Why is sudden testicular pain treated as an emergency?
Torsion happens when the testicle twists on its own blood supply and starts to lose circulation. It can happen at any time, including during or shortly after sex, and it isn't caused by an infection or an STI. It usually needs surgery within about 4 to 6 hours of the pain starting. After that, the testicle can be permanently damaged and may need to be removed. The typical picture is sudden, severe pain on one side, sometimes with swelling, nausea or vomiting.
What if the pain came on gradually instead?
If the pain built up over hours or days, torsion is less likely. An infection or irritation is more likely, and that's exactly what a sexual health clinic can help with. Speed of onset and severity are what matter most. Gradual, milder pain that's easing can be seen at a routine or same-day appointment with us. If you're ever unsure which you're dealing with, treat it as the emergency and get seen urgently, because torsion can't be diagnosed from a description.
Could it just be arousal, with no infection involved?
Yes, and it's common and harmless. Long arousal without ejaculation can cause a dull, heavy ache or pressure in the testicles and lower pelvis, sometimes called testicular congestion. Blood flow to the area increases during arousal and takes a while to clear if sex doesn't end in ejaculation. The ache typically settles within a few hours, with no swelling, redness or fever, and needs no treatment. If it keeps coming back, lasts longer, or comes with swelling, get it checked.
What is epididymitis, and how does it connect to sex?
Epididymitis is inflammation of the epididymis, the coiled tube behind the testicle that stores and carries sperm. In sexually active men under 35 it's most often caused by chlamydia or gonorrhoea. In older men it's more often linked to a urine infection.
It typically causes pain and swelling in one testicle that builds over hours to days. The scrotum may be red, warm or tender, and there may be pain when urinating or a discharge from the penis. Left untreated, it can lead to an abscess, chronic pain, or reduced fertility in cases that affect both sides or keep recurring. It's treated with antibiotics chosen for the underlying cause, usually with good results once treatment starts.
What testicular pain after sex is likely to mean:
Which tests are relevant if it looks like epididymitis?
A chlamydia test is the place to start, with a gonorrhoea test alongside it. These are the two infections most often behind epididymitis in sexually active men under 35. Both are urine tests at £104 each, with results within 3 working days. Try not to pass urine for around 2 hours beforehand so the sample is accurate.
If you'd rather cover more in one visit, the Bronze men's package at £250 includes chlamydia and gonorrhoea alongside HIV and syphilis, and higher tiers add further infections. Package results come back in about 24 hours for blood tests, and within 3 working days for urine and swabs. If you'd like answers sooner, FAST Screen Simple (£350) covers HIV, syphilis, chlamydia and gonorrhoea, and FAST Screen Complex (£450) adds hepatitis B and C. Both return all results in 6 hours.
When is it worth being examined as well as tested?
Book to be seen by a doctor, as well as tested, if you have swelling, redness, warmth, fever, or pain that's getting worse. Epididymitis benefits from a physical examination alongside the test. Aim to be seen the same day for these symptoms, and the same goes for a fever, vomiting, or a testicle that looks very swollen, red or hot. Mild, settling symptoms without swelling or fever can reasonably start with a test alone, with a review if anything changes.
How testing works at our Harley Street clinic
Every men's package includes a consultation with a doctor, testing, and treatment if you need it. You can walk in seven days a week at 117a Harley Street or book online, and the visit is confidential. You can read how private STI testing in London works before you come.
Book a men's screening package at 117a Harley Street: from £250, including chlamydia and gonorrhoea.
References
- Testicular torsion, NHS
- Epididymitis and orchitis, NICE Clinical Knowledge Summaries
- UK national guideline for the management of epididymo-orchitis, British Association for Sexual Health and HIV (BASHH)
- Chlamydia and gonorrhoea, NHS
