What should I do if one testicle is larger than the other?

Sep 16, 2025 Source: Cainiu Health
Dr. Cao Zhiqiang
Introduction
In general, a difference in size between the two testicles may be caused by physiological developmental differences, scrotal trauma, orchitis, epididymitis, varicocele, or other reasons. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition through general measures, medication, or other treatments under a doctor's guidance. In daily life, avoid prolonged standing or sitting, engage in appropriate physical activity, and strengthen overall physical health.

  In general, a size difference between the two testicles may be caused by physiological developmental differences, scrotal trauma, orchitis, epididymitis, varicocele, and other reasons. It is recommended to seek timely medical attention, identify the underlying cause, and then improve the condition through general treatments, medications, and other methods under a doctor's guidance. A detailed analysis is as follows:

  1. Physiological developmental differences: In normal males, slight differences in the size of the two testicles are common, typically with the left one slightly smaller than the right. This condition, without pain, swelling, or other discomfort, is considered a normal physiological phenomenon. No special treatment is required. Daily attention should be paid to monitoring the condition of the testicles, avoiding external impacts, and maintaining cleanliness and dryness in the scrotal area.

  2. Scrotal trauma: External impacts or compression to the scrotum may cause swelling, bruising, and size differences in one testicle, accompanied by pain. Within 72 hours after injury, apply cold compresses using an ice pack to reduce swelling; after 72 hours, switch to warm compresses to promote the absorption of bruising. Avoid strenuous physical activity.

  3. Orchitis: Bacterial or viral infections can cause inflammation of the testicles. The inflamed testicle may swell and hurt, leading to size differences. Patients should follow medical advice to take medications such as Cefixime Dispersible Tablets, Levofloxacin Tablets, Acyclovir Tablets, and others to combat infection.

  4. Epididymitis: The epididymis is adjacent to the testicle. When bacterial infection causes epididymitis, the inflammation may spread to the testicle, causing swelling on the affected side and resulting in size differences, accompanied by scrotal heaviness and pain. Under medical guidance, patients may use medications such as Azithromycin Capsules, Minocycline Hydrochloride Capsules, Cefuroxime Axetil Tablets, and others to control the inflammation.

  5. Varicocele: Obstruction of venous return in the spermatic cord leads to blood accumulation, causing enlargement of the affected side of the scrotum. The testicle may become slightly smaller due to impaired blood supply, accompanied by a feeling of scrotal heaviness. Patients with mild symptoms may take medications such as Venoruton tablets, Diosmin tablets, and Citrus bioflavonoids tablets as directed by a doctor to improve circulation.

  In daily life, avoid prolonged standing or sitting, engage in appropriate exercise, and enhance physical fitness. Pay attention to moderate sexual activity, avoiding excessive indulgence or abstinence, maintain regular sleep patterns, eat a balanced diet, reduce the intake of spicy and irritating foods, and protect the health of the reproductive system.