There’s a lot going on below your belt, from sperm and testosterone production in your testicles to the fluid transporter that is your penis. And a lot going on means a lot can go wrong, says Tobias Köhler, M.D., urology chair at Memorial Medical Center in Springfield, Illinois. Here are five of the most common pains lurking down below, and the possible causes of each:
1. TIP TROUBLE
The pain: A burning or sharp pain at the tip of your penis.
The cause: If you’re lucky, this could just be the result of a little soap or shampoo slipping inside the opening at the end of your penis, Dr. Köhler says. Typically you’ll feel this pain right away after soap exposure, although sometimes it won’t show up until you take a leak, he explains. If the pain doesn’t go away after a day or two, it could be a sign of a sexually transmitted infection (STI), especially if it’s accompanied by a green or whitish discharge, he adds. Also, if in the days leading up to the tip pain you feel some aching in your back or lower stomach, you may be dealing with a kidney stone, he adds.
The fix: Give it a couple days. If the pain goes away or fades, you’re fine. But if it persists, returns, or gets worse, see a doctor, Dr. Köhler advises.
2. SORE SACK
The pain: A dull, heavy ache in your scrotum that seems to show up after you’ve lifted weights, moved heavy furniture, or were standing up for long periods of time. Also, it tends to subside if you lie down.
The cause: An enlargement of the veins within your sack heats up your balls and causes tenderness or a dull pain. “A lot of guys describe this as having blue worms in their sack,” Dr. Köhler says. Basically, you have a defect in your scrotum veins that causes blood to collect, which can hurt your ability to produce sperm and testosterone.
Do this: See your doc soon, but no need to rush to the E.R., Dr. Köhler says.
3. HORRIBLE HARD-ON
The pain: A boner that won’t go away, and hurts like hell.
The cause: A priapism—or a problem with the way blood flows out of your erect penis. Dr. Köhler explains that during a normal erection, blood pumps both in and out of your erection. But during a priapism, the blood doesn’t escape the penis. Eventually, the blood trapped in your dong becomes “deoxygenated,” and the pain settles in. Dr. Köhler says this typically happens to men who are mixing erectile dysfunction medications like Viagra or Cialis with drugs like cocaine or ecstasy. It’s also seen with impotency drugs injected directly into the penis. “Or, it may come about for no reason at all,” he adds, horrifyingly.
Do this: Get thee to an emergency room, posthaste, Dr. Köhler says.
4. TERRIBLE TWIST
The pain: A sharp, shooting pain in your balls that doesn’t let up and may be accompanied by nausea or vomiting.
The cause: One testicle may have become twisted in your sack, which cuts off the blood flow and oxygen your nut needs to survive. “Basically, this is like your testicle is having a heart attack,” Dr. Köhler explains. The condition is called “testicular torsion,” and it could cost you one of your boys if you don’t act fast, he says.
Do this: High-tail it to the E.R. as soon as f*#@ing possible. “If you don’t untwist the testicle within a couple hours, you could lose it,” Dr. Köhler says.
5. GROIN GROAN
The pain: A persistent ache or tenderness on the top of the scrotum, near the base of the penis. It may gradually become worse, and could be accompanied by swelling or redness.
The cause: This is likely epididymitis, or an infection of the epididymis—the small organ located between your penis and balls that stores your sperm while they learn how to swim, Dr. Köhler says. In men younger than 35, this infection is usually caused by an STI. In men 35 and older, it’s more often the cause of a bacterial infection.
Do this: In either case, you need to get it checked out by a physician as soon as possible, Dr. Köhler explains. If the pain seems to be getting worse, it may be testicular torsion (see above), and you need to get to the hospital, stat, he recommends.