What should you know about pain in the scrotum and pelvic area?

Pain in the scrotum or pelvic area needs attention to its timing, severity, location and associated symptoms, because some causes require urgent assessment. Pain may be felt in the testicle, groin, lower abdomen, pelvis or around the opening of the vagina, and it may move between these areas. A clinician may need to examine you and arrange urine, pregnancy or imaging tests to identify the source. Do not try to diagnose the cause from pain alone.

Pelvic pain can be linked with menstrual cramps, ovulation, urinary infection, constipation, muscle strain or irritation of nerves. Conditions such as endometriosis, adenomyosis, uterine fibroids, ovarian cysts and pelvic inflammatory disease can also cause pelvic or lower abdominal pain. An ectopic pregnancy is another urgent possibility when pregnancy is possible, particularly with one-sided pain or bleeding. These conditions can overlap in their symptoms, so the pattern and examination matter.

Scrotal pain has different causes, including infection, inflammation, injury, an inguinal hernia or twisting of the testicle. Sudden severe pain, especially with swelling, nausea or a testicle sitting higher than usual, can signal testicular torsion. This is time-sensitive and cannot be safely assessed at home. If the pain is in someone else’s scrotum, encourage them to seek care promptly rather than relying on this page to interpret it.

Note when the pain began, whether it is constant or comes in waves, and whether movement, urination, bowel movements, sex or periods change it. Record bleeding, discharge, fever, vomiting, urinary symptoms, a new lump, swelling or a possible injury. If pregnancy is possible, take that possibility seriously and tell the clinician. Rest and avoid activities that worsen the pain while arranging medical advice. Do not delay assessment by repeatedly taking pain medicine to see whether the symptom settles.

For ongoing or recurrent pelvic pain, a gynaecology or primary-care appointment can help connect symptoms with the menstrual cycle, bowel or bladder changes, sexual pain and previous infections or operations. Bring a list of medicines and the first day of your last period. A clinician may ask sensitive questions about sex and pregnancy because those details can change which tests are safest.

Seek emergency care for sudden or severe scrotal pain, rapidly increasing swelling, or pain with nausea or vomiting. Get urgent help for pelvic pain with fainting, marked dizziness, shoulder-tip pain, heavy bleeding, fever, repeated vomiting or a rigid or very tender abdomen. If pregnancy is possible, one-sided pelvic pain with bleeding or dizziness needs prompt assessment because an ectopic pregnancy can become dangerous.

Arrange medical care soon for pain that persists, returns, follows an injury, occurs with fever or unusual discharge, or comes with burning urination, blood in urine, a new groin or scrotal lump, or pain during sex. If symptoms are worsening or you feel seriously unwell, use local emergency services rather than waiting for a routine appointment.

You could ask: What examinations or tests might identify the source of this pain? Could the timing with my period, urination or bowel movements be relevant? What symptoms should send me to emergency care? If pregnancy is possible, which test should I have and how quickly? What can I safely do while waiting for results, and when should I follow up if the pain continues?