Life After Testicular Cancer Treatment: Fertility, Hormones and Getting Back to Sport

The gym bag has been sitting by the door for three weeks. He walks past it every morning on the way to work, and every evening on the way to the sofa. The surgery went fine, the surgeon said so, and the scar is already fading to a thin pink line above the groin. But nobody handed him a leaflet titled “how to be a normal 29-year-old again”, and the questions he did not ask in clinic are the ones keeping him up: Can I still have kids? Is my testosterone going to crash? When can I get back on the bike?

These are the ordinary, practical questions of life after testicular cancer treatment, and they deserve straight answers grounded in evidence rather than locker-room folklore. Testicular cancer most often affects men between their late teens and mid-forties, which means recovery is not about winding down. It is about picking a full life back up.

This explainer walks through what actually changes in the body after surgery, chemotherapy or radiotherapy, what usually does not change, and how fertility, hormones and sport fit back together in the months that follow.

What actually happens to your body after testicular cancer treatment?

Start with the anatomy, because much of the anxiety dissolves once the mechanics are clear. Almost everyone treated for testicular cancer has an orchidectomy, the surgical removal of the affected testicle through a small cut in the groin rather than the scrotum. The testicle is taken out along with the spermatic cord, the bundle of blood vessels and the tube that carries sperm. The surgery is usually a day-case procedure, and the NHS describes recovery as taking a few weeks.

The remaining testicle does two jobs. Leydig cells inside it produce testosterone, the hormone that drives libido, muscle mass, bone density and energy. Separate structures called seminiferous tubules produce sperm. When one testicle is removed, the other typically increases its output to compensate, which is why most people notice no hormonal change at all.

Some people need more than surgery. Chemotherapy uses drugs that damage rapidly dividing cells, and sperm-producing cells divide quickly, which is why sperm counts often fall during and after treatment. Radiotherapy is used less often now for testicular cancer, but when it is aimed at lymph nodes in the abdomen, scattered radiation can reach the remaining testicle. A minority of people have a larger operation called retroperitoneal lymph node dissection, which removes lymph nodes at the back of the abdomen and can affect the nerves that control ejaculation.

Each of these treatments has a different recovery signature. Surgery alone is mostly about wound healing and tenderness. Chemotherapy is about fatigue, nerve and hearing effects, and the slow return of sperm production. The rest of this article separates those threads so you can find the one that matches your own treatment plan.

Is one testicle enough for normal hormone levels?

In most cases, yes. The NHS and Mayo Clinic both note that a single healthy testicle usually produces enough testosterone to maintain sexual function, mood, muscle and bone, and enough sperm to father children. Think of it like a kidney: the body was built with a spare.

That reassurance comes with two honest caveats. First, the remaining testicle may have been quietly underperforming before diagnosis. Testicular cancer is more common in men with a history of an undescended testicle or with reduced fertility, so the “healthy” side is not always operating at full capacity. Second, chemotherapy and abdominal radiotherapy can temporarily suppress testosterone production as well as sperm production, though hormone output tends to recover faster than sperm output.

Doctors measure testosterone with a morning blood test, when levels are naturally highest, and often repeat it before drawing conclusions because a single reading can be misleading. Many follow-up protocols include periodic hormone checks precisely because low testosterone can develop slowly over years rather than appearing immediately after treatment.

People who have both testicles removed, which is uncommon and usually only happens when cancer affects both sides, will need testosterone replacement for life because the body has no other significant source of the hormone. Testosterone replacement therapy comes in several forms, all designed to deliver a steady physiological level, and the choice, timing and monitoring belong entirely with the prescribing team.

The practical point for most people is simple: the absence of one testicle is not, on its own, a reason to expect hormonal problems. It is a reason to keep follow-up appointments, where the question can be answered by a blood test rather than by worry.

Testosterone after orchiectomy: what low levels can feel like and how they are checked

Low testosterone, which doctors call hypogonadism, rarely announces itself. It tends to arrive as a vague sense of running on a flat battery: tiredness that sleep does not fix, less interest in sex, a lower mood, difficulty holding on to muscle despite training, or hot flushes similar to those women describe at menopause. None of these is specific. Fatigue after chemotherapy, disrupted sleep, and the emotional weight of a cancer diagnosis can all produce the same picture, which is exactly why guesswork is a poor guide.

