Testicle Pain and Swelling? Don’t Ignore Signs of Orchitis

What Is Orchitis, and Why Should You Care?

Orchitis is inflammation of one or both testicles. It might sound rare, but it’s more common than most people think, especially among men under 35, the demographic most likely to get sexually transmitted infections. It can come on suddenly or build up slowly over days. In many cases, it’s triggered by an untreated STD like chlamydia or gonorrhea, which then spreads to the testicles through the urinary or reproductive tract. But it doesn’t always involve sex. You can get viral orchitis from mumps, E. coli, or even after a bad case of the flu.

Imagine someone like Jordan, 26, who had a sore throat and low-grade fever for a few days after a flu-like illness. A week later, he felt a sharp, nagging pain in his right testicle. He thought he had pulled something at the gym. Two days later, it doubled in size. It wasn’t until urgent care did an ultrasound and ruled out torsion that they confirmed: viral orchitis, possibly from a recent mumps infection. His childhood vaccines had worn off. No one told him that could happen.

This is why orchitis matters, it’s easy to ignore until it’s not. It can cause infertility if untreated, and in some cases, lead to an abscess or loss of testicular tissue. Early testing and treatment can make all the difference.

What Does Orchitis Actually Feel Like?

The symptoms of orchitis can sneak up on you or hit like a freight train. For many, it starts as a minor ache that quickly becomes unmistakable. One or both testicles swell. They may feel warm, heavy, or unusually firm. Some men notice a pulling sensation in the groin or lower abdomen. Others feel feverish, nauseated, or just... off.

There’s no one-size-fits-all presentation, which is what makes it so frustrating. Some people never develop discharge or classic STD signs. Others might only have testicle swelling after ejaculation or a workout. The key signs are:

Table 1. Key symptoms that may signal orchitis, especially in post-exposure or post-viral settings.

If you feel any combination of these, especially with a recent STD risk or illness, it’s time to test, not just wait and see.

People are aslo reading: Alabama’s Syphilis Epidemic: Missed Tests, Missed Chances

STD or Not? What Actually Causes Orchitis

This is the part where most guys hesitate: is this from an STD or something else entirely? Here’s the deal, orchitis can come from both bacterial and viral infections. And in men under 35, the number one cause is usually untreated chlamydia or gonorrhea. These infections can silently travel through the urethra and settle into the epididymis (a coiled tube near the testicle). From there, they can trigger full-blown inflammation, sometimes called epididymo-orchitis.

But sex isn’t always to blame. Mumps, a viral illness most people are vaccinated against, is a leading cause in younger patients who missed a booster or weren’t fully immunized. Mumps-related orchitis typically appears 4–8 days after the swelling of salivary glands (those chipmunk cheeks). In some cases, other viruses like Coxsackievirus or echovirus are culprits, especially in post-viral fatigue syndromes.

Then there are the weird ones: urinary reflux in older men, trauma from intense exercise, catheter use, or even prolonged sitting on hard surfaces. These are less common, but not impossible.

Table 2. Common causes of orchitis based on age, exposure type, and STD involvement.

The tricky part? You can’t always tell just by looking or guessing. That’s where testing comes in, and why waiting it out can backfire.

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When to Test and What to Expect

By the time a reader lands here, they’re already uncomfortable, physically, emotionally, or both. Maybe you're like Chris, who Googled “testicle swelling no STD” at 2AM while icing himself with frozen peas. He didn’t have discharge, and condoms were used during sex, but something still felt off. When Chris finally tested, he found out it was epididymo-orchitis from a low-level chlamydia infection that had been hiding without symptoms for months.

The reality is: if you have swelling, pain, or tenderness in one or both testicles, you need to test for chlamydia and gonorrhea, even if you don’t have classic symptoms. A full STD panel may also be recommended if you’re at risk for syphilis, HIV, or trichomoniasis. At-home test kits make this possible without a clinic visit, which is helpful when the last thing you want is to sit in a waiting room explaining your balls hurt.

Here’s the most important part: timing matters. Testing too early can miss infections still in the incubation phase. Most bacterial STDs show up on tests around 7 days after exposure, but testing at 14 days improves accuracy. Viral causes like mumps or other non-sexual triggers might require different evaluation, so it’s key to test for what fits your symptoms and timeline.

You can start with an at-home Combo STD Test Kit that checks for multiple infections discreetly, or go to a clinic if fever, high pain, or sudden swelling is present, it could be torsion, which is a surgical emergency.

How It’s Diagnosed (And Why You Need to Be Honest)

Let’s cut through the shame here: it’s not “weird” to talk about your sex life when your testicles are swollen. Doctors aren’t judging, they’re trying to help you get the right care, fast. A physical exam and some important questions are usually the first steps in making a diagnosis. These questions include recent sexual activity, any urinary symptoms, previous STDs, or flu-like illness.

You may be asked to provide a urine sample and, in some cases, a urethral swab (less common with modern NAAT testing). If a viral cause is suspected, a blood test or mumps titer might be ordered. Ultrasound is often used if torsion is a concern, or if swelling is severe and one-sided. The scan shows blood flow, critical for ruling out emergency issues.

