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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online. A doctor can judge how urgently you need to be seen and what is likely; the examination, tests and treatment are in person.
- What it is: swelling and pain of the epididymis, the coiled tube at the back of the testicle that stores and carries sperm, usually from an infection.
- Main causes: under 35, most often an STI such as chlamydia or gonorrhoea; over 35, most often a urine infection.
- Recovery: antibiotics treat it; most men feel better within a few days, but full recovery can take up to 3 months.
- Emergency: call 112 or go to an emergency department for sudden, severe testicle pain, or testicle pain lasting more than an hour or continuing at rest: a twisted testicle needs surgery within hours.
Do not book a video appointment if you have sudden, severe pain in a testicle or your tummy, or testicle pain that has lasted more than an hour or continues when you rest. Go to an emergency department now or call 112, and do not drive yourself. A twisted testicle can look like epididymitis and needs surgery as soon as possible.
Can an online doctor help with epididymitis?
No, epididymitis cannot be treated online: testicle pain needs an examination, a urine test and a swab, and the first-line treatment when an STI is likely includes an injection. Sudden, severe testicle pain, or pain that has lasted more than an hour or continues when you rest, means an emergency department now, to rule out a twisted testicle. What a doctor by video can do is help you judge how urgently you need to be seen, explain the likely cause and the tests, plan partner testing, and follow up if recovery is slow.
How an online consultation helps with epididymitis
- Urgency made clear: Whether you need an emergency department now, and what to tell the staff when you get there.
- The likely cause: An STI or a urine infection, judged from your age, symptoms and sexual history, which decides the tests and treatment.
- Partners tested too: Who needs testing and treatment when an STI is the cause, and how to tell them.
- Help while you recover: Pain relief, support, sex and when slow improvement needs a review.
What the doctor checks in an online assessment of testicle pain
The doctor asks first about the signs that mean an emergency department now. The doctor asks about:
- Warning signs: sudden or severe pain, pain lasting more than an hour or continuing at rest, pain in the tummy, or a high temperature.
- The pain: one or both testicles, whether it started suddenly or gradually, and how it has changed.
- Swelling and lumps: a warm, swollen scrotum, a lump, or a change in the shape of a testicle.
- Other symptoms: discharge from the penis, pain when peeing, needing to pee often, or blood in the semen.
- STI risk: a new partner, a partner with an STI, sex without a condom, and anal sex.
- Your health: an enlarged prostate, a urinary catheter, recent surgery to the groin, prostate or bladder, mumps, and your medicines, including any history of seizures.
If the doctor thinks you need an examination urgently, you are told where to go. Do not drive yourself with severe pain, and take a list of your medicines with you.
What are the symptoms of epididymitis?
The main symptom is pain in one or both testicles, which can start suddenly or gradually, often with swelling. Other symptoms are:
- a tender, warm, swollen or discoloured scrotum
- a build-up of fluid around the testicle, called a hydrocele, which can feel like a lump
- pain when peeing, or needing to pee often or urgently
- a white, yellow or green discharge from the tip of the penis
- discomfort low in the tummy or pelvis
- blood in the semen
- a high temperature, which is less common
Epididymitis or a twisted testicle?
A twisted testicle, testicular torsion, is the most important condition to rule out, because the testicle can be lost if it is not treated quickly. Only an examination can tell them apart, so do not try to work it out at home:
Swipe sideways to compare →
| Condition | How it starts | Clues | What to do |
|---|---|---|---|
| Epididymitis | Suddenly or gradually | Swelling, warmth, discharge or pain when peeing; an STI or a urine infection | Prompt in-person assessment and tests |
| Twisted testicle (torsion) | Suddenly, with severe pain | Most common around puberty and in newborn babies, but can happen at any age | Emergency: surgery within 6 hours gives the best chance of saving the testicle |
| Inguinal hernia, a cyst or swollen veins (varicocele) | Varies | Other common causes of testicle pain, as is an injury | See a doctor to check |
| Testicular cancer | Varies | A lump, swelling or change in the shape of a testicle | See a doctor promptly |
What causes epididymitis?
Epididymitis is usually caused by an infection, and the likely infection depends on age and risk:
- Under 35: most often a sexually transmitted infection, such as chlamydia or gonorrhoea.
- Over 35: most often bacteria from a urine infection. Urine infections are less common in men, and more likely with an enlarged prostate, a urinary catheter, or recent surgery to the groin, prostate or bladder.
- Insertive anal sex: can pass on gut bacteria that cause epididymitis at any age.
- Less common causes: mumps, tuberculosis, the heart medicine amiodarone, an injury to the groin, and Behçet’s disease.
Other things that make it more likely are a partner with an STI, sex without a condom, a past STI or urine infection, and a weakened immune system, for example with HIV.
Is epididymitis an STI?