The evidence-based path is a conversation with your team followed by blood tests. Cleveland Clinic explains that diagnosis relies on testosterone measured in the morning, usually on more than one occasion, alongside other pituitary hormones that reveal whether the testicle or the signalling from the brain is the weak link. This distinction matters because it changes what treatment, if any, is appropriate.

If replacement is recommended, the goal is to restore a normal physiological level, not to boost performance. The mechanism is straightforward: the medicine supplies the hormone the body can no longer make in sufficient quantity. Effects on energy and libido are typically noticed within weeks, while changes in muscle and bone density accrue over many months, according to Cleveland Clinic. Monitoring usually includes blood counts and prostate checks over time.

Two cautions deserve emphasis. Testosterone replacement suppresses sperm production, so anyone hoping to conceive should raise this before starting. And testosterone bought outside medical supervision, including products marketed for bodybuilding, carries real cardiovascular and fertility risks and offers no way to check whether the dose or the diagnosis is right. Leave both the decision and the prescription with your treating team.

Fertility after testicular cancer: what changes and what usually recovers

This is the question people whisper. It should be said out loud, because the outlook is more nuanced than either the fear or the reassurance suggests.

Surgery alone rarely causes infertility. A single testicle can produce enough sperm, and Mayo Clinic notes that most men treated with orchidectomy alone remain able to father children. The bigger variable is what happens next.

Chemotherapy is the main threat to sperm production. The drugs used for testicular cancer, most commonly a platinum-based combination, damage the rapidly dividing cells in the seminiferous tubules. Sperm counts typically drop sharply during treatment and can stay low for a long time afterwards. Recovery, when it happens, is measured in months to years rather than weeks, and it is not guaranteed. The National Cancer Institute and Mayo Clinic both describe infertility as a possible long-term effect of chemotherapy, which is why sperm banking is discussed before treatment starts rather than after.

Radiotherapy to abdominal lymph nodes can scatter a small dose to the remaining testicle. Shielding reduces this, but sperm production may still fall temporarily.

Retroperitoneal lymph node dissection presents a different problem. The nerves that coordinate ejaculation run through the area being operated on. Nerve-sparing techniques aim to protect them, but some people experience retrograde ejaculation, where semen travels backward into the bladder rather than out. Sperm production itself is unaffected, and assisted reproduction can often retrieve sperm from urine or directly from the testicle.

The honest summary: fertility after testicular cancer is often preserved, sometimes reduced, and occasionally lost. Because nobody can predict which group an individual will fall into, the standard of care is to bank sperm first and check semen analysis later, on a schedule your team sets.

Sperm banking: when it is offered and how it works

Sperm banking, or cryopreservation, means freezing semen samples in liquid nitrogen so they can be thawed and used for assisted conception later. Frozen sperm remains viable for decades. The NHS and Mayo Clinic both recommend that anyone who might want children in future is offered banking before chemotherapy or radiotherapy, and ideally before the orchidectomy itself when there is time.

The process is less clinical than people imagine. A sample is produced by masturbation in a private room at a fertility unit, usually after a short period of abstinence to maximise quality. Several samples on separate days are often requested because a single sample may contain fewer or less mobile sperm than expected, particularly in men whose fertility was already reduced by the cancer or its risk factors. Each sample is analysed, divided into vials and frozen.

Timing creates genuine tension. Chemotherapy sometimes needs to begin quickly, and men understandably want to get on with treatment. Yet a delay of a few days to bank sperm rarely changes the cancer outlook, and oncology teams will say so if it would. Ask directly whether there is time; do not assume there is not.

What if you cannot produce a sample, or the sample contains no sperm? Surgical sperm retrieval, where sperm are extracted directly from testicular tissue under anaesthetic, is an option in some cases and can sometimes be done at the time of orchidectomy. Fertility specialists can explain whether this applies to you.

One more point that often goes unsaid: banking sperm is not a commitment to using it. Many men never need their stored samples because natural fertility recovers. Banking simply removes the gamble.

