Mumps and Puberty: Orchitis, Oophoritis, and Long-Term Fertility Risks

Mumps (paramyxovirus) primarily causes parotitis. Pubertal and post-pubertal individuals face higher complication risks than young children.

Gonadal Involvement

• Orchitis (testicular inflammation): Occurs in 15–30% of post-pubertal males; bilateral in 10–30% of those. Typically 1–2 weeks after parotitis. Symptoms: testicular pain, swelling, fever, nausea. Can cause testicular atrophy (30–50% of affected testes) and reduced spermatogenesis. Infertility is rare (<1%) but subfertility possible.
• Oophoritis (ovarian inflammation): ~5–7% of post-pubertal females. Lower abdominal pain, vomiting, fever. Rarely causes premature ovarian insufficiency or infertility.

Other Complications

• Meningoencephalitis (<1%), pancreatitis (4%), deafness (1:20,000), myocarditis, thyroiditis.

Prevention and Management

MMR vaccine (2 doses) is 88% effective against mumps. Outbreaks occur in vaccinated populations due to waning immunity; third dose recommended in outbreak settings. No specific antiviral; supportive care (analgesia, scrotal support, hydration).

Most children with mumps recover fully without pubertal or fertility impact. Concerned individuals should consult a pediatrician or reproductive endocrinologist for hormonal evaluation (AMH, inhibin B, semen analysis).