Not always. In younger men it is usually caused by an STI, and then partners need testing and treatment too. In older men it is usually caused by a urine infection, which is not passed on through sex. You can get epididymitis without having an STI, but the tests are what tell you which it is.
How is epididymitis treated?
With antibiotics, as an injection, tablets or both, after a urine test and a swab. Because the results take a few days, treatment usually starts before they are back, based on the likely cause. UK guidelines recommend:
Swipe sideways to compare →
| Likely cause | Usual treatment | Course |
|---|---|---|
| An STI, including possible gonorrhoea | A ceftriaxone injection, plus doxycycline tablets | Doxycycline for 10 to 14 days |
| Chlamydia or another non-gonococcal STI | Doxycycline, or ofloxacin | 10 to 14 days, or 14 days |
| A urine infection (gut bacteria) | Ofloxacin or levofloxacin | 14 days, or 10 days |
| Quinolone antibiotics unsuitable | Amoxicillin with clavulanic acid | 10 days |
If there is no improvement after 3 days, the diagnosis and treatment are reassessed. Finish the whole course even when you feel better. Most men start to feel better within a few days, but it can take up to 3 months to recover fully; if symptoms continue after that, further tests are arranged.
How to relieve testicle pain
While the antibiotics work, painkillers such as paracetamol or ibuprofen, a cold pack or a bag of frozen peas wrapped in a towel, and supportive underwear help. If you have had seizures, ask a pharmacist before taking ibuprofen, because it should not be taken with some of the antibiotics used. Sudden, severe pain needs an emergency department, not home remedies.
Chronic epididymitis
Epididymitis that lasts longer than 6 weeks, or keeps coming back, is called chronic. It can start gradually, the cause is sometimes never found, and it needs further tests to look for a cause.
Can epididymitis cause complications?
Most men recover fully with treatment. Uncommonly, epididymitis can lead to:
- an abscess, a pocket of pus in the scrotum
- a hydrocele, fluid around the testicle
- infection spreading to the testicle itself, epididymo-orchitis
- rarely, reduced fertility, although the link with fertility is not well understood
What might the doctor recommend for testicle pain that could be epididymitis?
What happens next depends on how the pain started, how long it has lasted and what comes with it. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Sudden, severe testicle pain, or pain lasting more than an hour or continuing at rest | Emergency assessment to rule out a twisted testicle | No | Go to an emergency department now |
| A swollen, aching testicle with discharge or pain when peeing | Examination, urine test and swab, then antibiotics | Only to assess | Promptly, in person |
| Diagnosed epididymitis, not better after 3 days of antibiotics | Reassessment of the diagnosis and treatment | Yes, to assess | For the examination and any change of treatment |
| A partner diagnosed with chlamydia or gonorrhoea | Tests and treatment for you | Yes | For the tests, at a clinic or with a kit |
| Recovering from epididymitis | Advice on pain relief, support and sex | Yes | If symptoms last beyond 3 months |
| A painless lump or a change in the shape of a testicle | An examination and an ultrasound scan | Only to assess | Promptly, in person |
Not sure how urgent your testicle pain is? A doctor can tell you in one consultation where to go and how quickly.
See available times →Treatment options for epididymitis
What you can do yourself
- Take paracetamol or ibuprofen for the pain, after checking ibuprofen is safe with your antibiotic.
- Hold a cold pack or frozen peas wrapped in a towel against the scrotum.
- Wear supportive underwear, and rest.
- Do not have sex until you have finished treatment for chlamydia or gonorrhoea, or for 7 days afterwards, depending on the treatment.
- Tell your partners if an STI is found, so they can be tested and treated.
Prescription treatment
A prescription is never issued without a consultation. Epididymitis is treated in person after an examination and tests: when an STI is likely, the first-line treatment includes an antibiotic injection with tablets, and other causes are treated with tablets. Afterwards, the doctor may advise on pain relief, partner testing and follow-up. Strong opioid painkillers are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Waiting at home with sudden or severe pain. Trying to work out at home whether a testicle is twisted. Stopping antibiotics when the pain eases. Treating yourself without your partners when an STI is the cause.
Special situations
Men over 35, and an enlarged prostate
In older men, epididymitis usually follows a urine infection, and an enlarged prostate or a catheter makes that more likely. A urine sample for culture guides the antibiotic. The enlarged prostate and bladder infection pages explain why urine infections in men need tests.
Epididymitis while travelling in Europe
Sudden or severe testicle pain is an emergency wherever you are: go to the nearest emergency department or call 112. If you are treated abroad, keep the names of the antibiotics and any test results, so the course can be finished and partners treated when you are home.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When epididymitis is assessed online, and when you need in-person care
Assessed online: how urgently testicle symptoms need to be seen, the likely cause and the tests, partner testing, recovery advice, and follow-up when improvement is slow.
