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Our Bodies: Protecting the Jewels

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Dear Dr. Levister: Why does it hurt so much when I get whacked in the testicles? Once I even puked, it was that painful.
D.J.

Dear D.J. Ah yes, that smarts, does it not? A bad hit down under can be really, really bad. We are so very vulnerable. Sometimes it takes a person of your own gender to appreciate a certain type of pain. Women have childbirth and men have scrotal injuries. It can be a tap, a bump, a poke, a hit from a well-aimed knee or a direct hit during contact sports; whatever the source, any blow to those two fragile jewels can convince the most macho hulk that there might be something to primal-scream therapy after all.
As miserable as it feels, the momentary discomfort of minor testicular trauma doesn’t threaten the vitality of these vital organs. However, a strong blow to the sack can actually fracture the testicles, or more specifically, the fibrous membrane that holds them together. This is a medical emergency that requires immediate attention.
Perhaps you know that the testicles need to be about 7 degrees F cooler than your body to produce sperm. To keep the temperature low, there is zero fat in the scrotum -- even in the most morbidly obese men -- which means zero protection. The cremasteric or air conditioning muscle lowers the testicles when the body heats up. This is the basis for the term often uttered by weary field hands during slavery, “boss man done worked my balls to the ground.”
The testicles houses one of the highest concentration of nerves in the male body -- nerves that reach up into the abdomen, which explains the crippling pain that extends to your stomach and can give you nausea and vomiting.
The best treatment: ice, on and off for 24 hours, then warm baths for 2 days after that. Elevate a swollen scrotum by lying down and putting a towel under your testicles. See your physician in case there is an underlying infection or more serious problem.
But please, from one man to another, protect yourself. Whenever you play contact sports, wear a cup or athletic supporter. Anything that holds your testicles close to your body is better than nothing. If you don’t have a supporter available, briefs are better than boxers. And while a plastic cup may not be comfortable to wear, it provides the most security against contact injuries. Direct hits to the testicles can cause testicular bleeding or scarring, can block sperm ducts (potentially interfering with fertility), and in the worst cases, can cause the death of your favorite friends down under -- a condition known as testicular atrophy. Which means Auf Wiedersehen Jugen (Goodbye boys)!

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