Testicular Cancer
Hormone treatment for testicular cancer
Men who have lost one testicle due to cancer do not usually need testosterone replacement therapy, also called hormone replacement therapy (HRT). When one testicle has been surgically removed the other testicle produces extra hormones to compensate for what is lost.
However, in rare situations men are advised to have testosterone replacement (HRT). For example, sometimes the remaining testicle is shrunken and so not enough testosterone is produced, and so more testosterone is needed. Testosterone replacement may also be needed if a man is born with just one testicle, and later develops testicular cancer, or if a man has cancer in both testicles.
HRT is recommended in these situations because if testosterone levels are low in later life there may be a decrease in bone mass (osteoporosis), decreased bone marrow activity leading to anaemia (a low blood count), muscle wasting, and a reduction in sexual drive and sperm production. A man's mood may also be affected.
HRT can be given by mouth, injected into a muscle, implanted as pellets under the skin of the lower abdomen, given via patches on the scrotum or elsewhere on the body, or as a gel. Each method has advantages and disadvantages, and the pros and cons should be discussed with the doctor.
Most men find that HRT is helpful and that it maintains a good quality sex life.
One man interviewed here, aged 39, who had fairly recently had cancer in both testicles, was taking hormone tablets three times a day. He was considering other options, but said that he liked the tablets. He recognised that he would not be able to have any more children, but said that the tablets keep his sex life going.
Explains that he is taking tablets of testosterone because he has had both testicles removed.
Explains that he is taking tablets of testosterone because he has had both testicles removed.
Describes different forms of HRT and explains why the tablets have been beneficial.
Describes different forms of HRT and explains why the tablets have been beneficial.
There are injections where, I believe its two to three weeks apart you have the injections. I don't think I'll go for that one because I think I'm having my blood tests, I actually want to get those as far apart to actually go back to two weekly ones now. And the third option is a small implant under the skin which I believe lasts for two to three months, which just slowly dissolves and goes through the body, provides the hormone replacement. Hormones in the tablet form, my GP laughs, he says it doesn't matter if you forget one because it's not critical! The worst that you can have if you're not taking a tablet is you sweat a bit is not a problem. But I mean basically it keeps your sex life going, both the, I guess the capability and the desire and it seems to work. I function normally, I have no necessity to worry about buying a bigger house because we will not have any more children, but its all the fun and none of the pain I guess. I don't know which way I'll go on hormones. I'm a bit of a coward so to do implants is, is probably not my bag. Although for some people, it lasts three months, its maybe what they want.
Oh, patches are the other one that you can have. But I have been told again by one of my doctors that I see is that patches aren't necessarily good for a bloke, yeah. Because all blokes are hot and hairy and sweaty so, all the patches tend to fall off!
Right yes.
But I'm quite happy on tablets, it's something that you have to do.
A young man, aged 26, born with only one testicle, told us he was offered an HRT gel but didn't like the idea of rubbing it onto his body, and the possibility that he might rub it onto someone else by mistake. At the time of the interview he was having an intramuscular injection every three weeks. He said that thanks to the HRT injections his sex life was 'great'. He was considering using a capsule, which would be injected under the skin, which would slowly release testosterone over a period of four months, which would be more convenient if he went travelling.
A man aged 50, who had lost both testicles, described how he felt before he had HRT. He had tried tablets, skin patches and implanted pellets, but had suffered unwanted side effects. He said that he could usually tolerate a drug called Virormoneâ, a form of HRT that he injected himself under the skin, and he said that HRT had changed his life in a spectacular manner. However, he developed polycythaemia (overproduction of red blood cells), a serious side effect of testosterone treatment (see 'Side effects of hormone treatment').
Explains that he injects himself with Virormone and that HRT is most effective for men who have lost both testicles.
Explains that he injects himself with Virormone and that HRT is most effective for men who have lost both testicles.
I've tried all the different sorts of HRT and for various reasons I've found that one thing doesn't agree with me, or the other thing doesn't work, and I now have a self injectable cannula into my tummy. And every day or so I give myself a little push on a syringe which gives me a hormone cocktail. I get on all right with that; I do it myself, so that's fine.
So now I self-administer myself with a cocktail of drug called Virormoneâ. Virormoneâ is a testosterone compound with other things in it, mixed in, and I have a cannula which is like a small blood sampling kit that I put into my tummy wall. I deal with it myself, it is very easy, it is painless. Once you've done it, once you've overcome the hurdle of the very first time it is literally painless. You attach a syringe to it and you give it a squeeze and that way you're getting the amount of testosterone that you need without having massive overdoses of testosterone.
All I can say is, examine every single option that you are given because you will eventually find what is right for you, and once you find what is right for you, you will be stunned because the change in your life, of getting HRT, is nothing less than spectacular. You will go, within 2 or 3 days you will go from being a tired bear that just wants to hibernate and sleep all day, to someone that has got their vitality back, has got their energy back, that is a nice type of human being to be around.
Occasionally, men who don't have any testicles can feel well without hormone treatment. One man interviewed was diagnosed in 1967, and he described his distress when HRT wasn't offered. In 1981, when he was offered HRT, he disliked the side effects, and stopped taking it in 1992 (see 'Side effects of hormone treatment'). When interviewed, aged 52, he said he was managing quite well without HRT.
Last reviewed December 2017.
Last updated December 2017.
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