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Testicular Cancer

Sex after testicular cancer

Men may resume sexual activity after the removal of a testicle as soon as they feel well enough to do so. One man said that he had sex two days after the operation, but he found it was 'sore and painful'. Most men waited a few weeks before resuming sexual activity, mainly because they felt tender where the incision had been made in the groin area. One man said that he enjoyed sex more after his operation. However, there may be a decrease in libido (sexual desire), at least for a while, and this can lead to temporary erectile problems. Some men may feel a bit anxious the first time they try to have sex after surgery.

 

Explains that the operation to remove a testicle made no difference to his sex life.

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Age at interview: 28
Sex: Male
Age at diagnosis: 27
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Once I'd had the operation to be honest with you sex wasn't on my mind for a good month I reckon because of the scar healing and it was too sore, difficulty sleeping at night anyway. But once a month had elapsed it was normal, no, nothing to worry about at all. Nothing went through my mind thinking Christ I've only got one, is it going to work and stuff like that. It was the same as before.

Good.

Yeah so nothing different at all. The wife didn't feel any different she, you know she, it wasn't as though it was going through her mind blimey my husband's only got one testicle now, is it going to be any different. So the message really is it makes no difference whatsoever to your sex life.

Oh that's good.

To be honest with you yeah, yeah. You've got to get it in your mind that although you've only one you're still the same person yeah and it's not going to affect you in any way at all.
 
 

Explains that the operation made no difference to his sex life or to his relationship with his wife.

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Age at interview: 37
Sex: Male
Age at diagnosis: 37
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As far as my sex life was concerned three weeks after I had the operation we managed to have full sex. So if you can imagine even though it's [the operation] very invasive, there was no real problem. You have to be so careful because you're very tender, especially where the incision was. The swelling had gone down quite dramatically by then. But it was still, still say orange size! Or small orange size, Satsuma size or maybe or whatever, on that side, but there was still, the, the actual effects of the swelling wasn't stopping us now from enjoying sex if we wanted sex. I was finding, I wasn't as, shall we say randy as I normally was but within two weeks of the first time I was back to being my normal self, if not more than my normal self. I, I found that I wanted sex more. Maybe that's a psychological thing of losing the testicle I don't know but it was, it definitely was the case and it hasn't gone away yet; to my wife's annoyance! But no, so as far as sex is concerned it doesn't seem to have an affect at all. My wife has also explained that as far as she's concerned it doesn't actually look that different from the time before, unless you're looking straight on and normally it doesn't get in the way of our sex life anyway. But uh, no there is no, thinking about it there was no, it hasn't affected her at all. But that's our relationship.

 
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Reassures men that sex is just as good as it was before the operation to remove a testicle.

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Age at interview: 51
Sex: Male
Age at diagnosis: 46
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So is sex just the same?

Afterwards I mean, to be quite honest with you, I enjoyed it more [laughs]. But uh, no I mean there's no, I couldn't find any difference at all with sex at all. There is none. I mean they did say to me they could freeze my sperm but seeing as it wasn't active beforehand that would have made no difference to me, but for other people they can, they can freeze, freeze half a gallon of the stuff if you want about a thousand babies, I mean its up to them. But you literally, once you've had the op you don't 

So for you sex is just the same, you've had an erection just the same, you can ejaculate just the same?

Oh in fact I found I ejaculate more. It seems to produce more whatever it is it's producing, but it seems to produce more.

That's good.

Yeah, everything, literally everything in that quarter, none of its gone; it was just the same.
 
 

Explains that although he was anxious about sex it was just the same as always, and he wasn't...

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Age at interview: 50
Sex: Male
Age at diagnosis: 33
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I thought so originally, I wondered was I going to function the same way er you know what was sex was going to be like in the future. The very first time I was terrified, I wondered you know have they tied up all the tubes up properly, you know am I going to have a leak or something. And it was, it was nerve-wracking it was worrying. I needn't have bothered it's not affected me physically since and that was what 17 years ago. Had no, no side effects, I'll still go swimming, whatever.

So for young men who might be watching this and thinking, Oh my God will I be able to have sex again, or something, can you just repeat that sex is just the same with one.

It's exactly the same er you will not know any difference. You'll be as nervous as hell the first time, just you know to wonder, worry. Don't worry, I don't feel any differently now to when I was 18. There's been no, no effect at all, even psychologically. I don't, I'm not aware that I still have one testicle and not 2. I sometimes get the sensation that I've got 2. You sometimes can feel them moving and I can feel the missing one move er but they say you can feel a leg that's been amputated. I never think about it now.
 

