When it comes to injury susceptibility, the testicles are low-hanging fruit.
We all pretty much know it hurts like hell to get kicked in the balls.
Or for your testicles to endure any similar trauma — whether it’s catching an errant soccer ball with your crotch, a playful nut-punch gone wrong, or even just a gentle flick. But have you ever stopped to wonder why? BuzzFeed Health reached out to Dr. Seth Cohen, assistant professor in the department of urology at New York University, and Dr. Landon Trost, assistant professor of urology and head of male infertility and andrology at the Mayo Clinic, to understand more about just why a blow to the ‘nads is so uniquely and painfully unpleasant.
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The first thing you need to know is that the testicles are so sensitive because they’re very important.
Our bodies have various ways of ensuring that our most important parts are kept out of harm’s way. For example, the brain is protected by the skull. The ovaries, crucial to reproduction, are inside the body and further protected by the pelvic bone. On the other hand, testicles — which produce sperm and testosterone, making them essential for reproduction — lack protective armor like the skull and are external, making them ~low-hanging fruit~ when it comes to injury susceptibility. But testicles have something the brain doesn’t: pain fibers. Lots of them.
The genitals have a high number of nerves per surface area, says Trost, which makes them more sensitive and allows you to feel things more discriminately than you would on other, less sensitive parts of your body, like your back. Additionally, the brain devotes a lot of space to processing what the genitals feel, even though they're a relatively small part of the body. Just think about how gently you can touch the testicles and still cause intense sensation. So, in the same way that cuts on the lips or fingers often hurt more than, say, a cut in the middle of the back, “injuries to the penis and scrotum are more tender,” Trost tells BuzzFeed Health.
Also, the testicles hail from a land far far away from your crotch (i.e. your abdomen).
After sustaining a blow to the testicles, you might have a stomach ache or feel pain ripping through your abdomen. One of the reasons for this probably has something to do with the fact that your testicles weren’t always where they typically end up, just behind and underneath the penis, says Cohen.
The testicles actually start developing in the abdomen, just underneath the kidneys. They start to descend just before birth, making their way from the abdominal cavity to the scrotum by way of a passage called the inguinal canal, and are typically in the scrotum by birth or within the first year of life. What this means is that the testicles’ nerve fibers travel from the scrotum back up the inguinal canal to where they developed, in the abdomen. As a result, pain from a kick in the nuts is not localized to the crotch — basically because your brain thinks it's your abdomen that’s been attacked.
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You might also get sweaty and light-headed, or tear up or cry, and want to collapse into the fetal position.
This is all part of the grand evolutionary plan that has made sure our bodies are programmed to freak out on a systemic level when we encounter trauma. Some people may feel faint or light-headed, weak, nauseated, or even pass out. This is called a vasovagal response, says Trost, and it occurs when the vagus nerves, which control heart rate, breathing, and blood pressure, and which are very sensitive to emotional response, are overstimulated. The vasovagal response can be triggered by lots of things — the sight of blood, fear of bodily trauma, and, in this case perhaps, severe pain.
Not every single person will have the same reaction, though. It is difficult to pin down exactly which autonomic systems are triggered when you get kicked in the balls because the testciles are “complicated from a nerve standpoint in that they have multiple different pathways, multiple different sources for pain, and take up a relatively large space in the brain,” Trost says.
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