Epididymitis itself is not contagious, but the infections that cause it sometimes are. The condition is inflammation of the epididymis, a coiled tube behind each testicle that stores and carries sperm. You can’t “catch” epididymitis from someone. However, when the underlying cause is a sexually transmitted infection like chlamydia or gonorrhea, that infection can absolutely be passed to a sexual partner.
When It Is and Isn’t Transmissible
The answer depends entirely on what’s causing the inflammation. Epididymitis falls into two broad categories: cases driven by sexually transmitted bacteria and cases driven by non-sexual sources.
In men under 35, STIs are the most common cause. A study of 130 men diagnosed with epididymitis in the emergency department found that about 15% tested positive for gonorrhea, chlamydia, or trichomonas. Among those who tested positive, chlamydia was by far the most frequent, showing up in 84% of STI-positive cases. Gonorrhea accounted for 21%. These bacteria live in genital fluids and spread through sexual contact, meaning your partner is at risk even if they have no symptoms themselves.
The other category involves gut bacteria, most commonly E. coli, that migrate into the urinary tract and eventually reach the epididymis. This type is more common in men over 35 and in men who’ve had recent urinary tract procedures or have structural issues in the urinary system. These infections are not sexually transmitted and pose no risk to a partner.
How to Know Which Type You Have
You won’t be able to tell the difference based on symptoms alone. Both types cause gradual scrotal pain and swelling, usually on one side, that worsens over a few days. You may notice warmth or redness in the affected area, pain during urination, or discharge from the urethra. A low-grade fever is common.
Your doctor will typically run a urine test and a urethral swab to check for both STI and non-STI bacteria. This distinction matters because it determines whether your sexual partners need treatment too. If you’re sexually active and develop these symptoms, expect to be tested for chlamydia and gonorrhea as part of the workup.
One important note: sudden, severe testicular pain that comes on within minutes is more likely testicular torsion, a medical emergency where the testicle twists and loses blood supply. Epididymitis pain tends to build gradually over hours or days. If the onset is rapid and intense, get emergency care immediately.
What STI-Related Cases Mean for Partners
When epididymitis is caused by chlamydia or gonorrhea, the CDC recommends notifying all sexual partners from the previous 60 days. Those partners should be evaluated, tested, and treated presumptively, meaning they receive antibiotics even before their own test results come back. This is because chlamydia and gonorrhea frequently cause no symptoms, especially in women, while still causing damage and spreading further.
You should avoid sexual intercourse until both you and your partner have completed treatment and your symptoms have fully resolved. Skipping this step is one of the main reasons people get reinfected shortly after finishing antibiotics.
Treatment and Recovery
Antibiotics are the standard treatment for bacterial epididymitis. The specific antibiotic depends on whether the cause is an STI or a urinary tract organism, so accurate testing upfront shapes the entire treatment plan. It’s important to finish the full course of antibiotics even if you start feeling better partway through. Stopping early can leave bacteria behind and lead to a relapse.
Most men notice improvement in pain within a few days of starting antibiotics, but swelling can take weeks to fully resolve. During recovery, supportive measures help: rest, scrotal elevation, over-the-counter pain relievers, and ice packs wrapped in cloth applied for short intervals. Some men find that wearing supportive underwear reduces discomfort during movement.
If the infection spreads to the testicle itself, a condition called epididymo-orchitis, recovery can take longer and the risk of complications increases. Untreated or poorly treated cases can lead to chronic pain, abscess formation, or in rare cases, reduced fertility. Surgery is uncommon but may be needed if an abscess develops or if the condition doesn’t respond to antibiotics.
Preventing Recurrence
For STI-related cases, consistent condom use is the most effective way to prevent another episode. Getting tested regularly for STIs, particularly if you have new or multiple partners, catches infections before they have a chance to spread to the epididymis. Making sure all partners are treated when an STI is diagnosed prevents the cycle of reinfection that leads many men back to the same diagnosis within months.
For non-STI cases, the focus shifts to urinary tract health. Staying well hydrated, urinating regularly, and addressing any underlying prostate or bladder issues reduces the chance of bacteria reaching the epididymis. Men who’ve had recurrent urinary tract infections may benefit from further evaluation to check for structural abnormalities in the urinary system that make infections more likely.