Orchitis: Symptoms, Causes, Diagnosis, Treatment and Prevention Guide
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Orchitis is inflammation or infection of one or both testicles, usually coming on quickly with swelling, pain, fever and sometimes nausea. [1] The most common causes are sexually transmitted infections and the mumps virus. [1] Diagnosis involves an exam, urine and STI tests, and ultrasound. [2] Bacterial orchitis is treated with antibiotics, and most people feel better within 3 to 10 days. [2]
What the research says
Orchitis is the most common complication of mumps, and more vaccine doses go with fewer cases. In a meta-analysis of 47 studies from 21 countries covering 71,174 mumps cases, orchitis was the most common complication (63.1%). The pooled attack rate was 35.7% among people who had one vaccine dose versus 10.1% among those who had three doses (PubMed: Agrawal et al., Front Public Health, 2025) [3].
Sudden testicular pain has to be sorted quickly into inflammation versus torsion. A clinical review found that epididymitis and orchitis have a slower onset and are linked to a C-reactive protein level above 24 mg/L and increased blood flow on ultrasound, while testicular torsion must be repaired within six hours of symptom onset to reliably save the testicle (PubMed: Crawford & Crop, Am Fam Physician, 2014) [4].
Antibiotic choice depends on the likely germs. The 2024 European guideline on epididymo-orchitis advises a single 1 g intramuscular dose of ceftriaxone plus doxycycline when a sexually transmitted cause is suspected, and levofloxacin or ofloxacin alone when gut bacteria are the likely cause; your clinician chooses the regimen (PubMed: Justice et al., J Eur Acad Dermatol Venereol, 2026) [5].
What Is Orchitis?
Orchitis refers to infection or swelling and irritation — called inflammation — of one or both testicles. Infections are the most common causes. These include sexually transmitted infections (STIs) and infection with the mumps virus. [1]
Orchitis is often linked with an infection of the epididymis, the coiled tube at the back of the testicle that stores and carries sperm. That infection is called epididymitis. When orchitis occurs together with it, the combined condition is called epididymo-orchitis. [1]
In the male reproductive system, the testicles produce sperm, and fluid from the seminal vesicles and prostate gland mixes with sperm to form semen. [1]
Key fact | Detail |
Definition | Inflammation or infection of one or both testicles |
Most common causes | Sexually transmitted infections and the mumps virus |
Combined condition | Epididymo-orchitis (orchitis plus epididymis infection) |
Typical treatment | Supportive underwear, cold packs, anti-inflammatories; antibiotics when bacterial |
Recovery window | Most feel better in 3 to 10 days |
Main vaccine-related prevention | Mumps vaccine (for viral orchitis) |
What does orchitis feel like?
Orchitis symptoms most often come on quickly and can include testicle swelling, pain, fever, nausea, vomiting and feeling ill. [1] They can include:
Swelling in one or both testicles
Pain ranging from mild to very bad
Fever
Nausea and vomiting
Feeling ill, called malaise
Symptom | What it means |
Testicle swelling | In one or both testicles |
Pain | Ranges from mild to very bad |
Fever | A sign of infection |
Nausea and vomiting | A whole-body response to the inflammation |
Malaise | A general feeling of being unwell |
When should you see a doctor about orchitis?
For pain or swelling in your scrotum that comes on quickly, see your healthcare professional right away. If the pain is sudden and severe, go to an emergency room immediately, because testicular torsion must be treated within hours to save the testicle. [1]
A number of conditions can cause testicle pain, and many go away on their own. But some need treatment right away. [1]
One such condition involves twisting of the spermatic cord, called testicular torsion. The pain of torsion might feel like the pain of orchitis. Your healthcare professional can do tests to find out which condition is causing your pain. [1]
Situation | What to do |
Rapid-onset testicle pain or swelling | See a healthcare professional right away |
Pain that could be testicular torsion | Needs urgent evaluation to tell it apart from orchitis |
Mild pain that fades on its own | Many causes resolve without treatment, but a check-up is still wise |
What causes orchitis to develop?
