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Epididymitis: What It Feels Like for Men and How to Treat It

Pain in the scrotum may be a sign you have an infection brewing.
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Last updated April 22, 2024

Epididymitis quiz

Take a quiz to find out if you have epididymitis.

Care Plan

1

First steps to consider

  • If you have scrotal pain or swelling, you should see a healthcare provider to make sure you don’t have something serious like an infection.
  • Epididymitis is usually treated with antibiotics.

Symptom relief

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  • You can take OTC pain medications and ice the area for temporary pain relief.
  • Supportive boxers can help relieve pressure on the scrotum.

Emergency Care

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Go to the ER if you have any of the following symptoms:

  • Sudden or severe scrotal pain
  • Scrotal swelling

What is epididymitis?

Pro Tip

Even experts have difficulty definitively diagnosing epididymitis versus torsion by symptoms and exam alone. It is often necessary to have an ultrasound to rule out testicular torsion, which is twisting of the testicle. It can lead to loss of testicle and infertility if not diagnosed and surgically treated as soon as possible. —Dr. Chandra Manuelpillai

Epididymitis is inflammation (swelling) caused by an infection of the epididymis. The epididymis is a tube located in the back of the testicle. It stores and transports sperm—and also helps sperm mature. It is usually caused by a bacterial infection, sometimes from a sexually transmitted disease.

The most common symptom is gradual pain by the epididymis. See a doctor as soon as possible because other serious diagnoses can have similar symptoms. For example, testicular torsion is a twisting of the testicles and a surgical emergency. Fournier’s gangrene, though uncommon, is an infection in the groin area that can lead to death if not treated right away.

Epididymitis symptoms

The most common symptom of epididymitis is a gradual onset of scrotal pain. It is usually along the back of the testicle, but you may feel it in other parts of the area. Swelling is common too.

Other symptoms you may have

  • Reddened skin
  • Mild fever
  • Pain when urinating
  • Urinating more frequently
  • Penile discharge (not urine or semen)

Epididymitis quiz

Take a quiz to find out if you have epididymitis.

Take a diagnosis quiz

Causes of epididymitis

Dr. Rx

Be honest with your doctor. People are often embarrassed to discuss their sexual history with their doctor, including if they are sexually active, have had unprotected intercourse, or engaged in insertive anal intercourse. They also avoid getting medical attention when symptoms involve their genitalia. Delay in diagnosis and treatment may lead to worsening infection, loss of fertility, and even death. Your doctor is there to help you, not judge you. —Dr. Manuelpillai

Epididymitis is often caused by an infection from other areas—like the urethra, bladder, prostate, or kidney—that spreads to the epididymis. In men under 35 years old, it is more commonly caused by a sexually transmitted disease (STD) such as gonorrhea and chlamydia.

In older men, it is more likely to be caused by an enlarged prostate. Males of any age who have anal intercourse are at risk of infection from exposure to bacteria in the rectum.

In children and teenagers (teens who are not sexually active), it may be due to anatomic abnormalities that can lead to urinary tract infections. Scrotal pain and swelling in children could also be caused by orchitis, which is another type of infection of the testes.

Teenagers who are sexually active are more likely to have an infection caused by an STD.

What is the best way to treat epididymitis?

If you suddenly have scrotal pain, go to the emergency room to rule out more serious issues like testicular torsion.

Epididymitis is treated with antibiotics. Which ones depend on whether you have an STD, urinary tract infection, or enlarged prostate. Finish all antibiotics to prevent the infection and symptoms from returning.

If you are diagnosed with an STD, make sure your sexual partner is tested and treated too.

Other symptoms can be relieved with over-the-counter or prescription pain medications and icing the area. You can also use scrotal support like supportive boxers.

Here are over-the-counter (OTC) options to help manage symptoms until you can see your doctor:

Pain Relievers: OTC pain relievers such as ibuprofen or acetaminophen can help reduce pain and inflammation associated with epididymitis.

Supportive Underwear: Wearing supportive underwear can help alleviate pain by reducing scrotal sagging.

Cold Packs: Applying cold packs to the scrotum can help reduce swelling and provide temporary relief from pain.

Follow up

Symptoms should start to improve after 3 days of home care. If not, you should see your doctor again. You want to make sure you have the correct diagnosis. Or you may need a different antibiotic.

Pro Tip

Follow up with referrals including to a urologist. They are experts on epididymitis and its causes, particularly when related to an anatomical abnormality. It is especially important for children and teenagers with suspected abnormalities to be evaluated. These conditions are usually surgically correctable. But if left untreated, they can lead to recurrent infections. —Dr. Manuelpillai

How to prevent epididymitis

Practicing safe sex (i.e., using condoms) helps prevent epididymitis from an STD.

Older men with an enlarged prostate can help prevent a urinary tract infection by drinking plenty of fluids.

Hear what 1 other is saying
Once your story receives approval from our editors, it will exist on Buoy as a helpful resource for others who may experience something similar.
The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Sore penisPosted October 4, 2024 by S.
1. pain in my penis for about 3 weeks now. 2. frequent urination, sometimes several times per hour and painful. 3. urine smells bad. 4. got a prescription for amoxicillin and tamsulosin on 9-16. These did not help. 5. review of symptoms on the web indicate I might have nongonoccocal urethritis and treatment does not include the above prescriptions? 6. it has been effecting me psychologically. 7. urologist gave me a prescription for doxycycline. Took it for a week - no improvement. 8. 3 urine tests and no infections and no VD. 9. Local urologist unable to identify the cause of the problem. HELP???
Dr. Le obtained his MD from Harvard Medical School and his BA from Harvard College. Before Buoy, his research focused on glioblastoma, a deadly form of brain cancer. Outside of work, Dr. Le enjoys cooking and struggling to run up-and-down the floor in an adult basketball league.

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