The Testicle Was Removed Due to Testicular Cancer

Will This Affect My Masculinity? Do I Need Hormone Replacement Therapy?

Introduction

Receiving a diagnosis of testicular cancer is a physically and psychologically traumatic experience, especially for young and middle-aged men. Among the most common questions patients ask are the following:

  • “One of my testicles was removed—will my masculinity be affected?”
  • “Will my sex life be affected?”
  • “Will my testosterone levels drop?”
  • “Will I have to take hormones for the rest of my life?”
  • “Can I have children?”

In this article, we will addressthe most frequently asked questionsabout masculinity, hormones, sexuality, and quality of life followingthe removal of a testicle (orchiectomy) due to testicular cancer, using scientific language that is accessible to everyone.

What Is Testicular Cancer?

Testicular cancer consists of malignant tumors that develop from the sperm-producing cells or supporting cells in the testicles. It is one of the most common cancers, particularlyamong men aged 15–40.

📌Important note:
Testicular canceris one of the cancers with the highest treatment success rates when diagnosed early and treated properly.

Why Is a Testicle Removed in Testicular Cancer?

The first and most important step in treating testicular canceris the complete removal of the affected testicle. This procedure is calleda radical orchiectomy.

Why is it a requirement?

  • Preventing the spread of the tumor
  • Establishing a definitive pathological diagnosis
  • Planning Treatment
  • To avoid increasing the risk of spread through hormone therapy or a biopsy

As Prof. Dr. Volkan İzolhas also emphasized in his clinical practice, the “let’s take a sample and see” approachis absolutely the wrong one when it comes to testicular cancer.

Does the Removal of One Testicle Affect Masculinity?

This is patients' greatest fear.

👉Short answer: No, it usually doesn't.

The concept we call "masculinity" actually consists of a few basic elements:

  • The hormone testosterone
  • Sexual desire (libido)
  • Ability to achieve an erection
  • Ejaculation
  • Reproduction (sperm production)

Removal of a single testicledoes not affect most of these functions, because:

🔹 What Does the Other Testicle Do?

  • The remaining healthy testicle restores balanceby increasing testosterone production
  • In most men, hormone levelsremain within normal ranges
  • Sexual desire and performance are maintained

📌 In studies conducted:

  • In the vast majority of men with only one testicle
  • Testosterone levels were found to benormal or very close to normal

What Is Testosterone and Why Is It Important?

Testosterone is the male hormone and has the following functions:

  • Regulates sexual desire
  • It contributes to the mechanism of erection
  • Helps maintain muscle strength and bone density
  • It affects your energy and mood
  • A beard, like body hair, is a secondary male characteristic

Is Testosterone Sufficient with Just One Testicle?

👉Yes, in most patients.

The unaffected testicle:

  • It increases testosterone production over time
  • Meets the body's needs

However,it is not the same for every patient.

Who Might Experience a Drop in Blood Sugar?

  • Those who already have low testosterone levels before surgery
  • Elderly patients
  • People undergoing chemotherapy or radiation therapy
  • Those with dysfunction in both testicles

For this reason, postoperativehormone monitoring is very important.

Is Hormone Replacement Therapy (Testosterone Therapy) Necessary?

General Rule:

👉Not every patient who has had one testicle removed is automatically prescribed hormones.

Hormone replacement therapy is considered in the following situations:

  • If low testosterone levels are detected in blood tests
  • If you have any of the following symptoms:
    • A marked decrease in sexual desire
    • Lethargy, fatigue
    • Muscle loss
    • Depressive mood
    • Difficulty concentrating

Prof. Dr. Volkan İzol specifically emphasizes that hormone therapy must be plannedbased on blood test results and clinical symptoms.

Is Hormone Replacement Therapy Harmful?

Testosterone therapyis safe when administered to the right patient, at the right dose, and with regular follow-up.

However:

  • It should not be given unnecessarily
  • It should not be used without supervision
  • PSA, blood test results, and liver function should be monitored

Will My Sex Life Be Affected?

Erection

  • Removal of a single testicledoes not directly cause erectile dysfunction
  • Erection involves blood vessels and nerves
  • Psychological factors can lead to temporary problems

Sexual Desire (Libido)

  • If testosterone levels are normal, libido is usually maintained
  • Psychological support may be needed

Ejaculation and Orgasm

  • The ejaculation mechanism is not affected
  • The sensation of an orgasm doesn't go away

Psychological Impact: An Invisible but Very Important Factor

Removal of a testicle in some men:

  • “Feeling incomplete”
  • Loss of self-confidence
  • Shyness toward one's partner

can create.

📌 This conditionis not physical but psychological,and it is often temporary.

What Is a Testicular Prosthesis (Artificial Testicle)?

Testicular prosthesescan be implanted for patients with cosmetic concerns.

Testicular Prosthesis:

  • Contains silicone
  • Natural in appearance and weight
  • It has nothing to do with sexual function
  • It is intended solely for aesthetic purposes

It can be inserted during or after surgery.

Can I Have Children?

👉Most patients say YES.

  • A single testicle can continue to produce sperm
  • However,sperm freezingis recommended before chemotherapy

Prof. Dr. Volkan İzol emphasizes that fertility must be discussed before treatment begins for young patients diagnosed with testicular cancer.

What Should Postoperative Follow-Up Involve?

  • Regular blood tests (including testosterone)
  • Tumor markers
  • Imaging methods
  • Physical examination

Follow-up is planned based on the stage of the disease.

The Most Common Mistakes Patients Make

  • Saying, “It’s no big deal,” and not going for a checkup
  • Buying hormones online
  • Ignoring the psychological effects
  • Cutting off communication with your partner

Recommendations for Patients

  • Don't skip your checkups
  • Don't ask for treatment without having your hormone levels checked
  • If you have any sexual problems, don't hesitate to talk about them
  • Seek psychological support if necessary
  • Adjust your lifestyle

Conclusion

In most men, the removal of one testicle due to testicular cancerdoes not permanently affect masculinity, sexual function, or hormonal balance.
The remaining testicle usually meets the body’s needs. Hormone therapy is administered only to patients who require it.

With proper follow-up, accurate information, and a personalized approach,it is possible to lead a healthy, active, and fulfilling life after testicular cancer.

The primary goal of Prof. Dr. Volkan İzol’sapproachis not to frighten the patient, butto empower them with information and help them maintain their quality of life.