Trying for a baby after treatment: timing, contraception and testing

A surprising number of people learn only after the fact that they were expected to use contraception during chemotherapy. The reason is biological: chemotherapy drugs can damage the genetic material inside developing sperm, and a pregnancy conceived during or shortly after treatment carries a theoretical risk to the embryo. The NHS advises using contraception throughout treatment, and most oncology teams recommend continuing for a period afterwards while sperm that were exposed to the drugs are cleared and replaced. The specific interval varies between guidelines and teams, so ask yours for the number they want you to follow rather than relying on a figure from the internet.

Once that window has passed, the practical next step is a semen analysis, a laboratory test that counts sperm and assesses how well they move and how they are shaped. Because sperm production runs on a cycle of roughly two to three months from stem cell to mature sperm, a single test soon after treatment tells you little. Teams often repeat semen analysis at intervals over the following one to two years to track the trajectory of recovery.

If counts remain low or absent, this is not the end of the road. Banked sperm can be used for intrauterine insemination or in vitro fertilisation. For men who did not bank, or whose frozen samples are limited, techniques such as intracytoplasmic sperm injection can achieve fertilisation with very small numbers of sperm, and surgical retrieval from the testicle sometimes finds sperm even when the ejaculate contains none.

For anyone whose ejaculation changed after lymph node surgery, fertility clinics have established methods for collecting sperm from post-ejaculation urine or via minor procedures.

The through-line is that fertility decisions after cancer are rarely urgent and rarely closed. They are conversations to have with both your oncology team and a fertility specialist, ideally together.

How each treatment affects fertility, hormones and return to sport: a summary table

Treatment plans differ, and so do their after-effects. This table pulls the strands together so you can locate your own situation. The timeframes reflect typical patterns described by the NHS, Mayo Clinic and the National Cancer Institute; your team’s guidance for you takes precedence.

Treatment	Effect on fertility	Effect on hormones	Typical return to activity
Orchidectomy alone (one testicle)	Usually preserved; remaining testicle compensates	Usually normal; periodic checks advised	Light walking within days; heavier exercise and cycling after wound heals, usually a few weeks
Orchidectomy plus chemotherapy	Sperm count falls; recovery over months to years, not guaranteed; banking recommended beforehand	Temporary dip possible; long-term low testosterone risk increases modestly	Gentle activity encouraged during treatment; gradual rebuild over months after final cycle
Orchidectomy plus radiotherapy to abdominal nodes	Temporary reduction possible from scattered dose; shielding used	Small risk of reduced testosterone over time	Similar to surgery alone, with fatigue during and shortly after the course
Retroperitoneal lymph node dissection	Sperm production intact; ejaculation may be affected if nerves are damaged	Usually unaffected	Major abdominal surgery: several weeks before lifting or core-loading exercise
Removal of both testicles (rare)	Natural fertility lost; banked or surgically retrieved sperm needed	Lifelong testosterone replacement required	As for surgery; energy and muscle maintenance depend on adequate hormone replacement

Notice what the table does not say. It does not promise that fertility will return, nor that hormones will stay perfect, nor that you will be sprinting in three weeks. Recovery after cancer is a set of probabilities, and the value of knowing the typical ranges lies in recognising when your own experience is drifting outside them, which is the moment to raise it with your team.

The first days and weeks after surgery: what recovery usually looks like

Most people go home the same day as an orchidectomy or after one night. The groin is bruised and tender, the scrotum may swell, and walking feels cautious rather than painful. Supportive underwear helps more than most men expect. The NHS advises that simple pain relief is usually sufficient and that recovery takes a few weeks, though what “recovery” means depends on what you are trying to get back to.

The first week is about the wound. Keep it clean and dry as instructed, watch for increasing redness or discharge, and expect the incision line to look worse before it looks better. Gentle walking from day one is encouraged; it reduces the risk of blood clots and lifts mood. Stairs are fine. Lifting anything heavier than a kettle is not, because straining raises pressure in the abdomen and groin and can stress the healing tissue.