The hard truth? Not everyone is forthcoming. Some people downplay symptoms out of embarrassment. Others leave out sexual details that could help steer diagnosis. If you’re reading this and still unsure what to say to your provider, try this: “I had unprotected sex two weeks ago, and now one testicle is swollen. I don’t have discharge, but I’m worried.” That one sentence gives a provider everything they need to act fast and test appropriately.

If you’re testing at home, follow instructions carefully, timing, sample quality, and reading results correctly all matter. Retesting may be needed if you test early after exposure or if symptoms worsen despite a negative result.

Is Orchitis Treatable? Yes, But Timing Is Everything

The good news is: yes, orchitis is usually treatable. Bacterial causes, especially those from STDs like chlamydia and gonorrhea, respond well to antibiotics. Common regimens include doxycycline for 10–14 days, or a combination approach if more than one organism is suspected. Pain relief is typically managed with NSAIDs, rest, and scrotal support, yes, like those compression briefs you never thought you’d use.

Viral orchitis, on the other hand, doesn’t have a cure, but it does resolve on its own. The body needs time to fight the virus. Mumps orchitis may last up to 10 days and should be monitored for complications like abscess or testicular atrophy, which is rare but possible. Bed rest, fluid intake, and anti-inflammatories are the mainstays.

If your symptoms aren’t improving within 3–5 days of starting treatment, or if they’re getting worse, you need follow-up. Ultrasounds can check for worsening swelling or internal damage. If fever persists or pain becomes unbearable, return to urgent care or your provider immediately.

This is also the moment to talk about partners. If your orchitis was caused by an STD, your partner may also be infected, and not know it. Sharing a diagnosis isn’t about blame. It’s about care. You can use anonymous notification tools or let a provider help with contact tracing if needed.

When It’s Not Orchitis: Don’t Miss These Other Causes

Not every case of ball pain or swelling is orchitis. That’s the frustrating part, it shares symptoms with several other conditions that range from mild to medical emergency. Here’s where things get messy, and why self-diagnosis can be risky.

Let’s say someone has sharp, sudden pain with swelling on one side, often after exertion or randomly in the night. That could be testicular torsion, a twisted spermatic cord cutting off blood supply. It’s rare but time-sensitive, and waiting can result in loss of the testicle. Orchitis usually starts slowly and is accompanied by other symptoms like fever or trouble urinating.

Epididymitis without orchitis is another option. This type of infection is more common in the back of the testicle. It can feel like a tight knot or a pulling feeling, and it can also hurt when you pee. Hernias, hydroceles, and even cancer can mimic orchitis symptoms. Again, this is why testing and imaging matter, you can’t guess your way out of a swollen testicle.

Here’s a general comparison to help illustrate these distinctions:

Table 3. Symptom comparison across scrotal pain and swelling conditions, showing why accurate diagnosis is crucial.

If your instincts say something’s wrong, listen. Whether it's orchitis, an STD, or something else entirely, taking action early is the best move you can make.

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Why Retesting Isn’t Just for the Paranoid

Even if your test comes back negative and the swelling fades, don’t be too quick to close the chapter. Retesting is sometimes necessary, especially if you tested early, didn’t treat a partner, or had ongoing exposure after the fact. The first test might miss infections during their incubation period. And in the case of orchitis from bacterial STDs, re-infection is common if both partners aren’t treated.

Let’s go back to Chris, who tested negative for gonorrhea on day six after symptoms started. He relaxed. But his symptoms got worse a week later. When he finally retested on day 15, it came back positive. That lag between exposure and detection is what throws people off, and why one test sometimes isn’t enough. Waiting at least 14 days post-exposure for a more accurate result is key. And if you’re symptomatic before then, test early and again later if needed.

This doesn’t mean something’s wrong with you. It means you’re being thorough. Retesting isn’t about fear, it’s about clarity.

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The Fear, the Shame, and the Stories We Don’t Tell

Here’s where it gets real. When your genitals don’t look or feel right, it’s not just physical. It’s emotional. Shame creeps in. You wonder if it’s your fault. If someone will judge you. If you’re dirty. Maybe you delay treatment hoping it’ll go away. Maybe you don’t tell anyone at all. But you’re not alone, and this part matters just as much as the medicine.

We’ve heard it from guys who waited weeks to go in because they didn’t want to admit they had sex with a new partner. From people in long-term relationships terrified of what a diagnosis would mean. From men who assumed only STDs caused testicle swelling, only to learn it was a childhood virus making a comeback. Every one of them needed not just facts, but affirmation: what you’re going through is real, common, and fixable.

There’s power in naming things. In saying, “My ball is swollen and I don’t know why.” That honesty is what leads to healing. Not just medically, but emotionally. And if it is an STD, the sooner you know, the sooner you stop the spiral of shame and start taking care of yourself, and your partners.

