tube behind the testicle, often starts like this. And while it’s usually caused by chlamydia or gonorrhea in sexually active men under 35, it can also stem from bacteria in the bladder or even long periods of sitting. Meaning: yes, you can have an STD symptom even without a recent hookup. And yes, people still get infections in monogamous or dry spells. Infection doesn’t always follow logic. But it does follow biology.

Table 1: Quick Comparison – Infection vs Injury

Table 1. Infection vs Injury Characteristics: Understanding how pain shows up can help you decide your next move, but only testing confirms the cause.

The Big Infections Behind That Ache (And What They Feel Like)

So what kinds of infections actually target your testicles or the tubes around them? The most common culprits are chlamydia, gonorrhea, and urinary tract bacteria that migrate downwards. Sometimes, it’s a co-infection. Other times, it’s what's called non-gonococcal urethritis, a fancy name for inflammation without a clear bacterial source. Either way, the pain comes from inflammation and swelling, not from the STD crawling inside your scrotum. It’s your immune system doing battle, and the war zone just happens to be... down there.

Unlike a pulled muscle, infection pain doesn’t stay quiet when you’re still. It often worsens at night, especially if you're dehydrated. It might radiate to your lower abdomen or thigh. You might notice testicle swelling, redness, or a warm sensation when touching the area. And while not everyone gets discharge, many do report “dribbling” after peeing or feeling like they constantly have to go, even when their bladder’s empty.

One particularly telling symptom: pain during ejaculation or orgasm. If you wince or curl forward during climax, that’s not typical. Infection-induced inflammation can make the act of releasing semen feel like pushing something sharp through a garden hose.

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When It’s an Injury (And You Still Might Need Care)

Of course, not every sore testicle is caused by an infection. And not every non-infection cause is harmless. Let’s talk torsion. It’s rare, but dangerous. It happens when the spermatic cord twists, cutting off blood flow to the testicle. The pain is sudden, severe, and often comes with nausea or vomiting. If the testicle doesn’t untwist within six hours, permanent damage, or even surgical removal, can occur. Torsion is a medical emergency. You won’t be wondering if it’s an STD.

Then there’s blunt trauma. You took a soccer ball to the crotch. You crashed your bike wrong. You landed hard on a fence rail (yes, it happens). These cause visible bruising, tenderness, and usually go away with ice and rest. But even here, micro-hematomas or vein blockages can linger, and lead to conditions like varicocele (enlarged veins in the scrotum).

What about less dramatic injuries? A long road trip on a hot day. A new bike saddle. Overzealous masturbation. These can all cause inflammation or fluid retention in the scrotum that mimics infection, but resolves with hydration, positioning, and time. Still, the line is blurry. That’s why clinical guidance always recommends ruling out infection first when the source of pain isn’t obvious.

Table 2: Symptoms Timeline – Infection vs Injury vs Emergency

Table 2. Symptom Timelines: The longer pain persists or worsens, the more important it is to test or seek care, especially if you have no clear injury history.

Still Unsure? Here’s How to Test Without the Wait

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Why Some Infections Show No Symptoms (Until They Hurt)

Here’s one of the most frustrating truths about sexually transmitted infections: many don’t announce themselves until they’re already causing internal damage. It’s common for chlamydia and gonorrhea to hang out quietly in the urethra, especially in men, causing zero visible symptoms at first. No discharge. No pain when peeing. Nothing obvious. Until the bacteria travel upward to the epididymis, a coiled tube behind each testicle that stores sperm. That’s when things start to hurt.

This was the case for Carlos, 31, who only realized something was wrong after noticing his left testicle felt “heavier” than the right during a shower. No burning. No swelling. Just a weird weight he couldn’t ignore. Four days later, the ache was constant, and sex had become painful. He had no idea that an infection he’d picked up over a month ago was the source. He’d used protection, but not during oral. And that’s all it took.

Silent infections are more common than you think. One study published in Sexually Transmitted Diseases Journal found that up to 50% of men with urethral chlamydia report no symptoms. That means half of them are walking around completely unaware, until the infection hits deeper, or until a partner gets diagnosed. Testing isn’t just for when you “feel something.” It’s for when you don’t, but might need to anyway.

