Epididymitis Guide: Symptoms, Causes, and Treatment

Overview

The epididymis is a small, coiled tube located at the back of each testicle. It stores and carries sperm from the testicles to the vas deferens. Epididymitis occurs when this tube becomes inflamed, usually due to a bacterial infection. It is a common cause of testicular pain in men and people assigned male at birth, and most cases are treatable with prompt medical care.

Signs & Symptoms

Symptoms of epididymitis typically develop gradually over a few days, though they can come on suddenly in some cases. They most often affect only one side of the scrotum, but may spread to both sides in rare instances. Common symptoms include pain or tenderness in the testicle (which may worsen when touched or during movement), swelling, redness, or warmth in the scrotum, pain or burning when urinating, pain during ejaculation, blood in semen, fever and chills, abdominal or pelvic pain, and penile discharge (if caused by an STI).

Causes & Risk Factors

Diagnosis

To diagnose epididymitis, your healthcare provider will first ask about your symptoms, sexual history, and urinary health. They will then perform a physical exam of the scrotum, checking for swelling, tenderness, and lumps. Additional tests may include:

• Urine test: To check for bacteria or signs of a UTI or STI
• STI testing: Swab of the urethra or urine test to check for chlamydia, gonorrhea, and other STIs
• Scrotal ultrasound: To rule out other causes of testicular pain, such as testicular torsion (a medical emergency where the testicle twists and cuts off blood supply)
• Blood tests: To check for signs of infection or inflammation

Treatment & Management

Epididymitis is almost always treated with antibiotics to clear the underlying bacterial infection. The type of antibiotic prescribed will depend on the suspected cause of your infection, including your age, sexual activity, and any allergies you have. If an STI is the cause, your sexual partner(s) will also need to be tested and treated to prevent reinfection. Supportive care can also help reduce symptoms:

• Rest and scrotal support: Wear supportive underwear, avoid strenuous activity, heavy lifting, and sexual activity until symptoms improve
• Pain relief: Over-the-counter pain medications like ibuprofen or acetaminophen can help reduce pain and swelling
• Cold compresses: Apply a cold pack wrapped in a cloth to the scrotum for 15-20 minutes at a time to reduce swelling
• Complete your full course of antibiotics: Even if you start feeling better after a few days, finish all prescribed medication to fully clear the infection

Living With It & Recovery

Most people start to feel better within 2 to 3 days of starting antibiotic treatment. Full recovery typically takes 2 to 4 weeks, though some people may experience mild lingering discomfort for longer. To reduce your risk of future episodes:

• Practice safe sex: Use condoms during vaginal, anal, and oral sex to reduce your risk of STIs
• Get regular STI screenings if you are sexually active with new partners
• Drink plenty of water and urinate when you feel the urge to avoid UTIs
• Avoid holding in urine for long periods, especially after sexual activity