Your sex life and testicular cancer
Treatment for testicular cancer can affect your sex life. This is usually while you are having treatment and can be for some time afterwards.
Testicular cancer and its treatments can cause a loss of interest in sex. This is also called a low libido or sex drive. This can be for a few different reasons including tiredness after treatment.
How does treatment affect your sex life?
Most people are able to have a normal sex life after having testicular cancer. But you will need time to recover from surgery or any other treatment.
Removing one testicle (orchidectomy)
Most men with testicular cancer have surgery to remove the affected testicle. Having one testicle removed shouldn't affect your long term:
- sexual performance
- sex drive (libido)
- ability to get someone pregnant (fertility)
The remaining testicle usually makes more 
and sperm. This makes up for the removed testicle. But for some, the remaining testicle might not work so well. This could reduce your fertility. Your doctor will arrange for you before you start surgery.
You might also not feel like having sex for a while after your surgery.
Removing both testicles (bilateral orchidectomy)
It isn't common to have testicular cancer in both testicles. If you do have cancer in both testicles you need surgery to remove them both.
As the testicles produce the hormone testosterone, after removing both testicles, the levels of testosterone in the blood fall quickly. This will affect your sex life and your fertility.
To maintain your sex drive and be able to get an erection you would need testosterone replacement therapy.
Testosterone can be replaced by:
- injections into a muscle
- gel that you rub onto your skin
Removing lymph nodes (retroperitoneal lymph node dissection)
You might need this surgery to remove lymph glands at the back of your tummy (abdomen). This operation is called a retroperitoneal lymph node dissection (RPLND). It is a large operation.
The operation can damage nerves that control the release of sperm (ejaculation). This could affect your sex life and your ability to have children in the future.
You can still usually get an erection and have an orgasm. But a side effect of this surgery is dry ejaculation. The surgery can make you ejaculate backwards. This is called retrograde ejaculation. Your semen and sperm go back into your bladder instead of coming out of your penis.
If you have retrograde ejaculation you won't be able to make someone pregnant by having sexual intercourse.
Before you have surgery your doctor will talk to you about sperm banking.
Chemotherapy
Chemotherapy can lower your sex drive. This is because of the general side effects of treatment. And chemotherapy might lower your testosterone levels. This is not usually permanent but it can often take a few months to recover. But for some, it takes longer or may not recover.
Your doctor will speak to you about sperm banking before you start your chemotherapy.
Always use reliable contraception during your treatment and for a while after you finish. It is not advisable for your partner to become pregnant, as the treatment drugs could harm the baby. Your doctor or specialist nurse will explain more about this before you start your chemotherapy.
Advice like this can be worrying, but this does not mean that you have to avoid being intimate with your partner. You can still have close contact with your partner and continue to enjoy sex.
Radiotherapy
Having radiotherapy should not affect your ability to have sex. But a common side effect is tiredness and fatigue which can continue after your treatment. So you may lose interest in sex while you are having treatment and for some time after you finish your radiotherapy.
Doctors advise that you use contraception during radiotherapy treatment and for about a year afterwards. Your doctor will give you more information and explain the precautions you should take and how long you need to take them.
Coping with changes to your sex life
It can be helpful to have more information about any problems or changes you experience. There might also be practical advice or other treatments that can help.
Coping with a low sex drive.
Cancer and its treatment can make you lose interest in having sex.
Sex and cancer if you are single
If you are single and have cancer, you may have concerns about starting a new relationship, dealing with infertility or coping with rejection.
Supporting your partner if they have cancer
You may be wondering how to deal with any changes in your sex life if your partner has cancer. This might include issues around communication, supporting your partner or contraception.
Coping with other problems caused by cancer and its treatment
Find out more about:
- difficulty getting an erection
- problems after surgery to your pelvis or genitals
- sperm banking
Talking about sexual difficulties
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 through any 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.
