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How Is Epididymitis Related to Sexually Transmitted Infections?

14/03/2025
in Male Infertility

Epididymitis is a condition that affects the male reproductive system. It causes pain and swelling in the epididymis, the coiled tube located at the back of the testicles. This tube is responsible for storing and transporting sperm.

One of the most common causes of epididymitis is a sexually transmitted infection (STI). Bacterial infections, especially those caused by chlamydia and gonorrhea, can spread to the epididymis and lead to inflammation. Understanding the connection between epididymitis and STIs is essential for prevention, early diagnosis, and treatment.

Understanding Epididymitis

What Happens in Epididymitis?

Epididymitis occurs when bacteria or other infections enter the urethra and travel through the reproductive tract. The infection causes inflammation, leading to pain, swelling, and discomfort in the scrotum.

The condition can affect men of all ages but is most common in those between the ages of 14 and 35. In many cases, epididymitis is linked to sexual activity, particularly unprotected intercourse with an infected partner.

Symptoms of Epididymitis

The symptoms of epididymitis usually develop gradually. They may start as mild discomfort but can become severe if left untreated. Common symptoms include:

  • Pain and tenderness in one or both testicles
  • Swelling of the scrotum
  • A feeling of warmth in the affected area
  • Painful urination
  • Discharge from the penis
  • Fever and chills in severe cases

Early detection and treatment are important to prevent complications. If left untreated, epididymitis can lead to long-term damage, including infertility.

The Link Between Epididymitis and Sexually Transmitted Infections

How STIs Cause Epididymitis

Sexually transmitted infections are one of the leading causes of epididymitis, especially in sexually active young men. Bacteria from an STI can enter the urethra during unprotected sexual activity. From there, the bacteria can travel through the reproductive system and infect the epididymis.

STIs that commonly lead to epididymitis include:

  • Chlamydia – Caused by the bacterium Chlamydia trachomatis, this infection is one of the most frequent causes of epididymitis in young men. Many men with chlamydia do not have symptoms, allowing the infection to spread unnoticed.
  • Gonorrhea – Caused by Neisseria gonorrhoeae, gonorrhea can cause painful urination, discharge, and inflammation in the reproductive organs. If untreated, it can lead to epididymitis.

These infections not only cause direct inflammation but also weaken the immune system, making the reproductive tract more vulnerable to secondary bacterial infections.

Who Is at Risk?

Men who are sexually active with multiple partners and do not use protection are at higher risk of developing epididymitis due to an STI. Other risk factors include:

  • Having a previous STI
  • Engaging in unprotected sex
  • Having a partner with an untreated infection
  • Being under the age of 35 and sexually active

Those at risk should get regular STI screenings to detect infections early and prevent complications.

Diagnosis of Epididymitis Caused by an STI

Medical History and Physical Examination

Doctors diagnose epididymitis by reviewing a patient’s symptoms, medical history, and sexual activity. They also perform a physical examination, checking for tenderness, swelling, and warmth in the scrotum.

Laboratory Tests for Confirmation

To confirm an infection, doctors may perform the following tests:

  • Urine Test – This helps detect bacteria or white blood cells, which indicate infection.
  • Urethral Swab – A sample is taken from the urethra to test for STIs such as chlamydia and gonorrhea.
  • Blood Test – This may be used to check for infection-related markers.

Early diagnosis ensures proper treatment and prevents complications such as chronic pain or infertility.

Treatment of Epididymitis Caused by STIs

Antibiotics for Bacterial Infections

The main treatment for epididymitis caused by an STI is antibiotics. The type of antibiotic depends on the bacteria responsible for the infection.

  • Chlamydia Treatment – The most common antibiotics prescribed are azithromycin or doxycycline.
  • Gonorrhea Treatment – A combination of ceftriaxone (injection) and azithromycin is often used.

It is essential to complete the full course of antibiotics, even if symptoms improve. Stopping treatment early can lead to complications and antibiotic resistance.

Pain Management and Home Care

In addition to antibiotics, doctors may recommend:

  • Pain Relievers – Over-the-counter medications like ibuprofen help reduce pain and inflammation.
  • Rest and Elevation – Keeping the scrotum elevated and avoiding strenuous activity helps speed recovery.
  • Cold Compress – Applying ice packs can reduce swelling and discomfort.

Most men recover within a few weeks with proper treatment. However, untreated cases can lead to long-term problems, including infertility and chronic pain.

Prevention of Epididymitis Related to STIs

Safe Sexual Practices

The best way to prevent epididymitis caused by an STI is to practice safe sex. Using condoms correctly during sexual activity reduces the risk of infection.

Having regular STI screenings is also important, especially for men with multiple partners. Early detection of infections like chlamydia and gonorrhea prevents the spread of bacteria to the epididymis.

Partner Treatment and Communication

If a man is diagnosed with an STI, his sexual partners should also be tested and treated. Many STIs do not show symptoms, so partners may be unaware they are infected.

Open communication about sexual health and STI testing helps prevent reinfection and protects both partners from complications.

Good Hygiene and Urinary Health

Maintaining good hygiene reduces the risk of bacterial infections that can lead to epididymitis. Washing the genital area regularly and staying hydrated help keep the urinary tract healthy.

Avoiding prolonged sitting, wearing supportive underwear, and seeking early treatment for urinary infections can also lower the risk of epididymitis.

Complications of Untreated Epididymitis

Chronic Pain and Swelling

If epididymitis is not treated, inflammation can become chronic. Some men experience long-term pain and swelling in the scrotum, even after the infection has cleared.

Infertility and Damage to the Testicles

Severe cases of epididymitis can cause scarring in the epididymis, blocking sperm flow. This can lead to infertility, especially if both testicles are affected.

In rare cases, the infection can spread to the testicles, leading to orchitis. This condition can cause permanent damage and reduce testosterone production.

Abscess Formation

A bacterial infection that is not treated properly can lead to an abscess, a collection of pus that requires drainage. In some cases, surgery may be needed to remove the infected tissue.

Conclusion

Epididymitis is often linked to sexually transmitted infections, especially chlamydia and gonorrhea. These bacteria travel through the reproductive tract and cause inflammation in the epididymis, leading to pain and swelling.

Recognizing the symptoms early and seeking medical attention is crucial. With proper antibiotic treatment and supportive care, most men recover fully. However, untreated epididymitis can lead to complications such as infertility and chronic pain.

Prevention is the best approach. Practicing safe sex, getting regular STI screenings, and maintaining good hygiene help reduce the risk of infection. Open communication with partners and early treatment of STIs protect both individual health and long-term fertility.

Related topics:

What Are the Early Warning Signs of Epididymitis?

Can Men with Epididymitis Still Father Children?

Is There a Vaccine to Prevent Epididymitis?

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