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What Does the Mumps Revival Mean for Testicular Health?

Low MMR vaccination rates have caused measles and mumps to resurge, putting the nation’s nuts — and perhaps the future of our population — at risk

April is Testicular Cancer Awareness Month, and we’re grabbing it right by the balls. Every day for the entire month, we will be publishing a new story aimed at getting men to better consider — and cherish — their family jewels in hopes of helping prevent a diagnosis that, if caught early enough, shouldn’t prove fatal. Read everything here.

Although the pandemic has once again brought vaccine misinformation to the forefront of the news cycle, anti-vaxxers have been peddling myths and conspiracy theories about the dangers of vaccinations for as long as the vaccines themselves have existed. And, before they had Joe Rogan to do their bidding, they were already pretty successful at disseminating disinformation. This is most acutely exemplified by the late 1990s allegation that the measles, mumps and rubella (MMR) vaccine is linked to autism — a claim fraudulently peddled by a former U.K. physician Andrew Wakefield, and one that’s since been confirmed to be false.

Nevertheless, the damage of Wakefield’s 1998 paper — which was formally retracted in 2010 — can be starkly felt today. Although the prevalence of mumps has declined more than 99 percent in the U.S. since the MMR vaccine became available in 1967 — reducing cases from 150,000 per year to just 200 in 2003 — cases are once again on the rise. (The same thing is happening with measles, only worse — in 2019, the U.K. lost its World Health Organization “measles-free” status, and there’s fear the U.S. could be next.)

One particularly concerning complication of the mumps — a viral infection that causes painful swelling of the salivary glands in your face — is pain and swelling of the testicles, or, more commonly, one testicle (this is known as orchitis). According to the NHS U.K., up to one in three men who get mumps after puberty will suffer this side effect, which, in one in 10 men, will also reduce their sperm count, and, in rarer cases, cause infertility.

“You actually get a direct infection of the mumps virus into your balls,” men’s health doctor Jeff Foster tells me. “Not every guy gets this, but if you do, it’s extremely painful, and can have adverse, long-term effects.” Foster says if your testicles are going to be affected, it will usually happen “four to eight days into the infection” — though, unreassuringly, he adds that he’s seen patients get it even six weeks afterwards. “That’s when they get a delayed response,” he explains. 

As well as the swelling and pain, balls may also feel warm and tender — which apparently isn’t as nice as it sounds — and, if you’re the one person out of 10 whose sperm count reduces, you may also experience a drop in testosterone, which can make your balls shrink. According to a 2020 study, this reduction in sperm count is usually transient and tends to last between one and three months after recovery from mumps. It can also happen with other infections that lead to orchitis, most commonly with STIs like gonorrhea or HIV.

Unfortunately, there’s no way to know who’ll be affected by this plight, as doctors haven’t identified a genetic reason behind the swelling. Though, as Foster explains, “There’s generally the acceptance that if you’re younger, you’re more likely to have testicular involvement. So maybe age is a factor — but other than that, there isn’t any particular reason.”

When I ask if there’s any way for someone with mumps to prevent their testicles swelling, Foster replies: “No, you’re screwed, [which] is the medical way I would phrase that. Once you get this illness, you can’t go back — there’s nothing you can do to try and treat it once it’s there. We can give you anti-inflammatories and try to give you antibiotics if [your testicle] becomes infected — you can even try keeping your balls out in the air more to keep them cooler, but none of this stuff is going to make a major impact. The only thing you can really do to stop your balls getting infected with mumps is to have a vaccination.”

If you do already have swelling, however, Foster advises that you take ibuprofen or paracetamol, apply cold compresses to your balls and wear supportive underwear to take the pressure off your swollen nuts. You should only contact your doctor if the swelling is “particularly severe,” according to NHS U.K. Meanwhile, per the Mayo Clinic, it can take several weeks for the testicle tenderness brought on by orchitis to disappear.

When it comes to the long-term, more widespread effects of the mumps revival on testicular health, Foster issues a blunt warning. “There’s potential risk for the population to decline,” he says, acknowledging the starkness of what he’s saying. “If we have enough people get mumps, then a proportion of them will probably get pancreatitis (one in 25 cases of mumps can lead to short-term inflammation of the pancreas); a proportion may get meningitis (which happens in one in four cases, and is an inflammation of the membranes surrounding the brain and spinal cord); and a proportion will just get a swollen face. But one in 10 men will have problems with their sperm count, and a proportion of those guys will not be able to have children ever.”

Two years ago, one redditor shared his experience of this in the r/AntiVaxxers subreddit. “My stupid parents decided that vaccines were bad,” he wrote. “I caught a bad case of the mumps in my testicles. Five years later, we were trying to have a family. My wife was found fertile, I wasn’t — doctor figures it was from the mumps. I told my religious parents that maybe they should listen to God and not the idiots at their church. They will forgo any grandchildren because of their stupidity!” Replying to a comment, the redditor added that he wants to “work on more education” because he doesn’t “think many people realize that there are reasons for vaccinating that most people are unaware [of].”

Foster says even the rare chance of infertility is the “most devastating” aspect of mumps, and urges everyone to get the MMR vaccine — something you can still do as an adult, even if your parents refused to have you vaccinated as a kid. 

Come on, your balls are relying on you.