One Testicle Bigger Than the Other? Is It Normal or Problematic?

Symptoms, Complications, and Self-Examination

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It is more common than many people may think to have one testicle that is bigger than the other. In fact, according to a study on genital asymmetry in men, the right testicle is usually somewhat larger than the left.

This is because, in human men, the testis on the right seems to develop more quickly than that on the left. In addition, growth favors the development of the testicle on the right in a fetus in utero. For women, this phenomenon is the opposite, with the ovaries developing first on the left.

Not only is it normal to have one testicle that is slightly bigger than the other, but it’s also common to have one that hangs a bit lower than the other one in the scrotum.

But it’s not always normal for one testicle to be bigger than the other, and it’s important to know the difference between normal asymmetrical testicle size and what may constitute something more serious.

testicle and scrotum self-exam
Illustration by JR Bee, Verywell

Anatomy

Before one can screen for testicular problems, it’s important to learn about their normal structure and function:

  • A testicle (also called testis) is a small oval-shaped gland. It produces sperm and male sex hormones (testosterone).
  • The scrotum is the sac that surrounds the testicles. It is located outside of the body because sperm requires a lower-than-normal body temperature to be produced.
  • The epididymis is a chain of small tube-like structures located behind the testicles. Its function is to collect, mature, and store the sperm that is produced in the testicles. The epididymis links up with the vas deferens—a larger tube-like structure that carries the sperm out of the body during ejaculation.  

Important Symptoms

Pain, redness, or swelling in the testicles are possible signs of abnormal asymmetry in size. If one testicle is a different shape than the other, it may be another possible warning sign. If you notice either issue, set up an appointment with your doctor.

If you notice that one testicle is bigger than the other and experience pain in either testicle, notify your healthcare provider immediately.

Knowing the normal anatomy of the testes and other parts of the male reproductive system is important in self-examination. Being familiar with the normal shape, appearance, and the feel of the testes will help a person to notice when a change occurs.

General tips on normal anatomy of the testes and scrotum include:

  • Each testicle should feel like a firm, smooth egg.
  • Adult testicles should be approximately 2 to 3 inches in length and 1 inch in width.
  • It’s normal for one testicle to be slightly larger than the other and for one to hang slightly below the other.
  • There should not be any pain or discomfort when the testicles are gently examined.

Self-Examination

Self-examination of the testicles should be performed monthly. Testicular self-examination steps from the Victoria State Government in Melbourne, Australia, include:

  1. Shower or take a bath to ensure the scrotum is relaxed and warm.
  2. Stand in front of a mirror if that helps to visualize the process.
  3. Examine each testicle separately, one after the other.
  4. Use the fingers and thumbs on both hands to gently roll the testicle, check for lumps, protrusions, or any painful areas.
  5. Palpate (feel) along the underneath and back of the scrotum to locate the epididymis (it should feel like a bundle of tightly coiled tubules). 
  6. Examine the other testicle.

The examination should not result in any unusual findings, such as:

  • Pain
  • Lumps
  • Swelling
  • Change in size or shape (since the last exam)
  • Change in feel or consistency (since the last exam)

Testicular Conditions

Common conditions involving lumps, pain, or swelling of the testicle that are not life-threatening, but do require medical attention, include:

  • Cysts: An abnormal, but harmless, fluid collection
  • Blood clots: Caused by trauma or injury
  • Varicose veins (called varicocele): A cause of low sperm count and infertility
  • Orchitis: Inflammation of the testicle caused by an infection
  • Testicular torsion: Twisting of the cord (spermatic cord) that attaches the testicle to the body, causing excruciating pain.

Testicular torsion may result in loss of the testicle if blood flow is not restored. This is a medical emergency and must be seen for immediate evaluation.

Noticing or experiencing symptoms of any of these may feel frightening, but it's important to get them checked out quickly so that your symptoms do not progress.

Testicular Cancer

Performing monthly self-examinations is an important part of early testicular cancer screening. Symptoms of testicular cancer include lumps, new growths, and sometimes pain.

If you experience a change or pain in your testes, notify your doctor immediately for possible evaluation. A scrotal ultrasound is a diagnostic exam that can identify structural changes of the testes, including varicocele, cysts, and testicular cancer.

A Word From Verywell

Having one testicle that is slightly larger than the other is completely normal. However, swelling, pain, redness, and lumps are not.

It’s important to note that testicular cancer is rare, and although it’s vital to seek medical attention when a lump, pain, or other abnormality is noted, there is no need to panic. The symptoms are more than likely a result of a less serious condition.

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Article Sources
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