Protecting your testicles comes down to three things: preventing physical trauma, keeping them at the right temperature for long-term health, and catching problems early. Nearly 29,000 emergency department visits for sports-related testicular trauma were recorded in the U.S. between 2012 and 2021, and most of those injuries were preventable. Here’s what actually works.
Wear the Right Protection for Your Sport
An athletic cup is the single most effective piece of equipment for preventing testicular injury. Modern cups are made from hard plastic, carbon fiber, or reinforced fabric, and many now include gel padding around the edges for comfort. If you played sports as a kid and remember cups being miserable, the design has improved considerably.
Sports where groin protection is necessary, and often required, include baseball, football, hockey, lacrosse, martial arts, field hockey, soccer, basketball, and softball. Basketball, football, and soccer account for about 74% of all sports-related testicular injuries seen in emergency departments. What’s notable is that basketball and soccer produce injuries at rates comparable to football, likely because players in those sports rarely wear cups despite frequent contact.
Your position matters too. A catcher, goalie, or running back faces more direct impact than other players on the same team and should use a sturdier cup. For lower-contact positions, a softer cup or compression shorts with a built-in pouch may be enough. The key is matching the protection level to the actual risk you face during play.
Keep Them Cool
Your testicles need to stay 2 to 4°C (roughly 3.5 to 7°F) below your core body temperature to produce sperm properly. That’s the entire reason they hang outside your body. Anything that pushes scrotal temperature up toward core body temperature can impair sperm production over time.
Prolonged sitting is one of the biggest culprits. Research measuring scrotal temperature throughout the day found a clear dose-response relationship: men who sat for less than one hour had an average scrotal temperature of 33.1°C, while those sitting for more than six hours reached 34.7°C. That 1.6-degree increase pushes right into the range where sperm production starts to suffer. If you work a desk job or drive for long stretches, standing up and walking around periodically helps your body regulate temperature naturally.
Underwear choice makes a measurable difference too. A study of men attending a fertility center found that those who primarily wore boxers had 25% higher sperm concentration and 17% higher total sperm count compared to men who wore tighter underwear. The looser fit allows more airflow and lets the scrotum do its job of moving closer to or farther from the body to regulate heat. If you’re trying to conceive or want to preserve fertility, switching to boxers is one of the simplest changes you can make.
Choose a Better Bike Saddle
Traditional bicycle saddles concentrate pressure on the perineum, the area between your scrotum and anus. That compression can restrict blood flow to the genitals and put pressure on the pudendal nerve, which supplies sensation to the entire region. Over time, this has been linked to numbness, pain, and erectile issues in regular cyclists.
Saddle design makes a significant difference. Seats with a complete anterior cutout (a channel or gap running through the nose of the saddle) reduce pressure on the perineal area by 62 to 101% compared to standard designs. Nose-less saddles, which remove the front section entirely, eliminate compression on the external genitalia altogether. If you cycle regularly, upgrading your saddle is one of the highest-impact changes you can make. Getting a proper bike fit also helps by adjusting your posture so less of your weight rests on soft tissue.
Reduce Chemical Exposure
Certain synthetic chemicals found in everyday products can interfere with testosterone production and sperm quality. The most well-documented are phthalates, a class of chemicals used as plasticizers in PVC plastics, scent retainers in personal care products, and inactive ingredients in some medications. They’re in everything from vinyl flooring to shampoo to food packaging.
A comprehensive systematic review found robust evidence that two common phthalates (DEHP and DBP) negatively affect male reproductive outcomes, including reduced testosterone levels, lower sperm quality, and longer time to pregnancy. Four out of six phthalates studied had moderate or stronger evidence of harm to sperm. You can reduce your exposure by avoiding microwaving food in plastic containers, choosing “phthalate-free” or “fragrance-free” personal care products, and storing food in glass or stainless steel rather than soft plastic.
Do a Monthly Self-Check
Testicular cancer is the most common cancer in young men, and catching it early makes treatment far more effective. Starting at age 15, a monthly self-exam takes about a minute and helps you learn what’s normal for your body so you can spot changes.
The easiest time to check is after a warm shower, when the scrotum is relaxed. While standing, lift your penis out of the way and visually inspect your scrotum for any swelling or asymmetry. Then gently grip the top of one testicle and roll it between your fingers, feeling for any hard lumps. You’ll notice a soft, slightly tender tube along the top-back of each testicle. That’s the epididymis, which stores and transports sperm. Don’t confuse it with a lump. You’ll also feel a rope-like cord connecting to the top of each testicle, which is the blood supply. Repeat with the other side.
What you’re looking for: a painless, hard lump (often pea-sized or larger) on the testicle itself. Other warning signs include swelling, sudden fluid buildup in the scrotum, a feeling of heaviness, a dull ache in your groin or lower abdomen, or one testicle noticeably shrinking. The most common sign of testicular cancer is a painless lump, which is exactly why self-exams matter. Pain doesn’t always show up as an early warning.
Know When Minutes Count
Testicular torsion happens when a testicle twists on its blood supply cord, cutting off circulation. It causes sudden, severe pain and is a genuine emergency. The critical window is six hours from the onset of symptoms. Men who reach surgery within that window have a salvage rate near 100%. After 12 to 24 hours, that rate drops below 50%, and after 24 hours, saving the testicle is rare.
If you experience sudden, intense testicular pain, especially if it comes with swelling, nausea, or a testicle that sits higher than usual, go to the emergency room immediately. This isn’t a “wait and see” situation. The difference between keeping and losing a testicle is almost entirely determined by how fast you get treated. Torsion can happen at any age but is most common in adolescents and young adults.