The Emotional Toll of Not Knowing

Beyond the pain itself, what hurts most people is the spiral of uncertainty. Am I overreacting? Is this anxiety? Did I cheat without cheating? Will a doctor think I’m gross? These questions pile up fast. Especially if you’ve been in a monogamous relationship. Or if you’re queer and worried about being judged. Or if you’ve never been tested before and are too embarrassed to ask.

Jayden, 22, tried to ride it out. He told himself the pain was probably from lifting boxes during a move. He didn’t want to talk to anyone about it, not his roommate, not his ex, and definitely not a doctor. He waited six days before finally Googling “testicle pain chlamydia” and learning that yes, you can get STDs even if you only had oral sex. And yes, some men get pain without discharge. He ordered a home test that night. It came back positive. And while the diagnosis stung, it felt better than the six days of not knowing.

That’s the hidden cost of ignoring testicle pain: not just physical risk, but emotional stress. The kind that keeps you up at night wondering if you’re contagious, if you’ll be okay, or if you’ll be able to explain this to someone you care about. Testing isn’t just medical, it’s peace of mind.

Test Timing: When Should You Actually Check?

If your symptoms started very recently (within the last 24–72 hours), it's important to know that testing too early could lead to a false negative. Most standard STD tests, especially for chlamydia and gonorrhea, are highly accurate after about 7 days from exposure. That said, symptoms like pain in the testicle, groin ache, or discomfort while urinating can show up before that. So, what should you do?

The current recommendation is this: if symptoms are severe or worsening, test now, but be open to a second test in 7–14 days if your first result is negative and pain persists. This is especially true for infections that take time to multiply to detectable levels. You can test from home using a combo kit and then follow up with a clinic if results are unclear or your symptoms escalate.

Here’s the thing. No one likes to wait. But your body isn’t a binary machine, it’s a living system with variable timelines. Respect the biology. Let symptoms guide you, but also let time pass before ruling anything out.

Can You Have Testicle Pain Without Having Sex?

Yes. And that’s where the shame really kicks in for some people. The assumption that you have to be sexually active to have an STD is not only outdated, it’s medically incorrect. Bacteria like chlamydia can live in the throat or rectum and spread via skin-to-skin contact or oral sex. You can get infected even if there’s no ejaculation. Even if there was a condom involved but not worn the whole time. Even if the other person “looked clean.”

Infections don’t care about your assumptions. They follow biology, not morality. So yes, if you’re experiencing testicle pain and haven’t had “full” sex, it’s still worth testing. This is especially true for queer and questioning men, people in poly dynamics, and anyone whose sexual experience doesn’t fit the mainstream script. You deserve care and clarity, regardless of how many partners you’ve had or how you define sex.

Table 3: Should I Test? Self-Check Aid

Table 3. Testing Decision Aid: If you see yourself in these rows, it’s worth ruling infection out, if only to sleep better tonight.

What Happens If Your Test Is Positive

Let’s say your at-home test comes back positive. That moment can feel like a punch to the gut. But pause, breathe. A positive result doesn’t mean you’re “dirty,” broken, or unloveable. It means you have an infection. One that’s often curable. One that countless people around you have had. One that just needs to be treated.

Isaac, 36, found this out after two weeks of left testicle pain that he chalked up to stress and caffeine. His at-home combo kit came back positive for gonorrhea. He felt nauseous, not from the infection, but from the flood of thoughts: Who gave this to me? What if my partner freaks out? What does this say about me? He texted a close friend, cried for ten minutes, then made a telehealth appointment. By the next morning, he had a prescription and a plan. And by the end of the week, he was already feeling better.

Treatment for infections like chlamydia and gonorrhea is usually straightforward, oral antibiotics, sometimes a shot. What matters most is follow-through: take all the meds, avoid sex until you finish them, and notify anyone you’ve been with in the past 60 days. Most STDs clear quickly with proper care. It’s the shame that sticks around longer if we don’t talk about it. So talk. Or write. Or send that message. But don’t sit in silence.

