Overview
The epididymis is a coiled tube on the back of each testicle that stores and carries sperm. When it gets infected or inflamed, it swells and hurts. The infection can spread to the testicle.
In younger men, it's often caused by an STI like chlamydia or gonorrhea. In older men, urine infections are a more common cause. Testicular torsion, a twisted testicle, can look similar and is a surgical emergency.
Symptoms
Symptoms usually build up over a day or two.
- Testicle pain or swelling on one side
- Heaviness in the scrotum
- A tender, swollen lump at the back of the testicle
Less common
- Low fever and chills
- Burning when urinating
- Discharge from the penis
- Blood in semen
- Pain in the groin or lower belly
How it usually goes
- Over 1 to 2 days: Pain and swelling build.
- Within 3 days of treatment: Should start to improve.
- A few weeks: Discomfort fully clears.
When to get medical care
Causes
In men who are sexually active, chlamydia and gonorrhea are common causes. Germs from the bowel can cause it in men who have insertive anal sex, or after urinary procedures like a prostate biopsy or vasectomy.
Does it spread or run in families?
- It isn't contagious. You can't catch it from someone else.
Who is more likely to get it
- STIs or a partner with an STI
- Not using condoms
- Recent urinary procedures or a catheter
Possible complications
- Twisted testicle: Can look similar; an emergency
- Infertility: Rare, if severe or untreated
- Chlamydia: A common cause
Diagnosis
A healthcare professional will first make sure it isn't a twisted testicle.
Questions you may be asked
- How fast the pain started and how bad it is
- Burning when you pee or discharge
- Fever, nausea, or vomiting
- Recent partners or STIs
- Recent urinary procedures
The exam
They'll check the scrotum, testicles, and groin.
Tests
Tests may include:
- Urine tests: For infection, chlamydia, and gonorrhea.
- Ultrasound: To check blood flow and rule out a twisted testicle.
Treatment
Epididymitis is treated with antibiotics. Partners need treatment if an STI is the cause.
Self-care
- Rest lying down with the scrotum raised on a rolled towel
- Use ice packs wrapped in a cloth
- Wear supportive underwear or an athletic supporter
- Take all of your antibiotics
- Avoid sex until you and your partners finish treatment
Medicines
Antibiotics need a prescription.
| Medicine | Helps with | Good to know |
|---|---|---|
| Antibiotics | Treats the infection | Finish all of it. |
| Anti-inflammatory pain relievers Ibuprofen | Pain and swelling | Ask first if you have kidney disease, ulcers, or take blood thinners. |
Discomfort can take a few weeks to fully go away after antibiotics.
If you're not better within 3 days, go back. You may need different tests or treatment. Some men need the hospital for severe pain, high fever, or an abscess.
How it compares
| Epididymitis | Twisted testicle | Testicle lump | Prostatitis | |
|---|---|---|---|---|
| Pain starts | Over hours to days | Suddenly, severe | Often painless | Gradually |
| Nausea | Sometimes | Often | No | Sometimes |
| Urgency | Same day | Emergency | See a doctor soon | See a doctor |
Prevention
You can lower your risk:
- Use condoms correctly every time
- Get tested and treated for STIs
- Limit your number of partners
Which doctor treats this
- Start with your primary care provider (family doctor or internist).
- They may send you to a urologist (urinary tract doctor).
Children, pregnancy, and older adults
- Teens and boys: Sudden testicle pain is more likely a twisted testicle. Go to an emergency room right away.
- Diabetes: Infections can be more severe; get checked quickly.
Outlook
Most epididymitis gets better with antibiotics, without lasting problems. It can come back.
Getting ready for your visit
Tell them how fast the pain started.
What to bring
- When the pain started and how quickly
- Recent partners and STI tests
- Any recent urinary procedures
Questions to ask
- Could this be a twisted testicle?
- Do my partners need treatment?
- How long until the pain goes away?
- Can this affect fertility?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Sources
Last updated 2026-11-12.