Epididymitis: Symptoms, Causes, and Long-Term Outlook

The epididymis is a tube that stores and carries sperm. Epididymitis is the inflammation of this tube. It can be a painful condition that affects men of any age. It’s important not to ignore the symptoms and to seek care, so here’s what you need to know.

8 minute read

Last Updated July 14, 2020

What is Epididymitis? - Men's Health - 1MD

Your epididymis is the tube situated towards the back of your testicles that stores and carries sperm. Epididymitis is the inflammation of this tube, which causes swelling, tenderness, and pain in your testicles. 

This condition can affect men of any age but is more common among the ages of 14 and 35. It is usually caused by a bacterial infection or sexually transmitted disease and can be chronic or acute. 

If left untreated, epididymitis can lead to more severe health problems, so it is important not to ignore this symptom. 

Symptoms of Epididymitis

Symptoms will be mild at first as the condition has a very gradual onset. Symptoms will get worse if the condition is left untreated. Along with swelling and tenderness in the testicle area, you may also experience:

♦ Enlarged lymph nodes in the groin
♦ Painful urination
Frequent urination
♦ Swollen and warm scrotum
♦ Nausea 
Blood in semen
♦ Penile discharge
♦ Fever and chills
♦ Pain during sexual intercourse
♦ Pressure in the testicles

While men are more likely to get epididymitis, boys can also develop the condition too. The cause of the inflammation in children is likely to be different though. 

Direct trauma, UTIs, reflux of urine, and twisting of the epididymis are the common causes in boys. The symptoms to look out for include:

♦ Discharge from urethra
♦ Lower abdominal pain
♦ Redness on the scrotum
♦ Fever

Acute epididymitis lasts for six weeks or less, and the testes will also be inflamed along with the tube. Gonorrhea and chlamydia are the most common causes of acute epididymitis in men younger than 35. 

Unprotected sex and immunosuppressive drugs compromise the immune system, which increases your risk for acute epididymitis. Without treatment at this stage, the condition can become more chronic and painful.

Chronic epididymitis will last longer than three months and will have a more serious underlying cause that can also result in cysts or calcifications. It is characterized by inflammation in the absence of any infection. 

When the condition is chronic, you will also notice symptoms such as pain in the scrotum and testicles, as well as the epididymis. When pain becomes severe, you could develop testicular torsion, which cuts off blood supply to the testicles and requires immediate medical attention.

Causes of Epididymitis

The cause of epididymitis is usually a bacterial infection. The bacteria is introduced through a number of methods, including unprotected sex, and it travels back through the urethra, prostate, and vas deferens to reach the epididymis. 

The two forms of bacteria most commonly known to cause epididymitis are those transmitted sexually and a class of organisms known as coliforms (such as E.coli) that live in the intestines. These types of bacteria are found to be the causes of 80 percent of cases. 

Risks for Epididymitis

Infections are the most common cause of epididymitis, and you can reduce this risk with proper hygiene and safe sex practices. There are some factors that increase your risk for the condition. 

You can be at higher risk if you: 

♦ Have or have had tuberculosis
♦ Use a urinary catheter
♦ Use heart medication such as amiodarone
♦ Have a viral infection like the mumps
♦ Recently had urinary tract surgery
♦ Have an enlarged prostate
♦ Have an uncircumcised penis

Complications of Epididymitis

If epididymitis is left untreated, serious complications can arise. The formation of abscesses can occur as can testicular infarction. This is the death of testicular tissues that results from blood supply being cut off. 

Chronic epididymitis can cause permanent damage and scarring to the epididymis and testicles, causing infertility and hypogonadism. Hypogonadism refers to low gonad activity and reduction in the hormone testosterone. Your risk of infections also increases with chronic epididymitis, and these infections can easily spread to other areas in the body. 

Diagnosis of Epididymitis

A physical examination is done first to look for swelling in the testicles, swollen lymph nodes in the groin, and abnormal discharge. Should any discharge be present, your doctor will test this for STDs. Additional testing can also be done to determine the cause of the inflammation.

♦ A rectal examination is done to check the health of the prostate gland
♦ Culture taken from the urethra to identify infection
♦ The cremasteric reflex test helps to distinguish this condition from testicular torsion
♦ Blood tests will test for infections and sexually transmitted diseases
♦ Urine sample to test for urinary tract infections
♦ Imaging can also be done to rule out the presence of tumors or damaged tissues
♦ Nucleic acid amplification tests are done to detect microbial DNA

It is important to note that many of these tests take time to process, so you must regularly follow up with your doctor regarding results. Forgetting to get the results and a diagnosis will increase your risk of more serious complications.

Treatment for Epididymitis

Treatment will depend on the underlying cause of the inflammation. Antibiotics will be given for infections and pain, and anti-inflammatory medications are prescribed to help with pain and discomfort. 

You can also provide home care for any swelling. Applying ice packs to your scrotum, wearing an athletic cup for extra support, and avoiding heavy lifting can all help. It can take several weeks for discomfort to go away, and if it is not cleared up within three months, more invasive treatment may be needed, such as surgery.

Natural Treatment for Epididymitis


Outside of medications to reduce the inflammation, there are several natural options you can try. The ingredients below are proven to reduce inflammation associated with epididymitis. Once inflammation is reduced, swelling and pain will go away. 

Prolonged use of anti-inflammatory medications can cause unpleasant side effects for your stomach. Choosing a more natural alternative can prevent this and still help resolve your pain. 

♦ Boron has anti-inflammatory effects, and Boron AAC is a more absorbable and potent version to try. 
USPlus Saw Palmetto contains the antioxidants epicatechin and methyl gallate that reduce inflammation. 

Since epididymitis is most often caused by bacterial infections, it is beneficial to try ingredients that can fight these infections successfully. 

Pumpkin seed extract provides relief by reducing inflammation and providing antibacterial benefits. It also has analgesic properties that help with the pain.
Stinging nettle also contains powerful antibacterial compounds that reduce the inflammation caused by infections.

What Is the Long-Term Outlook?

In most cases, the causes of acute epididymitis are successfully treated with antibiotics, and there are no long-term problems. In rare cases, complications can occur, such as testicular shrinkage, testicular tissue death, infertility, and chronic epididymitis. With prompt treatment, you can avoid these complications. 

It is also important to complete all prescribed medications, and even after symptoms disappear. Once treated, you can make a complete recovery.

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