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Your sex life and testicular cancer

Men and woman discussing testicular cancer

This page is about how testicular cancer can affect your sex life. There is information about

 

A quick guide to what's on this page

Your sex life and testicular cancer

Having one testicle removed should not affect your fertility, your sexual performance or your sex drive. The remaining testicle will usually make more testosterone (the male sex hormone) and sperm to make up for the one that has been removed. But you may find you feel less like having sex until you have got over your treatment.

If you have to have both testicles removed, you will no longer produce sperm or testosterone. So you will not be able to father a child unless you have sperm banking. You will need testosterone replacement therapy to give you a normal sex drive and so that you can get an erection. You can have testosterone replacement injections every 2 to 3 weeks. Or you can wear a testosterone skin patch or use a skin gel.

Retrograde ejaculation

Having the lymph nodes at the back of the abdomen removed can cause nerve damage leading to retrograde ejaculation. This means ejaculating backwards. Your semen and sperm go back into your bladder instead of coming out of your penis. And your orgasms will feel different because they will be dry.

Protecting your partner

You cannot pass on cancer cells to your partner during sex. But you should use a condom if you are having chemotherapy in case the drugs come through in the semen. Chemotherapy or radiotherapy may damage your sperm, so it is sensible to use contraception for a while after treatment. But there is no increased risk of you fathering an abnormal baby in the future.

 

CR PDF Icon You can view and print the quick guides for all the pages in the living with Testicular cancer section.

 

 

Effects after having one testicle removed

If you have had one testicle removed, it should not affect your

  • Ability to father children (fertility)
  • Sexual performance
  • Sex drive (libido)

The remaining testicle will usually make more testosterone (the male sex hormone) and sperm to make up for the one that has been removed.

But you may find that you do feel less like having sex, at least for a while. This is perfectly normal. Any treatment can make you feel like this. Other treatment side effects, such as feeling tired or sick, can lower your libido.

Being diagnosed with cancer raises a lot of emotions such as fear, anxiety and anger. All these can affect your libido too. But this is temporary. After you have got over your treatment and are beginning to come to terms with having had cancer, you will find your libido comes back.

 

Effects after having both testicles removed

Some men are diagnosed with testicular cancer in both testicles. Or they may develop a second cancer in the other testicle, but this is rare. If this happens to you, you will need to have your other testicle removed. After the operation, you will no longer produce sperm or testosterone. So you will not be able to father a child unless you have sperm banking.

If you have had both testicles removed, you will have testosterone replacement therapy. This is necessary to give you a normal sex drive and so that you can get an erection. Low levels of testosterone can also cause mood changes and tiredness.

Testosterone replacement can be given by

  • Injection
  • Skin patches
  • Skin gel

Tablets are not very well absorbed, so tablets are not often used these days. Injections work well. You can have them into the muscle of your arm or leg every 2 to 3 weeks. Some research has shown that the levels of the hormone in your blood are more stable if you have injections at least every 2 weeks. If the levels are not stable, you can have mood changes, tiredness and loss of your sex drive between injections.

Skin patches are the newest way to give testosterone replacement. They are like plasters that give a small dose of testosterone through the skin all the time. They have very few side effects (just mild skin irritation in some men) and keep the testosterone levels very stable in your blood. Or your doctor may suggest you use a testosterone gel which you rub on to your skin every day. 

 

Retrograde ejaculation

One operation for testicular cancer that can affect your sex life is a retroperitoneal lymph node dissection. This means taking out the lymph nodes at the back of the abdomen. This operation is not commonly done in the UK. But you may need this operation if you have non seminoma cancer and your lymph nodes are still enlarged after radiotherapy or chemotherapy.

Retrograde ejaculation means ejaculating backwards. Your semen and sperm go back into your bladder instead of coming out of your penis. And your orgasms will feel different because they will be dry. This means you will not be able to have children by natural sexual intercourse. But it may be possible to take sperm directly from your testicles or from your urine after you have had sex. The sperm can be used to fertilise your partner directly or with the test tube baby technique (in vitro fertilization or IVF).

Talk to your surgeon about other possible side effects before you have a retroperitoneal lymph node dissection. Nerve damage may make you lose your ability to have erections. There is more information in our section about sex and cancer for men.

 

Protecting your partner

You may be afraid that you can pass on cancer cells to your partner during sex, or that ejaculation might make your cancer worse. This is not true. Ejaculation will not spread testicular cancer or make it worse in any way. Cancer is not infectious. But you should use a condom if you are having chemotherapy. Some chemotherapy drugs may come through in the semen and may cause some irritation to your partner. So wearing a condom makes sure that your partner does not come into contact with the drug.

It is sensible to use a condom or take precautions to prevent pregnancy for a while after radiotherapy or chemotherapy. This is because there may be a chance that your sperm have been affected by the treatment and this could cause abnormal development of a baby you father during this time.

There is no increased risk of abnormalities in the child if your partner becomes pregnant in the future after testicular cancer treatment has ended.

 

Talking about sexual difficulties

You may find it difficult to talk with your doctor or your partner about any difficulties you are having related to sex. After all, your sex life is very personal. But doctors and nurses deal with these situations all the time and are used to talking about them. You can ask them to refer you to a specialist counsellor or a sex therapist.

Remember that your doctor will have treated many other men with similar problems. Try not to feel embarrassed.

If you would like to talk to someone outside your own friends and family, look in our coping with cancer section for information about counselling and for details of counselling organisations

If you are worried about talking to your partner, it may be because you are afraid they might reject you. Or you may feel that they will get angry with you in some way. But your partner is likely to be relieved that you want to talk things over. They may have been trying to find the right time to raise the subject themselves. And you may feel even closer after you have talked any difficulties through.

You can look in the testicular cancer reading list for helpful books. Some of the testicular cancer organisations can give information about your sex life and cancer. Or they can put you in touch with cancer support groups where you can talk to other people who have been through similar experiences to your own.

There is more about sex and cancer for men, and for partners in the main coping with cancer section.

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Updated: 18 September 2014