The effect of chemotherapy on semen (the liquid that contains the sperm) is uncertain, so men are usually advised to use a condom during this treatment, and for about a month after treatment. This protects the man's partner and avoids any stinging sensation. However, one man recalled that he continued having sex during chemotherapy without a condom, and that his partner didn't notice any abnormal sensation. Although there is no evidence that chemotherapy can harm the unborn baby, doctors usually advise men to avoid trying to father a child for a year after chemotherapy treatment.

 

Explains that he continued to have sex during chemotherapy, and his wife didn't notice any...

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Age at interview: 51
Sex: Male
Age at diagnosis: 46
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Did it affect your libido for a while, I mean during treatment?

No actually it didn't, no it didn't affect anything like that, no. Me wife thought it would and it should, uh and I said 'Don't worry about it, it'll only burn you!' 

Were you told to take different precautions when you were having chemotherapy?

Well funnily enough, because I was having chemotherapy it was in me system you know. I was told, uh, I wasn't told, no, I wasn't told to avoid sex or anything like that. I don't think they actually thought I'd be capable of it to tell you the truth! But me being an awkward bugger, I obviously I was, yeah, I've still got erections through and after treatment, yeah.

And they didn't tell you to wear a condom or anything like that? 

No, no. Mind you I just used to tease the Mrs and say 'It'll burn you girl!'

But she didn't notice any difference?

No.
 

Sometimes there are physical reasons for sexual problems. For example, in rare cases when the other testicle isn't healthy, or when both testicles have been removed, sex is affected because of the lack of testosterone in the body. However, even those who have had a bilateral orchidectomy (both testicles removed) can still have an erection with the help of hormone replacement therapy. (See 'Hormone Treatment').

 

Explains that sex is good, even if both testicles have been removed, with the help of HRT, and a...

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Age at interview: 50
Sex: Male
Age at diagnosis: 39
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Speaking totally from personal experience there is no discernible difference in my sex life from before I had testicular cancer to after I had testicular cancer. There are, of course there are emotional changes, there are things that you find that affect you. You will find that the first 2 or 3 times that you have sex with a loving partner you will be very, very emotional because it's almost as a relief that things happen, that things work. Nothing stops, you know you haven't lost a limb, it still works, it works on 2 levels. You have to chemically get it to work by making sure that you have the HRT but more important than the chemically get it to work you have to psychologically get it work as well. Now I'm sure that everybody knows that if you totally screwed up, you've had a hard day, you're tense and whatever, even men in the prime of their health sometimes it don't work. That is not because of the testicular cancer, that is because you are totally stressed out. If you have a loving partner and someone that cares and understands there is no reason whatsoever that you cannot have a full and fulfilling sex life. 

If you sit there for an hour before and say, "It's not going to work, I'm going to be a failure, I'm going to be a flop in bed," and all these things, it won't work. But remember one thing, when you get into bed or when you start to make love for the first or second or third time, with somebody and that person knows that you've had testicular cancer they are going to be so caring, they're going to be so wanting, they're going to want it to work for you so badly that it will work, I guarantee you. It might not work the first time, it might not work the second time but there is no clinical reason whatsoever why it shouldn't work and the caring, loving person that you're lying next to will want it to work for you so much that they will work with you to make sure that everything is as good if not better than it was before.

Occasionally, it is necessary to have additional surgery to remove a tumour or the lymph glands in the abdomen. This operation can sometimes damage the nerves that control the discharge of sperm through the penis (ejaculation). This does not affect a man's ability to have an erection or an orgasm, and sperm can be stored before surgery so that it is possible to father a child by assisted reproduction (See also 'Fertility').

 

Explains he was no longer able to ejaculate after an operation to remove a lump of scar tissue in...

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Age at interview: 25
Sex: Male
Age at diagnosis: 22
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What I would say, well quite a big factor, which I had forgotten about, the final operation because of where it is, I was told that it can affect ejaculation. And they did say "Have you got your sperm banked?" I said "Yes." He said "Well," the urologist said "it is rare but because the nerves that control ejaculation run, are running very close to where the tumour is we may have to remove those as well and you might not be able to ejaculate. So it meant you wouldn't be able to have children in the regular way. And I said "Oh right okay." I thought oh well, again it's the lesser of two evils really, you either cut it out, and have that risk, or you leave it in and then have the risk of it possibly coming back. So I just, well there was no sort of contest for that. But it has, it has actually, it doesn't affect, I can't ejaculate, it doesn't affect erections or orgasms or anything like that but I can't have kids normally now and so. 

But your sperm is frozen?

Yes and we're, well we are in the process now of finding out what we've got to do to actually make that happen. So er that's, I suppose that is the only, the biggest effect that has had on me is that.
 

Last reviewed December 2017.

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