Epididymitis Treatment: How It Works

Per the Mayo Clinic, epididymitis is a medical condition characterized by “inflammation of the coiled tube, called the epididymis, at the back of the testicle. The epididymis stores and carries sperm.”[1] The epididymis is on top of the testicles, on top of the back part of the testicle (on the side of the scrotum that is not on the same side as the penis).

Those who are assigned male at birth and/or have male reproductive organs can get epididymitis at any age, at any time.

Symptoms of epididymitis include[2]:

• Swelling and redness in the scrotum

• Pain or tenderness in the testicles, usually only on one side

• Abnormal discharge

• Blood in the semen

• Pain in the pelvis or lower abdomen

• Painful, urgent, frequent urination

Infections of the epididymis are “often caused by a bacterial infection, including sexually transmitted infections (STIs), such as gonorrhea or chlamydia. Sometimes, a testicle also becomes inflamed—a condition called epididymo-orchitis.”[1]

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The majority of “people who are treated for epididymitis start to feel better after three days, though discomfort and swelling may last weeks or even months after finishing antibiotic treatment.”[3]

“Epididymitis is usually treated with antibiotics and measures to relieve discomfort.”[1]

The first step to treating epididymitis is seeking medical attention from a health care provider—this could be your primary care provider, an urgent care provider, or an emergency room provider.

If you are experiencing pain, swelling, or discomfort in the scrotum and/or testicles, it is imperative that you seek medical care. A healthcare provider will conduct physical examinations and might order lab tests, such as urine and blood tests, to identify the cause of your pain/discomfort/epididymitis. Based on their diagnosis, they will recommend a treatment plan or course of action—treatment options are discussed below.

In most cases, epididymitis is caused by a bacterial infection. This means that you must treat the underlying infection, which will ameliorate the epididymitis.

Epididymal infections may be caused by sexually transmitted infections (STIs) like chlamydia or gonorrhea or by bacterial infections in the urinary tract. Luckily, in these cases, the condition is treated simply with a prescribed course of antibiotics. The important thing to remember during treatment is that you must complete the entire course of antibiotics as they are prescribed to you—this is the only way to completely eradicate the infection and prevent future antibiotic-resistant infections. Even if you feel better or your symptoms have subsided, you have to complete your antibiotic treatment.

If left untreated, epididymitis can have serious consequences, such as infertility and chronic pain. The Cleveland Clinic offers: “An epididymitis infection can lead to serious problems if it’s not treated in a timely manner. Chronic epididymitis could cause an abscess to form on your scrotum. Or it could destroy your epididymis, resulting in infertility. In some cases, the infection can spread to other parts of your body.”[3]

Before the antibiotics and throughout the course of your treatment, epididymal swelling can cause discomfort and pain in the scrotum/testes. In order to manage this discomfort, ask your healthcare provider if you can take over-the-counter pain relievers like ibuprofen or acetaminophen—if you have other health conditions that prevent you from taking these medications, as your provider for alternatives.

Additionally, discomfort can be soothed by applying ice packs to the area and by elevating the scrotum (for example, by placing a rolled-up towel underneath).

When you have epididymitis, you should avoid strenuous activities that may cause further irritation.

According to the Cleveland Clinic, while ejaculating doesn't make an epididymitis infection worse, it can also make the pain more intense for certain individuals.[3] “It’s best to abstain from masturbation until you’re treated, and you definitely shouldn’t have sex with anyone until your healthcare provider gives you clearance.”[3]

The actions that you can take to prevent epididymitis include [3]:

• Using condoms throughout sex to avoid sexually transmitted infections that can lead to epididymitis

• Avoiding strenuous lifting or physical activity

• Minimizing long periods of sitting

• Taking your entire course of antibiotics to ensure that the infection goes away

If your symptoms appear again, you should immediately follow up with your healthcare provider to rule out tumors or testicular cancer.

For online STD treatment to help prevent epididymitis, Everlywell offers a telehealth option that lets you quickly connect with a clinician to discuss your concerns.

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