Infection with a virus or bacteria can cause orchitis. Sometimes a cause can't be found. [1]
Bacterial orchitis
Most often, bacterial orchitis is linked with or is the result of epididymitis. An infection of the urethra or bladder that spreads to the epididymis most often causes epididymitis. In sexually active people younger than 35, an STI such as chlamydia or gonorrhea is a common cause. In older adults, urinary tract germs are more often the cause. [1]
Viral orchitis
The mumps virus most often causes viral orchitis. Nearly one-third of people assigned male at birth who get the mumps after puberty get orchitis. This most often happens 4 to 7 days after the mumps start. Thanks to routine childhood vaccinations for the mumps, mumps orchitis happens less often than it used to. [1]
Cause type | Most common source | Notes |
Bacterial | Epididymitis (urethra or bladder infection spreading to the epididymis) | STIs are a common cause in sexually active people under 35; urinary germs are more common in older adults |
Viral | The mumps virus | Affects nearly one-third of those who get mumps after puberty, usually 4 to 7 days after mumps begin |
Unknown | No identifiable cause | A cause sometimes cannot be found |
What are the risk factors for orchitis?
Orchitis is more likely with urinary tract blockages, procedures through the urethra, skipping the mumps vaccine and sexual behaviors that can lead to STIs. Untreated conditions that block the urinary tract, such as prostate enlargement or scar tissue in the urethra (called a urethral stricture), increase the risk. [1]
Procedures done through the urethra also raise the risk of orchitis. These include having a tube, called a catheter, or a scope in the bladder. [1]
The main risk factor for mumps orchitis is not getting the mumps vaccine. Sexual behaviors that can lead to STIs put you at risk of sexually transmitted orchitis. Those behaviors include having more than one sexual partner, having sex with a partner who has an STI, having sex without a condom, and having a personal history of an STI. [1]
Risk factor | How it raises risk |
Urinary tract blockages (prostate enlargement, urethral stricture) | Untreated blockages set the stage for infection |
Urethral procedures (catheter, scope) | Instruments passed through the urethra can introduce infection |
No mumps vaccine | The main risk factor for mumps orchitis |
Multiple sexual partners | Raises the chance of an STI-related orchitis |
Partner with an STI | Increases exposure to STI causes |
Sex without a condom | Removes a key barrier against STIs |
Personal history of an STI | Signals higher ongoing STI risk |
How can orchitis be prevented?
Orchitis can be prevented by getting the mumps vaccine, practicing safe sex and talking with your healthcare professional about urination problems. [1]
Get the vaccine against mumps, the most common cause of viral orchitis [1]
Practice safe sex to help protect against STIs that can cause bacterial orchitis [1]
Talk with your healthcare professional if you have trouble with urination. That may mean you have a blockage or other condition that can lead to orchitis [1]
Prevention step | What it protects against |
Mumps vaccine | Viral orchitis (most common viral cause) |
Safer sex practices (including condoms) | STI-related bacterial orchitis |
Evaluating urination trouble | Urinary blockages that can lead to orchitis |
What complications can orchitis cause?
Most often, orchitis gets better with supportive care. It can take several weeks or months before the pain and swelling go away. Rarely, complications of orchitis may include testicular atrophy, in which the affected testicle shrinks over time; a scrotal abscess, in which the infected tissue fills with pus; and infertility or low testosterone (hypogonadism). These are less likely to happen if orchitis affects only one testicle. [1]
Complication | Description |
Testicular atrophy | The affected testicle can shrink over time |
Scrotal abscess | The infected tissue fills with pus |
Infertility | Rarely, orchitis can cause the inability to have a child |
Hypogonadism | The body may make too little testosterone |
Likelihood note | Complications are less likely when only one testicle is affected |
How is orchitis diagnosed?
Your healthcare professional starts with your medical history and a physical exam. The exam checks for enlarged lymph nodes in your groin and an enlarged testicle on the affected side. You also might have a rectal exam to check for prostate enlargement or tenderness. [2]
Tests might include an STI screen. If you have discharge from your urethra, your health professional puts a narrow swab into the end of your penis to get a sample of the discharge. The sample goes to a lab to be checked for gonorrhea and chlamydia. Some STI screens are done with a urine test. [2]
A urine test sends a sample of your urine to a lab for study. The test can rule out bacterial infection. [2]
An ultrasound is an imaging test to find the cause of testicular pain. Ultrasound with color Doppler can show if the blood flow to your testicles is lower than it should be. This could mean you have torsion. A higher than usual blood flow helps confirm the diagnosis of orchitis. [2] [4]
Diagnostic step | Purpose |
Medical history and physical exam | Checks for groin lymph nodes and an enlarged testicle; possible rectal exam for prostate enlargement or tenderness |
STI screen | Swab of urethral discharge or urine test; checks for gonorrhea and chlamydia |
Urine test | Lab study that can rule out bacterial infection |
Ultrasound (with color Doppler) | Finds the cause of testicular pain; low blood flow suggests torsion, high blood flow supports orchitis |
What are the treatment options for orchitis?