Weeks two to four bring a gradual widening of what feels comfortable. Many people return to desk work within one to two weeks and to physically demanding jobs a little later. Driving is usually possible once you can perform an emergency stop without pain and are no longer taking sedating medicines; check with your insurer and your surgeon.

By four to six weeks, the incision has typically healed enough for the wound itself to stop being the limiting factor. This is the point at which most surgeons are comfortable with a return to running, swimming and gym work, provided it starts light and builds.

If chemotherapy follows surgery, this tidy timeline is interrupted. Treatment cycles bring waves of fatigue, and the body’s priority shifts from wound healing to coping with the drugs. That is not a setback; it is a different chapter, covered in the sections below.

Exercise after testicular cancer surgery: running, lifting, cycling and contact sport

Different sports stress the healing groin in different ways, so a single return-to-play date makes little sense. Here is how the common ones usually unfold, with the caveat that your surgeon’s advice about your own wound overrides any general timeline.

Walking and light cardio come first, often within the first week. Running follows once the incision no longer pulls with each stride, typically after the wound has healed at around four to six weeks. Start with short, flat runs and let discomfort, not ambition, set the pace.

Resistance training deserves particular caution. Squats, deadlifts and anything involving bracing the core raise pressure across the groin, and the spermatic cord was cut through the inguinal canal, the same channel where hernias form. Surgeons commonly advise avoiding heavy lifting until the wound has fully healed, and building load back gradually rather than returning to previous weights in one session.

Cycling puts direct pressure on the perineum and the scrotum. Wait until swelling has settled and sitting is comfortable, and consider a wider saddle for the first rides back.

Contact and ball sports raise a question that surgery does not: how to protect the remaining testicle. A blow to the scrotum that would once have been merely painful now threatens the body’s only source of sperm and testosterone. A properly fitted protective cup is a sensible, low-cost habit for football, rugby, martial arts, cricket and hockey, and many men adopt it for the first time after diagnosis. It is also worth knowing that testicular injury is not a cause of cancer, a myth that persists despite no supporting evidence.

Swimming is gentle on the groin but should wait until the wound is fully closed to reduce infection risk.

Training during and after chemotherapy: fatigue, nerves and the long game

Chemotherapy changes the relationship between effort and recovery. The fatigue is not the pleasant tiredness after a hard session; it is a heaviness that rest does not fully lift and that tends to peak in the days after each cycle before easing before the next. The instinct is to stop moving. The evidence points the other way. Moderate activity during chemotherapy is associated with less fatigue, better mood and preserved muscle, which is why oncology teams now encourage gentle exercise rather than bed rest for people who feel able.

“Gentle” is the operative word. Walking, easy cycling on a stationary bike, light resistance bands and stretching fit most people. Intensity should be guided by how you feel that day, and blood counts matter: when white cells are low, crowded gyms and swimming pools carry infection risk, and when platelets are low, contact sport and heavy lifting risk bleeding. Your team can tell you where your counts are in each cycle.

Some platinum-based chemotherapy drugs, cisplatin among them, can cause peripheral neuropathy, a tingling or numbness in the hands and feet, along with hearing changes and cold sensitivity in the fingers. Numb feet alter balance and proprioception, which matters for trail running, cycling and anything involving quick footwork. The National Cancer Institute lists these among the recognised late effects, and they may persist after treatment ends.

Bleomycin, used in some regimens, can affect lung tissue. People who have received it are usually advised to discuss scuba diving and high-altitude exertion with their team before attempting either.

After the final cycle, rebuilding takes months. Cardiovascular fitness and muscle return with consistent, progressive training, but a good rule is to expect the timeline to be measured in seasons rather than weeks, and to treat plateaus as information rather than failure.

Who usually gets back to sport quickly, and who is asked to wait?

Two men leaving the same operating theatre on the same afternoon can face very different roads back to the pitch. The differences are worth spelling out, because knowing which group you are in prevents both reckless haste and needless caution.

The quickest returns usually belong to people who had orchidectomy alone with no further treatment needed, whose wound heals cleanly, and who were already active before diagnosis. For them, the limiting factor is tissue healing, and the timeline described earlier, light activity in days and full training within several weeks, generally holds.

