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Testosterone after orchidectomy: will one testicle be enough? | CION Cancer Clinics
For most men, the testicle that is left makes enough testosterone on its own, so energy, sex drive, erections and muscle stay much as before. A smaller group end up with a low level, more often after chemotherapy or radiotherapy, or when the remaining testicle was already weak. This page explains the signs to notice, how the level is checked, and who needs replacement. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Will my testosterone drop after one testicle is removed?
- What does low testosterone actually feel like?
- How is testosterone checked after the operation?
- What do the words on a hormone report mean?
- How is it different if both testicles are removed?
- What do men and families wrongly believe about testosterone?
- What happens if I do need testosterone replacement?
- Common questions about testosterone after orchidectomy
The short answer
Will my testosterone drop after one testicle is removed?
For most men, no. The testicle that is left usually makes enough testosterone on its own, so your energy, sex drive, erections, beard and muscle stay much as they were before the operation.
Why one testicle is usually enough
Testosterone is the main male hormone. It is made mostly in the testicles, and the brain keeps a close watch on the level in your blood. When one testicle is removed, the brain sends a stronger signal to the one that remains, and that testicle works a little harder to make up the difference. In a healthy testicle this happens quietly, over the weeks after surgery, without you doing anything.
When the level can fall
A smaller group of men do end up with low testosterone. It is more likely if the remaining testicle was already small or weak, if it was not fully descended in childhood, or if chemotherapy or radiotherapy follows the operation. Both treatments can slow down the testicle that is left, sometimes for a while and sometimes for longer. A few men have low levels that were never picked up before the cancer was found.
What this page cannot tell you
It cannot tell you what your own level is, or will be. Only a blood test can do that, read alongside how you actually feel. If both testicles are removed, the picture is completely different, and replacement is needed for life.
Low mood and tiredness are common after any cancer diagnosis. They are not always a hormone problem, which is why a blood test matters before anyone decides.What to notice
What does low testosterone actually feel like?
The signs are easy to blame on stress, poor sleep or the cancer itself. Mention them anyway, even if they feel awkward to raise.
Sex and erections
Less interest in sex than before, weaker erections, or fewer erections on waking in the morning. These are often the first signs a man notices.
Energy and mood
A tiredness that sleep does not fix, a shorter temper, feeling flat, or finding it harder to concentrate at work or at college.
Body changes
These come on slowly, over months rather than weeks, so a family member may spot them before you do.
Look out for
- Loss of muscle and strength
- More fat around the waist
- Slower beard and body hair growth
Hot flushes and sweats
Sudden waves of heat, sweating at night, or sleeping badly. These are more typical when the level has fallen a long way.
Not sure whether this applies to you?
Ask an oncologistChecking the level
How is testosterone checked after the operation?
Tell your team what you notice
Your follow-up visits are mostly about the cancer. Hormone symptoms will not be picked up unless you mention them, so write them down before the appointment.
An early morning blood test
Testosterone is highest in the morning, so the sample is usually taken early. One low result is often repeated before anything is decided, because the level moves from day to day.
Other hormones alongside
The same sample often measures the signals the brain sends to the testicle. They show whether the testicle is being pushed hard and still not keeping up.
A decision made together
The result is read with your symptoms, your treatment plan and your plans for children. Numbers alone do not settle it.
On your report
What do the words on a hormone report mean?
- Total testosterone
- The whole amount of the hormone in your blood. This is the main number your doctor looks at.
- LH
- A signal from the brain telling the testicle to make testosterone. A high LH with a low testosterone suggests the testicle is struggling.
- FSH
- A brain signal that drives sperm production. It is often checked when fertility is part of the conversation.
- Hypogonadism
- The medical word for testicles that are not making enough hormone, sperm or both.
- Testosterone replacement
- Hormone given as a gel, patch or injection to bring a low level back up to the normal range.
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Side by side
How is it different if both testicles are removed?
One testicle removed
Both testicles removed
The other testicle usually keeps making enough testosterone
The body can no longer make testosterone of its own
Replacement is needed only if tests and symptoms show a low level
Replacement is planned for life, unless the aim is to lower testosterone
Natural fatherhood often stays possible
Children depend on sperm banked before surgery
Usually done for testicular cancer
Done for cancer in both testicles, or to control prostate cancer
Commonly believed
What do men and families wrongly believe about testosterone?
"With one testicle gone, I will not be a full man."
Your voice, beard, strength and sex drive come from the hormone, not from the number of testicles. In most men the remaining one keeps all of that going. Nothing about being a husband or a father depends on having two.
