Mumps orchitis

Overview

Mumps orchitis is swelling and pain in one or both testicles caused by the mumps virus. It is a complication that mainly affects boys and men who get mumps, especially after puberty.

It is uncommon in children before puberty, but affects about 1 in 3 males who get mumps after puberty.

It mainly affects boys and men who have not been vaccinated against mumps or who have not had mumps before. It is rare in younger children.

Symptoms

Common symptoms

• Painful swelling of one or both testicles
• Tenderness in the testicles
• Fever and chills
• Headache
• Feeling generally unwell or tired

Symptoms in children

• Mumps orchitis is rare in children before puberty. If it occurs, symptoms are usually milder, with slight testicular discomfort and low fever.

Symptoms in older adults

• Mumps is uncommon in older adults; if mumps occurs, symptoms of orchitis are similar to those in younger adults but may be more severe.

Causes

Main causes

• Infection with the mumps virus, which usually starts in the salivary glands and can spread to the testicles in males after puberty.

Risk factors

• Not being vaccinated against mumps (no MMR vaccine)
• Being in close contact with someone who has mumps
• Being older than 10 years when infected with mumps
• Having a weakened immune system

When to see a doctor

See a doctor urgently if:

• If you have painful testicular swelling, especially with fever, you should see a doctor the same day.

Book a routine appointment if:

• If you think you have been exposed to mumps and develop any symptoms, such as puffy cheeks or swollen glands, even before testicular pain.
• If you are concerned about your vaccination status.

Diagnosis

A doctor will ask about your symptoms and do a physical exam. They may also take a blood test or a swab from inside your cheek to confirm the mumps virus.

Tests that may be done

• Physical examination of the testicles
• Blood test for mumps antibodies
• Swab test (viral culture or PCR) from the cheek or throat

What to expect at your appointment

The doctor will gently feel the testicles to check for swelling and tenderness. They may also ask about your recent contacts and vaccination history. The tests are usually quick and not painful.

Treatment

There is no specific medicine that kills the mumps virus, so treatment focuses on relieving symptoms and supporting your body's recovery. Most cases can be managed at home.

Self-care at home

• Rest as much as possible, especially during the first few days.
• Apply a cold pack (wrapped in a cloth) to the testicles for 15–20 minutes at a time to reduce swelling.
• Wear supportive underwear, such as briefs or a jockstrap, to help support the testicles and ease discomfort.
• Take over-the-counter pain relievers and fever reducers from your pharmacy. Ask your pharmacist or doctor which one is right for you.
• Drink plenty of fluids to stay hydrated.

Medical treatments

Doctors may recommend anti-inflammatory medicines to manage pain and swelling. In more severe cases, they might prescribe stronger pain relief or a short course of oral steroids to reduce inflammation. Always follow your doctor's advice on the right treatment for you.

When is surgery considered?

Surgery is rarely needed. In very rare cases, if a collection of fluid (hydrocele) forms around the testicle and causes pain, it may need to be drained. Surgery is not used for the orchitis itself.

Living with this condition

During the infection, you will need to rest and avoid physical activity until the swelling and fever go down. This usually takes about a week. Avoid heavy lifting, sports, or running until you feel completely better.

Lifestyle tips

• Get plenty of rest and sleep.
• Drink lots of fluids, like water or clear soups.
• Take pain relievers as needed, following the instructions on the label or from your doctor.
• Use a cold compress for comfort.
• Avoid sexual activity until the swelling has completely gone.

Diet and exercise

Eat a normal, balanced diet. You don’t need any special diet. Avoid strenuous exercise or heavy lifting until you have recovered fully. Light walking is fine if you feel up to it.

Mental health and emotional wellbeing

It can be frightening to have pain and swelling in the testicles. Remember that most people recover fully without lasting problems. If you feel anxious or worried, talk to your doctor or a trusted person. You can also contact a mental health support service.

Prevention

Yes, mumps orchitis can be prevented by getting vaccinated against mumps with the MMR (measles, mumps, rubella) vaccine. This vaccine is given to children and is also recommended for adults who have not been vaccinated.

Vaccines

The MMR vaccine is safe and effective. Two doses provide strong protection against mumps and its complications, including orchitis. Ask your doctor or local health service about getting vaccinated if you have not had the vaccine.

Screening programmes

There is no routine screening for mumps orchitis. Prevention relies on vaccination and avoiding contact with people who have mumps.

Complications

If left untreated

• In most cases, mumps orchitis gets better without treatment. However, if both testicles are severely affected, there is a small risk of reduced fertility (difficulty fathering a child).
• Mumps itself can also lead to other complications such as meningitis (inflammation of the lining of the brain and spinal cord) or hearing loss, but these are rare.
• If the swelling is very severe and does not improve, it can sometimes cause a testicle to shrink (atrophy).

Long-term outlook

The outlook for mumps orchitis is generally very good. Most people recover fully within 1 to 2 weeks. The swelling and pain go away, and the testicle returns to normal. Even if one testicle is affected, the other testicle often works fine, so fertility is usually not a problem. With rest and simple home care, you can expect a full recovery.

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