Telling Your Partner (Without Panic)

This is the part that most people dread more than the test itself. What do you say? How do you start? Will they think you cheated? Will they yell, cry, ghost you? It depends, but what you say matters less than how you say it. Start with honesty. Add care. Stick to the facts. For example:

"Hey, I just found out I tested positive for chlamydia. I wanted to let you know because you might need to get tested too. I’m already starting treatment. I’m here if you have questions."

If you were non-monogamous, or not sure when you were exposed, it’s okay to admit that. You’re not confessing a crime. You’re sharing important health info. And if the conversation feels impossible, consider using an anonymous notification service like TellYourPartner.org, which lets you alert someone via text without revealing your identity. It’s free, fast, and stigma-free.

Your goal isn’t to fix everything. It’s to protect the people involved, and to show that getting tested is normal, even if the results aren’t.

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Should You Retest? Here’s When and Why

Retesting isn’t just for the overly cautious. It’s recommended by most health agencies, especially after treatment. The CDC suggests retesting for chlamydia and gonorrhea three months post-treatment to ensure you haven’t been re-infected or that the infection didn’t persist. Even if you feel better, bacteria can linger without symptoms. Think of retesting like a follow-up dental cleaning, you’re making sure everything healed right.

But what if your test was negative, and your symptoms continue? That’s also a case for retesting. It might’ve been too early the first time. Or the test didn’t catch a non-STD issue like a UTI, prostatitis, or kidney problem. Home testing is powerful, but it’s still one piece of the diagnostic puzzle. If the pain sticks around, or evolves, get a second opinion. Imaging like ultrasound can rule out torsion, hernia, or growths.

If your test was positive and you're on meds now, mark your calendar for a three-month check-in. That simple step could save you from a future scare, and maybe even a deeper conversation about prevention and condoms.

Preventing Reinfection (and Reducing Panic Next Time)

Prevention doesn’t mean abstinence. It means agency. Knowing how infection happens and how to lower your risk. Condoms help, especially when used properly and consistently. But so does conversation, about status, testing habits, and monogamy agreements. If that sounds awkward, you’re not alone. But remember: awkward lasts five minutes, gonorrhea lasts longer.

Other tips? Get tested between partners, even if it’s been “just oral.” Use lube to prevent microtears that let bacteria in. Don’t share sex toys without washing them or using a fresh barrier. And for those with vaginas or receptive anatomy: get screened regularly even without symptoms. STDs aren’t just about what you feel. They’re about what you can’t always see.

Some people also opt for vaccines, HPV and Hepatitis B are preventable via shots. And if you’re part of a higher-risk group (like MSM, sex workers, or immunocompromised folks), routine testing every 3–6 months can be a game-changer. Not because you’re dirty, but because your health deserves proactive care.

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When It’s Not an STD: Other Causes to Consider

Sometimes, the test is negative. The partner is negative. You’ve ruled out trauma. And yet, the pain remains. This is where other medical issues may enter the picture. Prostatitis, inflammation of the prostate, can radiate pain into the groin and testicles, especially in people over 30. Varicocele, enlarged veins in the scrotum, can cause throbbing aches, especially after standing. Hydrocele, fluid buildup, can cause that heavy feeling, especially in hot weather or after long travel.

Testicle pain can even be “referred pain,” meaning it starts somewhere else (like your back or abdomen) but feels like it’s coming from your groin. That’s why getting a full evaluation matters if pain sticks around. Don’t gaslight yourself into thinking you're imagining it. Your body is talking. Listen to it, and don’t let shame turn down the volume.

If you're stuck in limbo, remember: it doesn’t have to be one answer. You could have both mild trauma and a mild infection. You could have a structural issue made worse by bacteria. That’s why clear timelines, honest tracking, and repeated testing (when necessary) are tools, not overreactions.

FAQs

1. Can an STD really make just one testicle hurt?

Yes, and it happens more often than you’d think. Infections like chlamydia and gonorrhea can settle into one side of the epididymis (the coil behind the testicle), leading to a dull, persistent ache on just that side. It doesn’t have to be both. It doesn’t have to come with discharge. One sore ball is enough to get tested.

