When should you worry about testicular pain with chlamydia?

Chlamydia can infect the urethra and spread to the epididymis, the coiled tube behind a testicle. This may cause gradually increasing pain, tenderness, warmth or swelling, sometimes with burning urination or discharge. Testicular pain can also have other causes, including twisting of the testicle, injury or a urinary infection.

Because torsion can threaten blood flow, do not use the suspected chlamydia diagnosis to explain away sudden or intense pain. A clinician may examine you and arrange urine or swab testing.

Arrange prompt sexual-health or primary-care assessment. Avoid sex until you and recent partners have been assessed and the clinician confirms when it is safe to resume. Tell the clinician about discharge, urinary symptoms, fever, recent partners and any antibiotics already taken.

Take prescribed antibiotics exactly as directed. Partners may need testing and treatment, and untreated infection can pass back and forth or lead to complications.

Go to emergency care immediately for pain that starts suddenly, is severe, or comes with nausea, vomiting, faintness, a swollen or high-riding testicle, or a testicle that looks unusually positioned. These features can occur with testicular torsion.

Seek same-day review for increasing swelling, fever, redness, severe tenderness, or pain that is not improving after treatment begins. Return for reassessment if symptoms persist or recur.

Could this be epididymitis or another urgent cause? Which tests do I need? When can I resume sex, and do my partners need treatment? What should I do if pain continues after antibiotics?