People who need chemotherapy are asked to reframe rather than wait. Activity is encouraged, but competition, personal bests and high-intensity training are typically deferred until treatment is complete and blood counts have recovered. Those with peripheral neuropathy may be advised to avoid sports where a loss of balance carries real consequences until the sensation has stabilised.

Anyone who has had retroperitoneal lymph node dissection is dealing with major abdominal surgery. The healing timeline is longer than for orchidectomy, and lifting, twisting and core-loading exercise are usually restricted for several weeks to protect the abdominal wall.

A smaller group is asked to pause for reasons unrelated to fitness. Wound infection, a collection of blood in the scrotum called a haematoma, or a suspected blood clot in the leg all take priority over training. So does any new symptom that the team wants to investigate.

Finally, people with a prosthetic testicle inserted at surgery are usually advised to avoid direct pressure and impact on the scrotum for a few weeks while the tissue settles around the implant.

If you are unsure which group you belong to, that uncertainty is itself the question to bring to your next appointment.

Testicular cancer follow up: what the check-ups are for and how long they last

Follow-up after testicular cancer is unusually structured compared with many other cancers, and understanding why makes the appointments feel less like a threat and more like a safety net. The purpose is to catch any recurrence early, when it is most treatable, and to monitor for the late effects of treatment.

The tools are three. Blood tests measure tumour markers, proteins that certain testicular cancers release into the bloodstream and that can rise before anything is visible on a scan. Imaging, usually CT scans of the abdomen and chest, looks for enlarged lymph nodes. Physical examination checks the remaining testicle and the surgical site. The National Cancer Institute describes surveillance as a standard approach for early-stage disease, sometimes used instead of additional treatment, with appointments spaced closely at first and then further apart.

How long does this continue? The NHS notes that follow-up typically runs for several years, and many protocols extend to five years or longer for people who received chemotherapy. The intensity tapers: monthly or quarterly visits early on, then annual reviews.

Follow-up is also where longer-term risks are watched. Men who have had one testicular cancer carry a small increased risk of developing cancer in the remaining testicle, which is why monthly self-examination is encouraged after treatment. Those who received chemotherapy have a modestly higher long-term risk of cardiovascular disease and metabolic changes such as raised cholesterol and blood pressure, so appointments may include weight, blood pressure and lipid checks. Testosterone levels are often monitored periodically for the same reason.

Missing appointments is common once people feel well, and it is the single most avoidable gap in care. Put them in the calendar as fixed points rather than optional extras.

Body image, prosthesis, sex and relationships after treatment

A missing testicle is not visible in trousers, yet many men describe an awareness of it that outlasts the physical recovery. The feeling is common, it is legitimate, and it has practical answers.

A testicular prosthesis is a silicone implant matched in size to the remaining testicle and placed in the scrotum, either during the orchidectomy or in a later procedure. The NHS explains that it is offered to restore the appearance and feel of the scrotum, and that the decision is entirely personal. Some men want one from the outset; others decide months later; many never feel the need. There is no medical reason to have or to avoid one, so the only relevant opinion is your own.

Sexual function is usually unchanged after orchidectomy alone. Erections depend on blood flow and nerve signals, not on the number of testicles, and libido depends on testosterone, which the remaining testicle typically supplies. Where problems do arise, low testosterone, the emotional aftermath of cancer, or changes in ejaculation after lymph node surgery are the usual explanations, and each has a specific assessment and management path.

Chemotherapy can dampen desire temporarily through fatigue and nausea, and this generally lifts as energy returns. Some men also notice a change in the volume or sensation of ejaculation after treatment; this is worth mentioning to your team, particularly if fertility is a concern.

Relationships absorb the strain too. Partners often carry their own fear and may not know whether to raise the subject of sex or children. Counselling and support groups exist specifically for people treated for testicular cancer, and many men report that speaking to someone who has been through it does more than any leaflet.

What people often get wrong about life after testicular cancer treatment

Myths cluster around this disease, partly because it is rarely discussed openly. Here are the ones that cause the most unnecessary distress, corrected by what the evidence actually shows.

