Can You Get an Erection Without Testes?

August 27, 2024

4 min

The testes are vital organs responsible for producing testosterone, a hormone that’s crucial in keeping your erections in check. Unfortunately, the removal of one or both testes is sometimes necessary for men due to certain health conditions or treatments. This surgical procedure is known as an orchiectomy. 

You’re not alone if the first thing you asked yourself after hearing about this procedure is, “Can you still have an erection if you don’t have your testicles?!”

In this article, we’ll help you understand the impact an orchiectomy may have on sexual function and how to keep your sex life alive post-surgery.

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Understanding Erections

When you see, feel, or think something that “turns you on,” nerve signals from the brain cause blood to fill the vessels in the penis and make it hard. This is the basic biological process that causes erections. Testes are crucial for this process because they produce testosterone, a hormone that helps enhance sexual desire and blood flow regulation.

Causes of Testicular Loss

There are various reasons why an orchiectomy may be necessary, such as testicular cancer, injury, or other health issues affecting the testes.

Testicular cancer

Testicular cancer is a rare type of cancer that typically affects men aged 15-45. It begins when changes in the DNA of testicle cells cause them to grow uncontrollably, leading to the formation of a tumor. While the exact cause of these DNA changes is unknown, if you’re diagnosed with testicular cancer, surgery to remove one or both testicles is typically necessary.

Trauma and injury

Testicles are located outside of your body and are vulnerable to being hurt. Trauma or damage from sports, accidents, or physical assaults can affect their function and disrupt blood flow — which is crucial for an erection. Infections and complications from surgeries in the pelvic or groin area (the area between the abdomen and the thigh) can also harm the testicles. If the damage is severe and repair isn’t possible, removing the testicles may be necessary.

Testicular torsion

The scrotum is the bag of skin that holds and helps to protect testicles. Testicular torsion happens when a testicle twists around inside the scrotum, cutting off its blood supply. This causes sudden, severe pain and swelling. If it's not treated quickly, the testicle can be damaged and may need to be removed.

Prostate cancer

Testosterone may spur the growth and spread of prostate cancer cells. Some men with a high risk of prostate cancer may choose to have their testicles removed in order to decrease the testosterone level by removing the source. However, taking medication to chemically reduce testosterone may also be an option.

Impact of an Orchiectomy on Sexual Function

During orchiectomy, one or two testicles can be removed. 

A unilateral orchiectomy refers to the surgical removal of one testicle. If you have a unilateral orchiectomy, it’s still possible to produce testosterone and sperm through the remaining testicle. This means that you can still get an erection and even become a father. 

However, research has shown that testosterone levels significantly decrease even after a unilateral orchiectomy because for some men, the remaining testicle may not function properly on its own. A study observed 60 men who underwent a unilateral orchiectomy to treat testicular cancer. In this study, 36 patients showed normal levels of sperm, seven showed no sperm, and 17 showed small amounts of sperm. 

A bilateral orchiectomy is the surgical procedure in which both testicles are removed. If you have a bilateral orchiectomy, your body will no longer produce testosterone, and you will no longer have erections without testosterone therapy.

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Psychological and Emotional Impact of an Orchiectomy

A study on men who had their testicles removed found that 32% felt a sense of loss, and 26% felt uneasy or ashamed about their bodies.

While some men may feel okay talking with friends about these feelings, it  may not be the same for others. If you are struggling with issues related to your sexual health and confidence after an orchiectomy, consider discussing your concerns with a therapist.

If the removal was due to cancer, support groups like the Testicular Cancer Society can offer great help. There are plenty of other counseling and support options available to help navigate any and all emotional challenges, as well.

Sexual Life After an Orchiectomy

An orchiectomy doesn’t have to mean your sex life is over. There are several ways to support erectile function after surgery.

Vacuum erection devices

Vacuum erection devices work by creating a vacuum around the penis. This vacuum draws blood into the area to help achieve an erection. These devices offer a non-invasive solution for those looking for alternative methods to support erectile function. 

Testosterone replacement therapy

Regular medical check-ups are essential for monitoring hormone levels and overall health after the surgery. After a bilateral orchiectomy, testosterone replacement therapy (TRT) is often recommended, though it can also be beneficial following a unilateral orchiectomy. 

How Rex MD Can Help

An orchiectomy can affect how you feel about yourself and your sex life. However, losing your testes does not mean that your sex life has to end. 

Balanced testosterone levels are not only a key factor to erections, but also for men’s general health. 

The Rex MD TestoRx program provides men access to ongoing care and prescription testosterone solutions — including testosterone replacement therapies — when deemed clinically appropriate by a Rex MD-affiliated provider. You can get started by filling out our dynamic questionnaire where you’ll answer questions about your symptoms and medical history. You may be asked to complete lab work, and you’ll have the option to consult virtually with a licensed healthcare provider. If you’re prescribed medication, it will be shipped discreetly, right to your doorstep.

Rex MD also offers treatments to support erectile function, including PDE5 inhibitors like Viagra and Cialis. These medications help to enhance blood flow to the penis and can support healthy erectile function after an orchiectomy. 

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