Treatment depends on the cause of orchitis. [2]
Treating bacterial orchitis
Antibiotics treat bacterial orchitis and epididymo-orchitis. If the cause of the bacterial infection is an STI, your sexual partner also needs treatment. [2]
Take all the antibiotics your healthcare professional prescribes, even if your symptoms ease sooner. This is to make sure that the infection is gone. [2]
Your scrotum may be tender for several weeks or months after treatment. Rest, support the scrotum with an athletic strap, apply cold packs, and take medicine to help relieve pain. [2]
Treating viral orchitis
Treatment aims to ease symptoms. You might take nonsteroidal anti-inflammatory medicines, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve). Be sure to talk with your healthcare professional before taking these medicines if you take blood thinners or have kidney disease. [2]
Rest in bed with your scrotum raised. Use cold packs. [2]
Most people with orchitis start to feel better in 3 to 10 days. But it can take a few weeks for the scrotum to stop being tender. Sometimes, the pain and swelling can last for several months. [2]
Treatment path | What it involves |
Antibiotics (bacterial) | Full prescribed course even if symptoms improve sooner; partners need treatment if an STI is the cause |
Anti-inflammatory medicines (viral) | Ibuprofen or naproxen sodium; consult your professional first if on blood thinners or with kidney disease |
Supportive care | Bed rest, raised scrotum, cold packs, athletic strap, pain relief |
Recovery time | Most feel better in 3 to 10 days; tenderness may last weeks, occasionally months |
Which lifestyle and home remedies ease orchitis discomfort?
Orchitis discomfort can be eased by resting in bed, raising the scrotum, using cold packs and avoiding heavy lifting. [2]
Rest in bed
Lie down so that your scrotum is raised
Put cold packs on your scrotum
Don't lift heavy objects
Home care step | How it helps |
Rest in bed | Reduces strain while inflammation settles |
Raised scrotum while lying down | Eases pressure and swelling |
Cold packs on the scrotum | Soothes pain and reduces swelling |
Avoiding heavy lifting | Prevents strain that can worsen discomfort |
How should you prepare for an orchitis appointment?
You might be sent to a specialist in urinary issues, called a urologist. [2] Making a few simple lists before your visit helps the appointment go smoothly.
Make a list of your symptoms and when they began, your childhood illnesses and vaccines — including recent illnesses, especially STIs or mumps — all medicines, vitamins, or other supplements you take, including doses, and questions to ask your healthcare team. [2]
Questions you might ask include: What's the most likely cause of my symptoms? What are other possible causes? What tests do I need? What treatments are there? How long will it take before I start to feel better? Will this condition affect whether I can have children? Do I need to restrict my sexual activity? [2] Be sure to ask all the questions you have.
Your healthcare professional is likely to ask how bad your symptoms are, what treatments you have tried, what seems to ease your symptoms, what makes symptoms worse, and questions about safer sex practices, including how many partners you have and whether you use a condom. [2]
Preparation list | Examples |
Symptoms and timeline | When pain or swelling began, how it has changed |
Childhood illnesses and vaccines | Especially recent STIs or mumps |
Medicines and supplements | All current medicines, vitamins, supplements, and doses |
Questions for your team | Cause, tests, treatments, recovery time, fertility impact, activity restrictions |
Key Takeaways
Orchitis is inflammation or infection of one or both testicles, most often caused by an STI or the mumps virus. Symptoms such as rapid swelling, testicle pain, fever, and nausea warrant prompt medical attention, because other causes like testicular torsion can look similar and need immediate care. Treatment matches the cause: antibiotics for bacterial orchitis and symptom relief (anti-inflammatories, rest, cold packs, scrotal support) for viral orchitis. Most people feel better within 3 to 10 days, though scrotal tenderness can linger for weeks to months. Vaccination, safer sex, and treating urinary blockages help prevent orchitis.