“Losing a testicle means low testosterone.” Usually false. One testicle generally compensates fully. Low testosterone does occur in a minority, more often after chemotherapy, which is why levels are checked rather than assumed.

“I am infertile now.” Not necessarily. Surgery alone rarely causes infertility. Chemotherapy reduces sperm counts, often temporarily, sometimes permanently. The only way to know is a semen analysis done at the right time, and banked sperm provides a backup either way.

“Sport caused the cancer, so I should avoid it.” There is no evidence that injury, cycling or any sport causes testicular cancer. Risk factors are an undescended testicle, family history and previous testicular cancer. Exercise after treatment is encouraged, not discouraged.

“I should rest completely during chemotherapy.” Guidance has moved in the opposite direction. Gentle, regular activity during treatment is associated with less fatigue and better recovery, within the limits your team sets around blood counts and infection risk.

“Once treatment ends, I am done with hospitals.” Follow-up runs for years, and it serves two purposes: detecting recurrence early and monitoring late effects on the heart, hormones and remaining testicle.

“The remaining testicle is safe now.” The risk of a second cancer on the other side is small but real, which is why monthly self-examination is advised and why a protective cup in contact sport is worth the minor inconvenience.

“Testosterone supplements will help me recover faster.” Unsupervised testosterone suppresses sperm production and carries cardiovascular risk. Any replacement should follow a documented deficiency and be managed by the prescribing team.

Questions to ask your care team before you head back to normal life

Appointments are short and memory under stress is unreliable. Writing questions down beforehand is the single most effective way to leave clinic with the answers you actually need. These are the ones that tend to matter most in the months after testicular cancer treatment.

• Was sperm banking offered before my treatment, and if not, is surgical sperm retrieval still an option for me?
• How long should I use contraception after chemotherapy, and when should I have a semen analysis?
• Will my testosterone be checked as part of follow-up, and how often?
• What is my follow-up schedule, and which tests will be done at each visit?
• When is it safe for me to run, lift weights, cycle and return to my particular sport?
• Are there any activities I should avoid because of the chemotherapy drugs I received, such as diving or high-altitude exertion?
• If I develop numbness in my feet or hands, what should I do and will it improve?
• Should I be checking my remaining testicle, and how?
• Do I have a higher long-term risk of heart disease, and what does that mean for my lifestyle and screening?
• Is a testicular prosthesis something I can still have, and who do I speak to?
• Who do I contact between appointments if something feels wrong?

A useful habit is to ask your team to write the key numbers on paper: the contraception interval, the date of the next scan, the point at which heavy lifting is allowed. Verbal reassurance evaporates on the drive home; a written plan does not.

Bring a partner or friend if you can. Two sets of ears catch more, and the person beside you may ask the question you were too self-conscious to voice.

When to call your doctor: red-flag signs after testicular cancer treatment

Most of what you will feel in the weeks after treatment is expected: soreness, tiredness, bruising, a low mood that comes and goes. A small number of symptoms are different in kind, not just degree, and should prompt a same-day call to your team or an urgent care visit rather than a note for the next appointment.

In the first weeks after surgery, contact your team promptly if the wound becomes increasingly red, hot or swollen, leaks pus or bleeds, or if you develop a fever. Rapidly increasing scrotal swelling or severe pain may indicate a haematoma or infection. A swollen, painful or warm calf, or sudden breathlessness or chest pain, can signal a blood clot and needs emergency assessment.

During or after chemotherapy, a temperature above the threshold your team gave you, shivering, or feeling suddenly unwell warrants an immediate call, because infection when white cell counts are low can escalate quickly. Sudden shortness of breath or a persistent new cough should also be reported without delay, particularly if you received bleomycin.

At any point during follow-up, a new lump, hardness or heaviness in the remaining testicle, new back or abdominal pain that does not settle, unexplained weight loss, persistent breathlessness, or breast tenderness or enlargement should be brought to your team’s attention. These do not mean the cancer has returned, but they are the signs your surveillance is designed to catch early.

Emotional health belongs on this list too. Persistent low mood, anxiety that interferes with daily life, or thoughts of self-harm deserve the same urgency as a physical symptom, and your team can connect you with the right support.

