Is it normal for one testicle to hang lower than the other?

1. Normal anatomy: asymmetry as the rule

Most reliable patient-facing sources and clinicians describe a slight difference in size and position as typical—one testicle is often a bit larger and typically hangs lower than its counterpart, with the left commonly lower than the right—an accepted anatomical variation rather than a disease ^{[1] [2] [4] [5]}.

2. Why one hangs lower: cords, muscles and cooling

The position difference arises from straightforward anatomy and physiology: the spermatic cords can be different lengths, and the cremaster muscle alters elevation in response to temperature and other stimuli, so one testis may descend lower to help with temperature regulation and because of intrinsic cord length differences ^{[5] [6] [7]}.

3. When asymmetry is benign versus when it’s a warning sign

A long-standing, stable difference in height without pain or other changes is generally harmless and requires no intervention ^{[1] [2]}, but a sudden positional change, new or severe pain, swelling, lumps, or rapid size change can indicate torsion, infection, varicocele, or hernia and should prompt immediate medical review ^{[2] [3]}.

4. Testicular torsion: the acute exception

Testicular torsion is an emergency that typically presents with sudden, severe scrotal pain and can involve an altered position of the testicle (often pulled higher) because the spermatic cord has twisted; rapid assessment and treatment are necessary to try to save the testicle ^[2].

5. Other causes to consider: infection, varicocele, hernia, tumors

Gradual or painful changes in size or position may reflect other treatable problems: varicocele (dilated veins), epididymitis or orchitis (infection/inflammation), inguinal hernia, or, more rarely, a testicular tumor—any new lump, persistent ache, or asymmetric growth should be evaluated by a clinician and often imaged with ultrasound ^{[3] [2]}.

6. Practical advice: self-checks and when to seek care

Regular self-exams to note baseline size and position are recommended; seek urgent care for sudden severe pain, and see a doctor within days for new lumps, noticeable growth, persistent discomfort, or otherwise unexplained changes ^{[4] [8]}. Long-standing asymmetry without symptoms typically does not require treatment ^{[1] [2]}.

7. How clinicians assess asymmetry

Clinicians use physical examination and, when indicated, scrotal ultrasound to distinguish normal anatomical asymmetry from pathology; history-taking focuses on onset, pain, trauma, fever, and urinary symptoms to guide urgency and testing ^{[2] [3]}.

8. Bottom line with balance and caveats

Asymmetry—one testicle hanging lower than the other—is ordinary and usually harmless, anatomic variation with physiological explanations ^{[1] [5] [4]}; nonetheless, medical attention is non-negotiable for sudden changes, pain, lumps, or swelling because such signs can indicate conditions that require urgent or specific treatment ^{[2] [3]}.