Treatment for testicular cancer can affect your sex life but this is usually just for a short while.
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.
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 for some men their remaining testicle might not work so well and this could reduce their fertility.
You might also 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.
Removing both testicles (bilateral orchidectomy)
Having testicular cancer in both testicles is not common. It happens in about 5 out of every 100 men (5%). 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.
Possible changes to your sex drive and becoming infertile can be difficult to come to terms with. Talking to someone about this could help. This could be a close friend or a professional.
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 you might need more surgery to treat a non seminoma (teratoma). This is to remove lymph glands at the back of your tummy (abdomen). This operation is a retroperitoneal lymph node dissection.
The operation can damage nerves that control the release of sperm (ejaculation). This could cause one of the following:
- a failure to ejaculate
- your sperm to go into your bladder (retrograde ejaculation)
You can still get an erection and have an orgasm. But a small number of men might not produce any semen. And this can affect their abiltiy to have children.
Before you have surgery your doctor will talk to you about this and the possibility of sperm banking.
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.
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.