When in doubt, call. Oncology teams would far rather field a question that turns out to be nothing than miss one that mattered.

Frequently asked questions

Does life after testicular cancer treatment usually include low testosterone?

For most people, no. A single healthy testicle typically compensates and maintains normal testosterone levels. Low testosterone does develop in a minority, more commonly after chemotherapy or when the remaining testicle was already underperforming, and it can appear years later. This is why follow-up often includes periodic morning blood tests. If a deficiency is confirmed, replacement therapy is a decision for the prescribing team, taking fertility plans into account.

What does fertility after testicular cancer look like if I only had surgery?

Fertility is usually preserved after orchidectomy alone, because the remaining testicle continues producing sperm. Mayo Clinic notes most men treated with surgery alone can still father children. Fertility may have been reduced before diagnosis, however, since the same risk factors that raise cancer risk can lower sperm counts. A semen analysis arranged through your team gives a clear answer rather than an assumption.

How long after chemotherapy should I wait before trying to conceive?

Teams advise using contraception throughout chemotherapy and for a set interval afterwards, because the drugs can damage the genetic material in developing sperm. The exact interval varies between guidelines, so ask your own team for the number they want you to follow. Sperm production takes roughly two to three months per cycle, so semen analysis is usually repeated over the following one to two years to track recovery.

Is testosterone after orchiectomy checked routinely?

Many follow-up protocols include periodic testosterone measurement, particularly for people who received chemotherapy or radiotherapy to abdominal lymph nodes. The test is done in the morning, when levels peak, and often repeated before any conclusion is drawn. If you notice persistent fatigue, low libido or mood changes between appointments, mention them; these can have several causes and a blood test is the reliable way to tell.

When can I start exercise after testicular cancer surgery?

Gentle walking is encouraged from the first day or two after orchidectomy to reduce clot risk and aid recovery. Heavier exercise, running and cycling usually wait until the groin wound has healed, typically around four to six weeks according to NHS recovery guidance, and lifting should build back gradually. Your surgeon’s advice about your own wound takes precedence over any general timeline.

Can I play contact sport with one testicle?

Yes, once your surgeon confirms the wound has healed and any prosthesis has settled. The main change is protection: a blow to the scrotum now threatens the body’s only source of sperm and testosterone, so a properly fitted protective cup is a sensible habit for football, rugby, martial arts, cricket and hockey. Sport itself does not cause testicular cancer, so there is no reason to give it up.

How long does testicular cancer follow up last?

The NHS notes follow-up typically continues for several years, and many protocols extend to five years or longer for people who had chemotherapy. Visits are frequent at first and taper to annual reviews. They involve tumour marker blood tests, CT scans and physical examination to catch recurrence early, alongside monitoring of testosterone, blood pressure, cholesterol and the remaining testicle for late effects of treatment.

Should I still exercise during chemotherapy?

Gentle, regular activity during chemotherapy is generally encouraged rather than bed rest, because it is associated with less fatigue, better mood and preserved muscle. Walking, light resistance work and stretching suit most people. Intensity should follow how you feel each day, and your team will advise on avoiding crowded gyms or pools when white cell counts are low and contact sport when platelets are low.

Will my sex life change after testicular cancer treatment?

Usually not after orchidectomy alone. Erections depend on blood flow and nerve signals rather than the number of testicles, and libido depends on testosterone, which the remaining testicle typically supplies. Chemotherapy can temporarily dampen desire through fatigue. Retroperitoneal lymph node dissection can occasionally affect ejaculation if nerves are damaged. Any change is worth raising, because each cause has a specific assessment.

Is a testicular prosthesis worth getting?

That is a personal decision with no medical right answer. A prosthesis is a silicone implant matched to the remaining testicle, offered to restore the appearance and feel of the scrotum. It can be placed during the orchidectomy or later. Some men want one immediately, some decide months afterwards, and many never feel the need. Ask your team who to speak to if you want to explore it.

References

• NHS: Testicular cancer, treatment
• MedlinePlus: Testicular cancer
• Cleveland Clinic: Low testosterone (male hypogonadism)

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.