Epididymitis – how to treat it

If you have pain and swelling in your testicles, epididymitis could be the cause – learn what it is and what you can do about it.


What are the symptoms of epididymitis?

What causes it and who is affected?

When to see a doctor and getting diagnosed

What’s the treatment?

Self-care tips

Epididymitis is painful swelling of a tube behind your testicles. The condition is usually caused by a bacterial infection, so typically needs to be treated with antibiotics. Discover the cause plus what can help relieve your discomfort.

The epididymis is the coiled tube behind the testicles (balls) that carries sperm. In epididymitis, the tube becomes swollen, causing a lot of pain in your testicle and scrotum area. 

There are 2 general types:
- __acute epididymitis__ comes on quickly and gets worse. It’s usually caused by a bacterial infection
- __chronic epididymitis__ causes symptoms for 6 weeks or longer. The pain is usually less severe than acute epididymitis, and may come and go.

Don’t be embarrassed to see a healthcare professional – it’s important to get an accurate diagnosis and get treated. 


## What are the symptoms of epididymitis?

When the epididymis becomes inflamed, you may develop symptoms including:
- pain in 1 or both of your testicles – this can come on suddenly
- a swollen or tender scrotum (bag of skin containing your testicles) that can be discolored or feel warm
- a build-up of fluid around your testicle that may feel like a lump or swollen area.

You may have other symptoms, depending on the causes of the epididymitis. For example, you may have difficulty peeing, or discharge from the tip of the penis. 

__Seek emergency medical help if you have sudden bad pain in your testicles or belly, as this could be due to a twisted testicle. 
__


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## What causes it and who is affected?

Epididymitis is usually caused by bacteria. Most cases result from:

- __[sexually transmitted infections (STIs)](https://www.livehealthily.com/sexual-health/whats-the-difference-between-an-sti-and-an-std-sti-questions-answered)__ – Epididymitis most commonly affects men under 35, caused by either chlamydia or gonorrhea. If you come into contact with these bacteria during sex, they may move into the epididymis
- __[urinary tract infections (UTI)](https://www.livehealthily.com/self-care/how-to-prevent-utis)__ – This is the most likely cause in men aged 35 and older, and the culprit is often the E.coli bacteria. If infected pee flows back down your ejaculatory tract (where sperm pass through during ejaculation), the bacteria in it can infect the epididymis.

UTIs are less common in men but may be more likely if you have an enlarged prostate, a catheter or you had recent groin, prostate, or bladder surgery.

It’s not common, but the mumps virus can also lead to epididymitis, as can a groin injury and tuberculosis infection.

## When to see a doctor and getting diagnosed
If you have [symptoms of epididymitis](https://www.livehealthily.com/health-library/conditions/epididymitis#what-are-the-symptoms), see a healthcare professional to get yourself checked

Plus make an appointment with your doctor if you have:
- a lump in your testicles
- swollen testicles
- a change in the shape or feel of your testicles
- 1 testicle that’s recently got bigger than the other
- aching or discomfort in your testicles that is not easing.

These can be signs of other conditions, including testicular cancer. That’s why it’s important to see a healthcare professional – they can carry out tests, make an accurate diagnosis, and give you the right treatment. 

Your healthcare professional will start by asking about your symptoms. They’ll carry out a physical examination of your groin, and may order tests, such as:
- urine (pee) and blood tests to check for bacteria
- a swab of your urethra – the tube that carries pee out of your body – again, they’ll be looking for bacteria
- an ultrasound.


## What’s the treatment?

Treatment for epididymitis usually involves a course of antibiotics to treat the infection – your healthcare professional will prescribe the best one for the type of bacteria they find.

You should start to feel better after a few days, although you may still have some [symptoms](https://www.livehealthily.com/health-library/conditions/epididymitis#what-are-the-symptoms) for several weeks.

Try not to worry if it takes a little while to recover fully, but if you still have symptoms after 3 months, speak to your healthcare professional, as you may need further tests and treatment.


## Self-care tips

It’s important to see your healthcare professional for an accurate diagnosis and treatment for epididymitis. However, you can try some self-care measures at home to ease symptoms while you’re recovering, including: 

- taking painkillers, such as acetaminophen (paracetamol), to help with pain (check with your healthcare professional before using [NSAIDs](https://www.livehealthily.com/health-library/drugs/anti-inflammatories-non-steroidal) like ibuprofen)
- placing a cold pack (or frozen peas) wrapped in a towel on your groin area
- wearing supportive, close-fitting underwear to ease swelling
- staying hydrated with plenty of fluids to help flush out infection from your body
- avoiding sexual activity until your healthcare provider says it’s safe – ejaculation can be painful while you’re affected, and if the condition is caused by an STI, you can pass it on until it’s cleared. Your partner should also be tested and treated if necessary.


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References

Charlotte Haigh

Jo Wheatley

Dr Ewan O'Farrell

Article information

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