If your head’s still spinning, peace of mind is one test away. You can order a discreet Combo STD Home Test Kit from STD Rapid Test Kits. It’s fast, doctor-trusted, and delivered in plain packaging. No clinic lines, no awkward waiting rooms, just answers.

FAQs

1. Can an STD really cause my testicles to swell?

Yep, and it happens more often than you'd think, especially with chlamydia or gonorrhea. These infections can travel up the urethra and inflame the testicle or the tubes around it. Even if you don’t have discharge or pain when you pee, that swelling could still be your body’s way of saying, “Hey, something’s off.”

2. What if just one testicle is swollen?

That’s actually super common with orchitis. One side swells up first, sometimes with pain, sometimes just this weird heavy feeling. But don’t get cocky, just because it’s one doesn’t mean it’s no big deal. You still need to get it checked before things get worse or spread.

3. How can I distinguish between orchitis and a more serious condition like torsion?

Think of torsion like a fire alarm: it comes out of nowhere, usually with sudden, intense pain that can make you double over. The testicle might ride high or change position. If that happens, don’t Google, go straight to the ER. Orchitis usually builds up slower and comes with fever, aching, or pee issues. But honestly, if you're not sure, play it safe and get looked at.

4. Do I really need to tell my partner if it’s an STD?

Look, we get it, these convos suck. But if your orchitis was caused by an STD, they might be carrying it too, even if they feel fine. Untreated, they could pass it right back to you (or someone else). You don’t have to make it a drama. Just be real: “Hey, I found out I had an infection. You might want to get tested.” Done.

5. Can I get orchitis from oral sex?

You can. It's rare, but if your partner had an oral gonorrhea or chlamydia infection and went down on you, that bacteria can still make its way into your urethra. Your balls don’t care if it was oral, vaginal, or whatever, they just react.

6. What if my test was negative, but I’m still swollen?

That happens. Some STDs take time to show up on tests, especially if you swab or pee too early. Other times, it’s not an STD at all but a viral infection like mumps or just your immune system overreacting. If your symptoms stick around or get worse, retest. Or better yet, go get an ultrasound and rule out the scary stuff.

7. Does orchitis mean I’ll have fertility problems?

Probably not, especially if it’s just one testicle and you catch it early. But leave it untreated, and yeah, it could lead to shrinking (atrophy) or even reduced sperm production. If you ever want kids in the future, don’t gamble with this. Treat it now.

8. How long do I need to wait before having sex again?

Until the pain, swelling, and infection (if present) are completely gone, and your doctor gives you the all-clear. Otherwise, you risk spreading something or aggravating the tissue. It’s not forever. Just give your body a damn minute to heal.

9. Do I need antibiotics if I have orchitis?

If it’s from an STD or bacteria, absolutely. You’re not gonna heal that with rest and water alone. Viral causes don’t need antibiotics, but you’ll still need pain relief and patience. Your provider will help figure out which one it is based on testing and symptoms.

10. Can I use a home test kit to check for the cause?

Yes, and for a lot of people, that’s the best place to start. Grab a Combo STD Test Kit, do it from home, and skip the waiting room. It checks for the major players: chlamydia, gonorrhea, syphilis, and more. If that comes back clear and you're still hurting, go deeper with imaging or viral panels.

You Deserve Answers, Not Assumptions

Swollen testicles don’t make you dirty, broken, or stupid. They make you human. Sometimes it’s an STD, sometimes it’s a virus, sometimes your body is just reacting to stress or injury. But no matter the cause, ignoring symptoms out of fear never leads to clarity, it leads to confusion, pain, and sometimes long-term consequences that were totally avoidable.

If you’ve read this far, you’re already doing more than most people ever do. You’re paying attention. You’re asking questions. You’re owning your body’s signals. That’s power, not weakness. Whether this is your first symptom or your tenth Google search, you deserve answers you can trust. Testing is the first step toward that clarity.

Get the clarity you deserve instead of waiting and wondering. This at-home combo test kit swiftly and covertly checks for the most prevalent sexually transmitted diseases. Today, take charge of your health in your own space and on your own terms.

Sources

1. Healthline – Orchitis: Causes, Symptoms, Diagnosis, and Treatment 

2. Epididymitis — STI Treatment Guidelines (CDC)

3. Orchitis: Symptoms and causes (Mayo Clinic)

4. Orchitis: Diagnosis and treatment (Mayo Clinic)

5. Orchitis (StatPearls/NIH)

6. Epididymitis and Orchitis: An Overview (American Family Physician)

7. Orchitis — Causes, Symptoms, Treatment & Prevention (Cleveland Clinic)

8. Mumps — Signs and Symptoms (CDC)

9. Epididymo‑orchitis: Empiric Therapy (Medscape)

About the Author

Dr. F. David, MD is a board-certified infectious disease specialist focused on STI prevention, diagnosis, and treatment. He blends clinical precision with a no-nonsense, sex-positive approach and is committed to expanding access for readers in both urban and off-grid settings.

Reviewed by: Monica L. Tran, NP-C | Last medically reviewed: November 2025

This article is meant to be informative only; it should not be used in place of medical advice.