Treatment for testicular cancer can affect your sex life but this is usually just for a short while.
Removing a testicle (orchidectomy)
Most men with testicular cancer have surgery to remove the affected testicle. Having one testicle removed shouldn't affect your long term:
- ability to father children (fertility)
- sexual performance
- sex drive (libido)
The remaining testicle usually makes more testosterone (the male sex hormone) and sperm, to make up for the one that was removed. But you might feel less like having sex, at least for a while, after your treatment.
Side effects like feeling tired or sick can also lower your sex drive.
Being diagnosed with cancer can cause fear, anxiety and anger and these emotions can affect your libido too. But the effects are temporary and your libido will come back.
Protecting your partner
Some people with testicular cancer worry that:
- you can pass on cancer cells to your partner during sex
- ejaculation might make your cancer worse
These things are not true. Cancer isn't infectious. Ejaculation doesn't make it worse in any way.
Chemotherapy and condoms
Some chemotherapy drugs can come through in the semen and might cause irritation to your partner.
You should use a condom if you are having chemotherapy. When the drugs are out of your system after treatment you will not need to use a condom.
Your sperm may be affected by chemotherapy or radiotherapy. This could cause abnormal development in a baby you father while you are having treatment.
You need to take precautions to prevent pregnancy during this time. A year after your treatment has ended the risk of abnormalities goes away. You no longer need to take these precautions.
Having testicular cancer in both testicles is very rare. If you did have cancer in both testicles you would need surgery to remove them both.
To maintain your sex drive and be able to get an erection you would need testosterone replacement therapy.
You would also be infertile. You can bank sperm before you have surgery so that you can still father children.
Testosterone can be replaced by:
- injections into the muscle of your arm or leg every 2 to 3 weeks
- skin patches (like plasters) that give a small dose through the skin all the time
- gel that you rub onto your skin every day
Removing lymph nodes (retroperitoneal lymph node dissection)
Very rarely, to treat non seminoma cancer, the lymph glands at the back of your tummy (abdomen) need to be taken out by surgery.
This operation is called is called retroperitoneal lymph node dissection. In a small number of men it can cause loss of ability to father children.
The operation can damage nerves that control the release of sperm from your penis (ejaculation). This happens in a small number of men and makes you ejaculate backwards into your bladder (retrograde ejaculation). You can still get an erection and have an orgasm, but you won't produce any semen.
You might still be able to give sperm samples and use them to fertilise your partner – directly or with the test tube baby technique (called in vitro fertilization or IVF).
Talking about sexual difficulties
With doctors and nurses
Your sex life is very personal. You may find it difficult to talk with a doctor or nurse about any sexual difficulties you have from treatment.
Doctors and nurses deal with these situations all the time. They are used to talking about them so try not to feel embarrassed.
You can ask them to refer you to a specialist counsellor or a sex therapist.
With your partner
You may be uncomfortable discussing sexual difficulties with your partner. You might think they could reject you or be angry in some way.
Your partner is likely to be relieved that you want to talk things over.
They could have been trying to find the right time to raise the subject themselves. You may feel even closer after you have talked any difficulties through.