In-person care: every examination, urine test, swab and scan, the antibiotic injection, any sudden or severe testicle pain, pain lasting more than an hour or continuing at rest, and a lump in a testicle.
When to get in-person care
Call 112 or go to an emergency department now for:
- sudden, severe pain in a testicle
- testicle pain that has lasted more than an hour or continues when you rest
- sudden, unbearable pain in the tummy with testicle pain
- severe pain in the scrotum
Get medical advice the same day for:
- discharge from the penis, or pain when peeing, with an ache in a testicle
- epididymitis that is not improving 3 days after starting antibiotics
- a high temperature with a swollen scrotum
A lump, swelling or change in the shape of a testicle, without pain, needs a doctor to check it promptly, because lumps can be a sign of testicular cancer.
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the pain: say when it started and how quickly, whether it is one side or both, and mention any discharge, pain when peeing or recent new partner.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Testicle pain can have more than one cause. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call. If you have an emergency sign listed on this page, call 112 instead.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Urethritis can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about epididymitis
What is epididymitis?
Swelling and pain of the epididymis, the coiled tube at the back of the testicle that stores and carries sperm. It is usually caused by an infection: an STI in younger men, and a urine infection in men over 35.
What are the symptoms of epididymitis?
Epididymitis causes pain in one or both testicles that starts suddenly or gradually, a warm, swollen, tender scrotum, and sometimes discharge from the penis, pain when peeing or a high temperature.
Is it epididymitis, a twisted testicle or something else?
Epididymitis builds over hours to days with a tender, swollen, warm back of the testicle, often discharge or burning on peeing, and sometimes fever. A twisted testicle starts suddenly and severely, often with nausea, the testicle sits high, and it is an emergency; a hydrocele is painless swelling; a hernia bulges from the groin and may ease lying down; orchitis after mumps swells the whole testicle with fever; and a painless hard lump is checked for cancer. An examination, often with ultrasound, tells them apart.
Is epididymitis an STD?
Not always. In men under 35 epididymitis is usually caused by an STI such as chlamydia or gonorrhoea, but in older men it is usually caused by a urine infection. Tests show which it is.
Can you get epididymitis without an STD?
Yes. Urine infections, an enlarged prostate, a catheter, recent surgery, mumps, an injury and some medicines can all cause epididymitis. Tests still check for STIs, because they are a common cause.
Does epididymitis go away on its own?
Epididymitis caused by an infection needs antibiotics. With treatment, most men feel better within a few days, though full recovery can take up to 3 months.
What is the best antibiotic for epididymitis?
The best antibiotic for epididymitis depends on the cause. UK guidelines recommend a ceftriaxone injection with doxycycline when an STI is likely, and ofloxacin or levofloxacin when a urine infection is the cause. The doctor treating you in person decides.
How can I relieve testicle pain at home?
Paracetamol or ibuprofen, a cold pack wrapped in a towel and supportive underwear help epididymitis pain. Sudden or severe testicle pain needs an emergency department straight away, not home treatment.
How long does epididymitis last?
Most men start to feel better within a few days of starting antibiotics, but it can take up to 3 months to recover fully. Epididymitis that lasts longer than 6 weeks or keeps coming back is called chronic.
How do I know if it is a twisted testicle?
You cannot tell epididymitis from a twisted testicle at home. Sudden, severe testicle pain, or pain lasting more than an hour or continuing at rest, needs an emergency department now, because a twisted testicle needs surgery within hours to save it.
Can epididymitis affect fertility?
Rarely. Most men recover fully, and the link between epididymitis and fertility is not well understood. Uncommon complications include an abscess or fluid around the testicle.
How can epididymitis be prevented?
Use condoms with new or casual partners, because chlamydia and gonorrhoea cause most epididymitis in younger men, have an STI check after unprotected sex and make sure partners are treated, finish the full antibiotic course, drink enough and empty the bladder fully, have an enlarged prostate or repeated urine infections assessed, avoid heavy lifting and straining with a full bladder, and have the mumps vaccine if you missed it. Epididymitis from catheters or surgery is prevented by good catheter care.
Can an online doctor treat epididymitis?
No. For epididymitis, a doctor by video can judge how urgently you need to be seen and explain the likely cause and tests, but the examination, the tests and the treatment, which often includes an injection, are in person.
- Epididymitis, NHS, National Health Service (UK), reviewed 6 August 2024.
- Testicle pain, NHS, National Health Service (UK), reviewed 26 June 2025.
- United Kingdom BASHH national guideline for the management of epididymo-orchitis, 2020, Chirwa M, Davies O, Castelino S, et al. International Journal of STD and AIDS, 2021.
- Epididymitis: symptoms and causes, Mayo Clinic (US), updated 14 October 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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