Take the Next Step
Orchitis is a treatable condition, but its rapid-onset pain and swelling deserve prompt professional attention. Getting the right diagnosis matters, because testicular torsion can mimic orchitis and requires immediate treatment. Once the cause is identified, antibiotics clear bacterial orchitis, while viral orchitis responds to rest, cold packs, and anti-inflammatory medicine.
Talk to your healthcare professional if you develop quick-onset testicle pain or swelling, and finish every antibiotic exactly as prescribed. Prevention is within reach: get the mumps vaccine, practice safer sex, and have urinary trouble checked before it leads to infection.
Related reading: Epididymitis: Causes, Diagnosis and Recovery
Further reading: Urology Care Foundation — Epididymitis and Orchitis · CDC — STI Treatment Guidelines: Epididymitis
Frequently Asked Questions
1. What exactly is orchitis?
Orchitis is inflammation or infection of one or both testicles. It most often results from a sexually transmitted infection or from the mumps virus, and it frequently occurs together with epididymitis, an infection of the tube behind the testicle. [1]
2. What does orchitis feel like?
Symptoms usually appear quickly and include swelling in one or both testicles, pain ranging from mild to severe, fever, nausea and vomiting, and a general feeling of being unwell. [1]
3. What are the main causes of orchitis?
A virus or bacteria can cause orchitis, and sometimes no cause is found. The mumps virus is the most common cause of viral orchitis, while bacterial orchitis is most often linked with epididymitis, which usually starts as a urethra or bladder infection. [1]
4. How is orchitis diagnosed?
Diagnosis begins with a medical history and physical exam, then may include an STI screen for gonorrhea and chlamydia, a urine test that can rule out bacterial infection, and an ultrasound with color Doppler to check testicular blood flow. [2]
5. How is bacterial orchitis treated?
Antibiotics treat bacterial orchitis and epididymo-orchitis. Take every dose even if symptoms improve, and if an STI is the cause, your sexual partner also needs treatment. [2]
6. How is viral orchitis treated?
Treatment eases symptoms: nonsteroidal anti-inflammatory medicines such as ibuprofen or naproxen sodium, bed rest with the scrotum raised, and cold packs. Ask your professional first if you take blood thinners or have kidney disease. [2]
7. How long does orchitis last?
Most people start to feel better in 3 to 10 days. The scrotum can remain tender for a few weeks, and sometimes pain and swelling last for several months. [2]
8. Can orchitis affect fertility?
Rarely. Severe orchitis can affect fertility, most often when the infection happens during childhood or the teen years. It can also rarely cause low testosterone, and these complications are less likely when only one testicle is affected. [1]
9. What are the complications of orchitis?
Rare complications include testicular atrophy (a shrinking testicle), a scrotal abscess filled with pus, infertility, and low testosterone. Most cases improve with supportive care. [1]
10. How can I prevent orchitis?
Get the mumps vaccine, practice safer sex including condom use, and talk with your healthcare professional about trouble with urination, which may signal a blockage that can lead to orchitis. [1]
11. When should I see a doctor for testicle pain?
See a healthcare professional right away for pain or swelling in the scrotum that comes on quickly, because testicular torsion can feel like orchitis but needs urgent treatment. [1]
References
Mayo Clinic Staff. Orchitis — Symptoms and causes. Mayo Clinic. Nov. 8, 2024. mayoclinic.org/diseases-conditions/orchitis/symptoms-causes/syc-20375860.
Mayo Clinic Staff. Orchitis — Diagnosis and treatment. Mayo Clinic. Nov. 8, 2024. mayoclinic.org/diseases-conditions/orchitis/diagnosis-treatment/drc-20375865.
Agrawal R, Rehman T, Sinha D, et al. Epidemiological trends and determinants of mumps outbreaks: a systematic review and meta-analysis. Front Public Health. 2025;13:1711759. PMID 41426656. https://doi.org/10.3389/fpubh.2025.1711759
Crawford P, Crop JA. Evaluation of scrotal masses. Am Fam Physician. 2014;89(9):723-727. PMID 24784335. https://pubmed.ncbi.nlm.nih.gov/24784335/
Justice ED, Fricker J, Ross JDC, et al. The 2024 European guideline on the management of epididymo-orchitis. J Eur Acad Dermatol Venereol. 2026;40(2):166-173. PMID 40698982. https://doi.org/10.1111/jdv.20865
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here.
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