Epididymitis and Erectile Dysfunction: Causes and Treatments

When you’re dealing with testicular pain, swelling, or discomfort caused by epididymitis, it’s natural to worry about your sexual health. One common concern many men have is: Does epididymitis cause erectile dysfunction? Epididymitis can cause temporary erectile dysfunction mainly because of inflammation and psychological stress. The inflammation irritates nerves and blood vessels around the testicles, making sexual activity painful. This discomfort, combined with anxiety about the disease, can interfere with arousal. Once treated, normal erections usually return. Let’s break down how this condition affects sexual health, what causes it, and how to recover safely and prevent it from affecting your erections.

Does Epididymitis Cause Erectile Dysfunction?

Yes, Epididymitis can lead to short-term erectile dysfunction because the pain, inflammation, and stress it causes can interfere with arousal and blood flow. Studies show that men with epididymitis are significantly more likely to experience sexual problems.[1] This shows how ongoing discomfort and anxiety can temporarily affect sexual function, though it usually improves once the infection and pain are treated. To understand how epididymitis can cause ED, first, let us look at what this disease is.

Epididymitis is an infection of the epididymis, a small tube behind the testicles that stores and carries sperm. It’s usually caused by bacteria, STIs, or urinary infections.

Symptoms: scrotal pain or swelling, painful urination, discharge, fever, or blood in semen.

If untreated, it can lead to abscesses or testicular shrinkage.

Early treatment helps prevent long-term damage or sexual problems.

How Does Epididymitis Cause Erectile Dysfunction?

1. Pain and Discomfort

Constant tenderness in the scrotum makes sexual activity painful. In one study, men with severe pain reported decreased erectile performance. [1]

2. Fear and Anxiety

The experience of pain during sex or ejaculation can lead to performance anxiety, creating a cycle of sexual dysfunction. Men start avoiding sexual activity because of the fear of pain. [1]

3. Hormonal Effects

Studies show that epididymitis can impair the testicles’ ability to produce testosterone, leading to reduced serum testosterone levels [2]. Testosterone is the main male hormone that causes sexual desire, and low levels of it can reduce sex drive. leading to  ED.

4. Inflammation Damages Blood Vessels

Persistent inflammation can damage blood vessels in the penis, leading to reduced circulation.[3] Since erections depend on healthy blood flow, this damage can cause ED over time.

5. Psychological Impact

Living with chronic epididymitis can be mentally draining. Nearly half of affected men report anxiety, frustration, and decreased marital satisfaction due to ongoing pain and reduced sexual activity. [4]

Symptoms of ED Caused by Epididymitis

When epididymitis affects sexual function, the symptoms are usually linked to pain, inflammation, and anxiety caused by the condition. Common signs include:

• Difficulty getting or keeping an erection due to pain or discomfort
• Pain during sex or ejaculation
• Reduced sexual desire or interest
• Anxiety or fear of pain during sexual activity
• Erections that are weaker or less frequent
• Discomfort in the scrotum, testicles, or groin that worsens with arousal
• Avoidance of sexual activity 

These symptoms are usually temporary and improve once the infection is treated.

When to See a Doctor

Seek medical advice immediately if you experience:

• Intense testicular pain or swelling
• Urethral discharge, fever, or chills
• Pain during urination, sex, or ejaculation
• Persistent ED
• Persistent discomfort after treatment

Most men recover completely from ED once epididymitis is treated. The key is to manage the infection early, control pain, and address both physical and emotional factors during recovery.”

How Do Doctors Diagnose ED Caused by Epididymitis?

The doctor will ask about your symptoms, such as when the pain started, whether sex or ejaculation makes it worse, and how it has affected your erections or desire. They might recommend a mix of physical exams, lab tests, and imaging to diagnose the condition. These include:

• Urine test to detect bacterial infection
• Nucleic acid amplification tests (NAATs) to identify sexually transmitted infections
• Blood tests for  hormone levels
• Scrotal ultrasound to rule out testicular torsion or testicular cancer
• In rare cases, a testicular biopsy, to assess tissue health

Treatment for Erectile Dysfunction Caused by Epididymitis

The good news is ED from epididymitis is usually temporary and reversible. Treatment focuses on:

1. Treating the infection
2.  Easing pain and discomfort
3. Treating ED due to infection
4. Mental Health Support

1. Treating the infection

• Antibiotics are prescribed to clear bacterial infections
• Long-term antibiotic therapy is used for chronic epididymitis
• In rare cases, surgical removal of the epididymis (epididymectomy) is adviced

2. Easing pain and discomfort

• Anti-inflammatory medications are given for swelling and pain relief
• Rest, scrotal support, and ice packs help to reduce discomfort

3. Treating ED due to infection

• Your doctor may prescribe ED medications such as sildenafil (Viagra) or tadalafil (Cialis). These medicines improve blood flow and help restore normal sexual function once the infection and inflammation are gone.
• If persistent ED develops, penile implants may be considered.
• If low testosterone caused due to an infection is causing ED,  a hormone test to check levels and testosterone replacement therapy is recommended. 

4. Mental Health Support

Anxiety about performance or fear of pain during sex can make erections harder to achieve. Psychotherapy can help reduce stress and rebuild confidence.

Tip: 

A few simple lifestyle changes can make recovery faster and more comfortable. These include:

• Avoiding sexual activity until pain improves
• Wearing supportive underwear
• Pelvic floor therapy or relaxation techniques

How to Prevent ED Caused by Epididymitis?

The best way to avoid ED due to epididymitis is to prevent the infection from occurring. This can be done by:

• Practicing safe sex to prevent sexually transmitted infections
• Treating urinary tract infections early
• Maintaining good genital hygiene
• Getting vaccinated against mumps
• Completing the full antibiotic course prescribed by your doctor
• Scheduling follow-ups if pain persists beyond 72 hours

Conclusion

With the right treatment and care, most men recover completely from erectile dysfunction caused due to epididymitis. Long-term problems are rare and usually happen only when the condition is left untreated or misdiagnosed. If you notice persistent erection problems or other signs of erectile dysfunction after recovering from epididymitis, see a doctor or urologist. Early evaluation helps rule out hormonal or vascular issues and ensures your sexual health stays on track.