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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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It's understandable to worry about the effects of testicular cancer and its treatment on your sex life, and your ability to father a child.
Different treatments can have different effects on your sex drive and fertility, and these changes may be temporary or permanent. Depending on your individual situation, you may also need to consider contraception during treatment, having children in the future, testosterone replacement and storing sperm (sperm banking)|.
Here’s how different treatments may affect you:
Removing a testicle| won’t affect your sexual performance or your ability to father children. The healthy testicle that’s left will produce more testosterone and sperm to make up for the testicle that’s been removed.
Men who have an operation to remove the lymph nodes at the back of the abdomen| may get nerve damage that causes retrograde ejaculation. This means that their sperm goes backwards into the bladder instead of coming out through the penis (it’s passed out harmlessly when you pass urine).
The operation doesn’t stop you from getting an erection but your orgasm will feel different because it’s dry (dry climax). Fortunately, new surgical techniques mean that this problem can usually be avoided. However, your specialist may still advise you to think about storing sperm if you need this operation.
Although chemotherapy| won’t affect your ability to have sex, the side effects might reduce your sex drive for a while. Chemotherapy often causes infertility that is usually temporary, so your doctor will talk to you about storing sperm before your treatment. High-dose chemotherapy has a much higher risk of causing infertility.
The rate at which the sperm count recovers varies from person to person. It generally starts to return to normal around 18 months after treatment. Men having high-dose chemotherapy may become permanently infertile.
Some men with testicular cancer have a low sperm count when they’re diagnosed. Sometimes successful treatment with chemotherapy improves sperm production.
Radiotherapy| to the nodes in the abdomen won’t affect your ability to have sex and doesn’t usually cause infertility. But your specialist might still suggest that you store sperm.
While you’re being treated with chemotherapy or radiotherapy it’s important to avoid getting your partner pregnant. This is because treatment can damage your sperm and could possibly harm a baby conceived at this time. Your doctor will usually advise you to carry on using contraception for up to six months to a year after your treatment.
There’s no evidence that cancer treatments can harm children fathered after treatment is over. But doctors usually advise you to avoid fathering a child for about a year after your treatment. This allows time for your sperm to recover from any damage that treatment may have caused.
Many men who’ve been treated for testicular cancer go on to have families when they’ve recovered.
Being diagnosed with testicular cancer brings up a lot of different emotions|. Some men might find that it affects their feelings of masculinity. Coping with all of this can of course make you feel less interested in having sex. It’s also common for the side effects of treatment, such as tiredness| or sickness|, to have an effect on your libido.
Although it’s worrying at the time this is usually temporary. You’ll re-discover your sex drive when your feelings are easier to cope with and you’re recovering from treatment.
Removing one testicle| doesn’t usually affect your sex drive as the other testicle makes enough testosterone to compensate. Occasionally the remaining testicle doesn’t produce enough testosterone, or rarely a man has to have both testicles removed (because of cancer).
A lack of testosterone can affect your ability to get an erection and reduce your sex drive. It can also cause tiredness, low mood and problems such as thinning of the bones (osteoporosis). It’s important to let your doctor know if you’re having these or other symptoms that you think may be caused by low testosterone.
Your testosterone level can be measured by a blood test.
If it’s low your doctor can prescribe testosterone replacement therapy. This will help to improve problems such as low sex drive and feeling constantly tired. It can be given as a gel, injection into a muscle, as an implant, or as a patch that is stuck on the skin. Your doctor can give you more information about testosterone replacement therapy.
Sexual difficulties are very personal. But talking openly with your partner about any problems you may be having can help. This can be difficult but you might find that you understand each other better. Having testicular cancer doesn’t mean that your partner will no longer find you sexually attractive.
You can also talk to your doctor or nurse about any sexual difficulties. Try not to feel embarrassed. They’re likely to have experience of talking to other men with testicular cancer who have gone through similar problems.
Some hospitals also have counsellors who are specially trained to help people having sexual difficulties. Your doctor can refer you to a counsellor.
We have a section on sexuality and cancer|, which has lots more helpful information. We also have a list of useful support organisations|.
A common worry is that cancer cells can be passed on to your partner during sex. This isn’t true. Cancer isn’t infectious and it’s perfectly safe for you to have sex.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.