Effects on sexuality and intimacy

Some people find that their sexuality and sense of intimacy are affected by treatment for testicular cancer. Learn about how surgery, chemotherapy and radiation therapy can affect sexuality and intimacy, and ways to manage this.

Surgery

The removal of one testicle won’t affect erections or orgasms but can affect testosterone levels. RPLND may damage nerves, causing semen to travel backwards into the bladder instead of forwards out of the penis. This still feels like an orgasm, but no semen will come out.

Chemotherapy

Chemotherapy drugs may remain in your system and be present in your semen for a few days. For a few weeks after chemotherapy, you may have some trouble getting and keeping an erection.

Radiation therapy

Radiation therapy to the pelvis may temporarily stop semen production. You will still feel the sensations of an orgasm, but will ejaculate little or no semen (dry orgasm). In most cases, semen production returns to normal after a few months.

Managing changes to sexuality and intimacy

• Protect your partner from any drugs in your semen by using barrier contraception, such as condoms, during chemotherapy and radiation therapy and for a number of days afterwards, as advised by your doctor. See Effects on fertility for information about avoiding pregnancy.
• Accept that tiredness and worry may lower your interest in sex, and remember that sex drive usually returns when treatment ends.
• Be gentle the first few times you are sexually active after treatment. Start with touching and tell your partner, if you have one, what feels good.
• Talk openly with your doctor or sexual health counsellor about any challenges. They may be able to help and reassure you.

For more on this, call Cancer Council 13 11 20, see Sexuality, intimacy and cancer and listen to our podcast on Sex and Cancer.