Medicines for Epididymitis

The mainstay of treatment is antibiotics, with the choice guided by the most likely cause. In younger, sexually active men the cause is often a sexually transmitted infection, so a regimen that covers chlamydia is used — typically including an antibiotic from the tetracycline group, such as doxycycline. In older men, or where a urinary-type infection is more likely, an antibiotic effective against urinary bacteria is chosen instead, ideally guided by a urine sample sent to the laboratory. Pain relief, rest and scrotal support ease symptoms while the inflammation settles. Importantly, before treating for infection, a doctor will make sure the problem is not testicular torsion, which is a surgical emergency rather than something antibiotics can treat.

Yes — this is the most important thing to be aware of. The sudden onset of severe pain in a testicle, especially in a teenager or young man, can be testicular torsion: a twisting that cuts off the blood supply to the testicle. It is a surgical emergency, because the testicle can be permanently damaged within hours if it is not untwisted quickly. Warning signs include very sudden, severe one-sided pain, a swollen or high-riding testicle, and feeling sick or vomiting. Do not assume severe testicular pain is just an infection and wait for it to pass — go straight to A&E or call 999 for immediate assessment. Epididymitis, by contrast, usually builds up more gradually over a day or two.

Not always — it depends on the cause. In younger, sexually active men, epididymitis is frequently caused by a sexually transmitted infection such as chlamydia or gonorrhoea, which is why treatment in this group is chosen to cover these and why testing at a sexual health clinic is recommended. In older men, and in those with urinary problems, a catheter, or after urinary procedures, it is more often caused by the same bacteria responsible for urinary tract infections, and is not sexually transmitted. Because the likely cause differs, working out which applies guides the right antibiotic. Where a sexually transmitted infection is the cause, recent sexual partners should be tested and treated to prevent reinfection and onward spread.

With the right antibiotics, the pain and fever often begin to ease within a few days, but the swelling and tenderness in the scrotum can take several weeks to settle completely, so some lingering discomfort is normal during recovery. It is important to finish the full course of antibiotics even once you feel better, to rest, and to support the scrotum and use simple pain relief as needed. If a sexually transmitted infection was the cause, avoid sex until you and any partners have completed treatment. See your doctor again if you are not improving after a few days, if the pain worsens, or if you become more unwell, as treatment may need adjusting or further checks may be needed.