The testicles, also called testes, are important organs of the male reproductive system. They have two major functions: producing sperm and making hormones, especially testosterone. The testicles are located inside the scrotum, below the penis.
Sometimes, a man may need to have one or both testicles removed because of conditions such as testicular cancer, serious injury, or certain hormone-sensitive cancers. The surgical removal of a testicle is called an orchiectomy (or orchidectomy).
A common question is: Can a man survive without testicles? The answer is yes, but the effects are very different depending on whether one testicle or both testicles are removed.
What Do the Testicles Do?
The testicles perform two major functions.
1. Sperm production
The testicles produce sperm, which are the male reproductive cells needed for biological reproduction. Sperm then travel through the epididymis and vas deferens and eventually become part of semen.
2. Testosterone production
The testicles are also the main source of testosterone in males. Testosterone plays an important role in:
- Sexual desire
- Muscle mass
- Bone health
- Energy and overall well-being
- Male sexual development
- Normal reproductive function
Therefore, losing testicular tissue can affect both fertility and hormone levels, particularly when both testicles are removed.
Can a Man Live With One Testicle?
In many cases, a man can live a normal life with one healthy testicle. The remaining testicle can often produce enough testosterone and sperm to maintain normal sexual and reproductive functions.
After removal of one testicle, testosterone replacement is generally not required if the remaining testicle is functioning normally.
A man with one healthy testicle may also be able to father biological children. However, fertility varies between individuals and can also be affected by cancer treatment, chemotherapy, radiation, or problems involving the remaining testicle.
What Happens When Both Testicles Are Removed?
When both testicles are surgically removed, the situation is different.
The procedure is known as a bilateral orchiectomy.
Because the testicles are the main source of testosterone and sperm production, removing both can cause:
- A major reduction in testosterone
- Loss of sperm production
- Infertility
- Reduced sexual desire
- Fatigue
- Hot flashes
- Reduced muscle mass
- Changes in mood
- Problems with erections or sexual function
- Increased risk of bone loss or osteoporosis
These effects are mainly related to the significant reduction in testosterone.
Does Removing Both Testicles Cause Infertility?
If both testicles are completely removed, the body can no longer produce sperm normally, resulting in infertility.
However, men who may need both testicles removed can sometimes discuss sperm banking before treatment. Sperm can be frozen and potentially used later for assisted reproduction.
This is particularly important when surgery is being performed for cancer and future biological parenthood is a concern.
What Happens to Testosterone After Both Testicles Are Removed?
Testosterone levels can fall sharply after bilateral orchiectomy because the main source of testosterone has been removed.
Low testosterone can cause symptoms such as:
- Low sex drive
- Fatigue
- Reduced muscle mass
- Erectile problems
- Mood changes
- Reduced energy
- Bone weakness over time
Cleveland Clinic notes that a significant reduction in testosterone following removal of both testicles can produce these types of effects.
Doctors can evaluate testosterone levels with blood tests when symptoms suggest low testosterone.
Can a Man Have Sex After Testicle Removal?
Having one testicle removed does not normally mean that sexual activity will stop. If the remaining testicle is healthy and produces adequate testosterone, sexual function can often remain normal.
After removal of both testicles, the substantial fall in testosterone can reduce sexual desire and may affect erectile function. The exact experience differs from person to person.
Medical treatment may help manage hormone-related symptoms, depending on the individual's underlying condition.
Can Testosterone Treatment Be Used After Both Testicles Are Removed?
In some situations, doctors may consider testosterone replacement therapy (TRT) for men with testosterone deficiency.
However, testosterone treatment is not appropriate for everyone. The reason the testicles were removed is extremely important. For example, in some hormone-sensitive cancers, reducing testosterone is actually part of the cancer treatment strategy.
Therefore, testosterone should never be started without medical evaluation and appropriate blood testing.
Why Are Testicles Sometimes Removed?
An orchiectomy may be recommended for several medical reasons.
Testicular cancer
Removal of the affected testicle is a standard and important treatment for many cases of testicular cancer. The removed tissue can also be examined to establish the diagnosis and determine the type of cancer.
Prostate cancer
In certain prostate cancers, reducing testosterone can be part of treatment because some cancer cells depend on male hormones for growth. Removing both testicles can permanently lower testosterone levels.
Serious injury or other medical conditions
In some cases, severe injury or other conditions affecting the testicle may lead to surgical removal.
The decision depends on the underlying disease and the condition of the testicle.
Does Losing One Testicle Affect Masculinity?
Removing one testicle does not automatically mean that a man will lose his sexual function or ability to father children.
If the remaining testicle is healthy, it can often compensate by producing testosterone and sperm. NHS hospital information also notes that removal of one testicle usually does not have a physical effect on sexual function.
It is therefore important not to assume that losing one testicle means losing "manhood."
What About Appearance After Testicle Removal?
Some men may feel concerned about the appearance of the scrotum after losing a testicle.
A testicular prosthesis can sometimes be placed inside the scrotum to provide a similar appearance. However, a prosthesis does not produce testosterone or sperm; it is primarily an appearance-related option.
Can a Man Father a Child With One Testicle?
One healthy testicle may produce enough sperm for natural conception. Cleveland Clinic specifically notes that a man with one testicle can potentially get his partner pregnant.
However, fertility should not be assumed solely from having one testicle. If there are concerns about fertility, doctors can perform tests such as semen analysis.
Cancer treatments such as chemotherapy or radiation can also affect fertility, so fertility preservation should be discussed before treatment when appropriate.
What Symptoms Should Not Be Ignored?
Men should pay attention to changes in their testicles.
According to the NHS, symptoms that should be medically assessed include:
- A lump or swelling
- A change in testicle size
- A change in shape or texture
- A heavy feeling in the scrotum
- Persistent pain or discomfort
- A new or unusual change in the testicle
These symptoms do not automatically mean cancer, because many other conditions can cause similar symptoms. However, they should be checked by a healthcare professional.
Final Takeaway
A man can live without one or even both testicles, but the consequences are different.
With one healthy testicle, testosterone and sperm production can often remain sufficient for normal sexual function and fertility.
With both testicles removed, sperm production stops and testosterone levels fall significantly. This can lead to infertility, reduced sexual desire, fatigue, loss of muscle mass, changes in mood and bone-health problems.
The good news is that many of these hormone-related issues can be medically evaluated and, in appropriate cases, treated. Fertility preservation should also be discussed before treatment if there is a possibility that both testicles will need to be removed or cancer treatment may affect fertility.
Medical Disclaimer
This article is intended for general health education and does not replace medical advice. A lump, swelling, persistent pain, change in size or any unusual change in a testicle should be evaluated by a qualified healthcare professional. Treatment decisions, including testosterone therapy and fertility preservation, should be made with an appropriate specialist.
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