"I should take testosterone just to be safe."
Extra testosterone when your own level is normal does not add strength. It tells your remaining testicle to slow down, and it can stop sperm production. It is prescribed only when a blood test shows a real shortfall.
"The gym supplements will fix it."
Products sold online or at gyms as testosterone boosters are not tested the way medicines are. Some contain real hormones in unknown amounts. Show anything you are taking to your oncologist.
"Low sex drive after surgery means the hormone has gone."
Worry, pain and the shock of a diagnosis often lower desire for a while. That usually improves as you recover. A blood test tells the two apart.
If the level is low
What happens if I do need testosterone replacement?
Replacement brings the level back into the normal range. Most men feel the difference in energy, mood and sex drive once the right dose is found. It is a routine treatment, usually overseen by an endocrinologist, a hormone specialist, working alongside your cancer team.
The forms it comes in
It is given as a gel rubbed onto the skin each day, as a patch, or as an injection repeated at regular gaps. The choice depends on what suits your routine, what is available near your home, and cost. Your doctor sets the dose and the gap between injections. Do not change either on your own.
Who it does not suit
Replacement is not the right step for a man who is trying to father a child soon, because it lowers sperm production. It needs care in men with a high blood count, some heart problems or untreated sleep apnoea, the condition where breathing stops during sleep. Your team weighs those before prescribing.
What it means for follow-up
You will have blood tests from time to time to check the level and your blood count. None of this changes the cancer follow-up itself, which carries on as planned.
Planning to start a family? Say so before any hormone is prescribed. It changes the choice.Questions we are asked
Common questions about testosterone after orchidectomy
Will I still be able to have sex after one testicle is removed?
Usually, yes. Erections, orgasm and ejaculation do not depend on having two testicles. Most men return to a normal sex life once the wound has healed. If erections or desire do not come back as you recover, tell your team, because both a hormone check and a conversation about worry can help.
When should testosterone be checked after surgery?
There is no single rule. Many teams check it if you have symptoms, if the remaining testicle was already small, or after chemotherapy or radiotherapy. Some check it as part of routine follow-up. Ask your oncologist whether a morning blood test makes sense for you, and when.
Can chemotherapy lower my testosterone?
It can. Chemotherapy may slow down the testicle that is left, and the level sometimes dips during or after treatment. In many men it recovers over the following months, though not in every case. Mention tiredness or low sex drive that lasts well beyond the end of treatment.
Will testosterone replacement bring the cancer back?
Testicular cancer is not known to be driven by testosterone in the way prostate cancer is. Replacement given for a proven low level is a recognised treatment after testicular cancer. This is different after orchidectomy for prostate cancer, where the aim is to keep testosterone low.
Does testosterone replacement affect having children?
Yes. Testosterone from outside tells the body to stop making sperm, so it can make you infertile while you take it. If a pregnancy is planned, other options are discussed first. Tell your doctor about your plans before any prescription is written, not afterwards.
My son seems low and withdrawn. Is it his hormones?
It might be, but often it is the weight of the diagnosis. Young men in particular find it hard to talk about. Encourage him to mention it at his next visit, or come with him. A blood test can rule the hormone question in or out, and counselling helps with the rest.
Can I buy testosterone gel or injections without a prescription?
Please do not. Hormone taken without a test and a doctor watching can shut down your own testicle, stop sperm, thicken the blood and hide the real cause of how you feel. If you think your level is low, ask for the blood test first.
Is the hormone check covered by Aarogyasri or insurance?
Cover depends on your scheme and policy, and on whether the test is part of an approved cancer follow-up plan. Aarogyasri, CGHS, ECHS, EHS and cashless insurers each have their own rules. Call the helpline with your card details and we will help you check before the test.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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Sources
- Cancer Research UK — Testicular cancer
- NHS — Testicular cancer: treatment
- National Cancer Institute — Sexual health issues in men with cancer
- American Cancer Society — Testicular cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Will One Testicle Be Enough for Fertility?Sperm and fatherhood with one testicleBilateral Orchidectomy: What ChangesWhen both testicles are removed and replacement is lifelongSurveillance, Chemotherapy or Radiation After OrchidectomyThe treatments that can affect the remaining testicleFollow-Up After Testicular Cancer SurgeryWhere a hormone check fits into your visits
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Worried your hormone level has changed?
Tell us what you have noticed since the operation. We will help you reach the right specialist for a proper check. One helpline serves every CION centre.