2. I haven’t had sex in months. Could it still be an infection?

Totally possible. Some STDs hang out silently for weeks, or even longer, before showing signs. And not all sex has to be penetrative to pass something on. Oral, grinding, mutual toys, even skin contact without ejaculation can still transmit bacteria. If you’ve got pain and no clear injury, don’t rule it out based on your dry spell.

3. I only did oral. Am I still at risk?

Yes, oral sex can absolutely transmit STDs. Gonorrhea and chlamydia can live in the throat and travel to the genitals after contact. We hear this one a lot: someone gets a BJ, thinks it’s “safe,” then ends up with testicle pain a week later. Surprise, it’s not just “real sex” that spreads infections.

4. How do I know it’s not just a pulled muscle or strain?

Good question. Strains usually come on fast, after lifting, sprinting, or sleeping weird. The pain often improves with rest, ice, or stretching. Infection-related pain tends to sneak in slowly, stick around, and may be paired with burning when you pee or a heavy, swollen sensation. If it's been more than 48 hours and not improving, it’s time to test.

5. Does testicle pain mean I’m infertile now?

Not necessarily, not even close. Most infections, when caught early, won’t affect fertility at all. But untreated STDs can cause scarring or blockages over time. The sooner you get checked, the more likely you are to dodge long-term issues. Think of testing as a way of protecting your future, not just reacting to your present.

6. My test was negative, but the pain’s still there. Now what?

First: don’t panic. False negatives can happen if you test too early, or if the infection is low-level. Retesting after 7–14 days is smart if your symptoms stick around. But also consider other causes, like torsion, hernias, kidney stones, or nerve pain. An ultrasound might be your next best step if tests keep coming back clear.

7. Will anyone find out if I order a test kit online?

Nope. At-home kits are discreetly packaged, shipped in plain boxes, and don’t mention anything sexual on the label. No nosy roommates, no post office judgment. Your health is your business. Period.

8. Is it dangerous to keep having sex if my testicle hurts?

If you don’t know the cause, then yeah, it can be risky. If it’s an infection, you could pass it to your partner or make it worse. If it’s an injury, friction might delay healing. Either way, take a pause until you’ve got a clear answer. Sex will still be there once you’re sorted out.

9. What if I’m scared to tell my partner?

That’s real. It’s hard. But sharing this info isn’t just responsible, it’s protective. You can keep it simple: “Hey, I’ve been having some pain and tested positive. You should probably get checked too.” If saying it out loud feels impossible, there are anonymous text services like TellYourPartner.org that do it for you. You’re not alone in this, even if it feels like it.

10. How long does it take to feel better after treatment?

Most people feel relief within 2–5 days of starting antibiotics, sometimes sooner. The ache fades, the urination burns less, and that “heavy” feeling goes away. But finish the full course. And don’t have sex again until your provider clears you. Healing is sexy, too.

You Deserve Answers, Not Assumptions

If you’ve made it this far, chances are you, or someone you love, is dealing with testicle pain and a growing pit of anxiety. The truth is, no blog can diagnose you. But the right information can lead you toward the clarity you’re craving. Whether it’s an STD, a muscle strain, or something else entirely, the best first step is knowledge. Then action. Then relief.

Don’t wait and wonder, get the clarity you deserve. This at-home combo test kit checks for the most common STDs quickly and privately. No clinic visit. No judgment. Just answers.

Sources

1. Planned Parenthood – What Is Chlamydia?

2. Epididymitis - Symptoms and causes (Mayo Clinic)

3. Epididymitis - STI Treatment Guidelines (CDC)

4. Chlamydia - StatPearls (NIH)

5. Testicle Pain Causes (Mayo Clinic)

6. Gonorrhea - Symptoms and causes (Mayo Clinic)

7. Testicular Pain: Causes, Sides, Diagnosis & Treatment (Cleveland Clinic)

8. Epididymitis (NHS UK)

9. About Chlamydia (CDC)

About the Author

Dr. F. David, MD is a board-certified infectious disease specialist focused on STI prevention, diagnosis, and treatment. He blends clinical precision with a no-nonsense, sex-positive approach and is committed to expanding access for readers in both urban and off-grid settings.

Reviewed by: Melissa Park, PA-C | Last medically reviewed: February 2026

This article is meant to give you information, not to give you medical advice.