One Ball’s Bigger Than the Other? Let’s Talk Testicular Asymmetry

One Ball’s Bigger Than the Other? Let’s Talk Testicular Asymmetry

Written by: Dr. Joshua Gonzalez

Key Takeaways

A slight difference in testicle size (testicular asymmetry) is usually normal

Regular testicular self-examinations help you monitor for changes

Sudden changes in size, pain, or lumps could indicate conditions like epididymitis, hydrocele, varicocele, or even testicular cancer

Testicular torsion is a medical emergency. Don’t wait

See your doctor for any new testicular lumps, scrotal swelling, or signs of testicular atrophy

Testicles: One Size Does Not Fit All

Popstar is back and ready to spill the tea about your teabags because when it comes to testicles, curiosity is healthy. Whether you’re doing a routine testicular self-examination or having a casual grope in the shower (you multitasker, you), you may have noticed something: your balls aren’t twins.

So, what’s the deal with testicular asymmetry? Is it a sign of something serious? Or are your boys just doing their own thing?

Spoiler alert: It’s usually nothing to worry about. But let’s get into the nitty gritty so you can feel confident about what’s hanging downstairs.

First Things First: What’s Testicular Asymmetry?

Testicular asymmetry simply means one testicle is a different size or shape than the other. Maybe one hangs a little lower or feels a bit heavier. Sound familiar? That’s because it’s incredibly common. Testicles are like houseplants: no two are quite alike, and they need regular attention.

But even though a slight difference in testicular size is normal, it’s important to know what’s normal for you so you can tell if something changes.

When Testicular Asymmetry Is Normal

Let’s keep it real: your body isn’t perfectly symmetrical. (No one’s is.) Your left foot might be bigger. Your right ear could be higher. Your balls? They’re probably fraternal, not identical.

It’s normal for:

  • One testicle to be slightly larger than the other

  • One testicle to hang lower

  • The difference to have always been that way since puberty

If that’s the case, congrats. You’re likely dealing with benign, run-of-the-mill testicular asymmetry.

Still, it’s a good idea to check in with your bits on a regular basis preferably once a month with a proper testicular self-examination. And yes, we’ll show you how.

Testicular Self-Examination: The How-To

Here’s your monthly maintenance routine preferably in the shower when everything’s relaxed:

  1. Gently roll each testicle between your thumb and fingers.

  2. Feel for any hard lumps, swelling, or changes in consistency.

  3. Make note of any new discomfort or differences.

If anything feels off, get it checked. Early detection is key, especially for testicular cancer symptoms.

When It Might Be Something More

Now for the serious stuff. If you’ve noticed a change in size, shape, or feel especially if it’s sudden or comes with testicular pain or scrotal swelling it’s time to talk to a doctor.

Some conditions that could cause testicular size difference include:

1. Epididymitis

This is an inflammation of the epididymis, the coiled tube at the back of the testicle that stores sperm. Epididymitis often causes swelling, tenderness, and pain, usually on one side. Sometimes, it’s caused by a bacterial infection (like an STI), or even a UTI.

2. Testicular Torsion

Testicular Torsion is a medical emergency where the spermatic cord twists and cuts off blood flow to the testicle. The result? Severe testicular pain and swelling that usually comes on fast. It needs treatment ASAP to avoid permanent damage.

3. Hydrocele

A hydrocele is a fluid-filled sac around the testicle that can make one side look puffier. It’s usually painless but might feel like a small water balloon hanging out in your scrotum.

4. Varicocele

This is like varicose veins but for your balls. It happens when veins in the scrotum get enlarged, often on the left side. A varicocele can feel like a bag of worms (we know, gross) and may even affect fertility.

5. Spermatocele

This benign cyst forms near the epididymis and is usually filled with sperm. It is not dangerous but can add to the testicular size difference game.

6. Testicular Cancer

This is the big one to rule out. Although testicular cancer is relatively rare, it most often shows up as a painless lump or swelling in just one testicle. That’s why staying on top of your testicular health and doing monthly self-exams is so important.

What About Testicular Atrophy?

If you’ve noticed one testicle shrinking, that’s called testicular atrophy. It can be caused by aging, hormone issues, injury, or certain medical conditions. Atrophy is something that definitely warrants a trip to the doctor, especially if it’s accompanied by pain or changes in function like low libido or trouble with ejaculation.

Should I Be Freaked Out If One Ball Is Bigger?

Not necessarily. If your testicles have always been different sizes, and you’re not experiencing pain, swelling, or other symptoms, you’re likely good. But if the asymmetry is new or comes with other red flags like testicular lumps or tenderness, don’t play it cool get it checked.

Diagnosis: What to Expect

If your doctor suspects something’s up, they’ll likely recommend a testicular ultrasound. It’s painless, quick, and the gold standard for spotting everything from hydrocele and spermatocele to testicular torsion and tumors.

You may also get blood or urine tests depending on what’s going on.

Conclusion: Be Ballsy About Your Health

Testicles are like snowflakes no two are exactly alike. But when it comes to your health, knowledge is power. You know your body better than anyone. Keeping an eye or a hand on your testicular health isn’t paranoid it’s smart. Regular self-checks, awareness of testicular cancer symptoms, and a willingness to see a doc when something feels off that’s the real “manscaping” that matters. So go ahead, give your balls a little monthly attention. They deserve it.

Frequently Asked Questions

How big is too big for one testicle?

It depends on your baseline. A slight difference is fine. A large or sudden change? Talk to your doc.

Is it normal to have one testicle hanging lower?

Yes. Usually, the left testicle hangs lower. Totally normal.

Does testicular asymmetry affect fertility?

Not usually. But varicocele or other underlying issues could, so get checked if you're trying to conceive.

Can testicular cancer cause size differences?

Yes. It can cause swelling, a lump, or firmness in one testicle. Always get changes evaluated.

What is a testicular ultrasound?

It’s a painless imaging test that uses sound waves to check the health of your testicles. No radiation. No drama.

Dr. Joshua Gonzalez

Dr. Joshua Gonzalez

Dr. Joshua Gonzalez is a board-certified urologist who is fellowship-trained in Sexual Medicine and specializes in the management of male and female sexual dysfunctions. He completed his medical education at Columbia University and his urological residency at the Mount Sinai Medical Center. Throughout his career, Dr. Gonzalez has focused on advocating for sexual health and providing improved healthcare to the LGBTQ+ community.

Dr. Brian Steixner

Dr. Brian Steixner

Dr. Brian Steixner is a board-certified urologist and an expert in men’s sexual medicine. He completed his General Surgery and Urology training at The University of Pennsylvania and The Children’s Hospital of Philadelphia, one of the busiest and most comprehensive programs in the nation. During his career, Brian has treated thousands of men with sexual health issues including male factor infertility.