Testicular Health: The Check Everyone Should Do Monthly

You spend plenty of time with your balls already. This just asks you to pay attention for about a minute a month. Testicular cancer is the kind of thing you don't think about, as it's relatively rare. It's also one of the more common cancers in younger adult men, and it's highly treatable, especially if you catch it early. Knowing what's normal for you is the easiest way to spot a change. It takes less time than choosing a show to watch.

This guide is for anyone with testicles, whatever your gender.

How to check

The best time's during or just after a warm shower, when everything's relaxed.

1. Have a look. Stand in front of a mirror, and look for any swelling or changes on the skin of your scrotum.
2. Check one at a time. Hold one testicle gently between your thumb and fingers, and roll it slowly. It should feel smooth and firm, a bit like a hard-boiled egg without the shell.
3. Feel all over. You're looking for a lump, a hard spot, a swelling or any change in size, shape or how firm it feels.
4. Find the normal bits, so they don't scare you. There's a soft, rope-like tube at the top and back of each testicle, called the epididymis. It's supposed to be there. Everyone panics about it at some point.
5. Do the other one.

That's all. It's normal for one to be a bit bigger than the other, and for one to hang lower. What you're looking for is any change from your own normal.

What to see your GP about

Make an appointment within the next few days if you notice:

• A lump or swelling on either testicle, even a small one that doesn't hurt
• A change in size, shape or firmness
• A dull ache or heaviness in your scrotum or lower belly
• Fluid in the scrotum
• Pain that keeps coming back

Most lumps aren't cancer. Many turn out to be harmless cysts or fluid. But you can't tell by feeling it, and it's a very quick and easy check. Your doctor will have a feel, and might send you for an ultrasound, which is painless. They've seen thousands of balls. Yours aren't going to be the ones they remember.

Please don't wait because you're embarrassed. A week of awkwardness beats the alternative.

When it's an emergency

Go to an emergency department right away if you've got sudden, severe pain in a testicle, especially with swelling, nausea, or vomiting, or if one's sitting higher than usual. This could be testicular torsion, when a testicle twists and cuts off its blood supply. It needs treating within hours, or you could lose it. Don't sleep on it, and don't wait and see. It can happen at any age, and it can happen after sex or exercise, or for no reason at all.

Also get seen promptly if you've had a heavy blow to your testicles and the pain doesn't settle or you've got significant swelling, or if you've got a painful swollen testicle along with a fever. That could be an infection, which might need antibiotics. Some STIs, including chlamydia and gonorrhoea, can cause this. Our STI testing guide has more.

Who's more at risk?

Testicular cancer is most common in younger adult men. Your risk is higher if you were born with an undescended testicle, or if you have a close relative who's had it. Having a previous testicular cancer also raises your risk. A lot of men who get it don't have any risk factors, so everyone should check. Healthy Male (healthymale.org.au) and Cancer Council (13 11 20) have more information.

Sex and your balls

If you've had a testicle removed for any reason, you can still have a great sex life. One healthy testicle can usually make enough testosterone and sperm. Prostheses are available as well, if you'd like. Talk to your specialist about fertility before treatment.

Enjoying your balls is a very good reason to know them well. Our guide to ball play has some ideas on that front. It's also a pretty good excuse to get someone else involved. A partner might be the first to notice a change, and "I reckon you should check this" is much better than the alternative. Be careful with anything that puts a lot of pressure on them, such as ball stretchers, and take it easy with cock rings. If you've got pain, numbness or discolouration, stop right away.

Make it a habit

Set a reminder on your phone for the first of each month. Do it in the shower, and it'll take you 60 seconds. Tell your brothers, the blokes at the pub and anyone else who's got a pair. It's a very good way to clear a room, and it might even save someone's life.

This is general information, not medical advice. If in doubt, get it checked.