Q&A with DR.P – I’m having a problem in the Bedroom, should I get checked out?

By April 2, 2015Ask Dr P

QUESTION:

I have been having issues in the bedroom and I was wondering if this has an effect regarding my post recovery? or is this simply just in my head ?  –Sean, New York, NY

Man in bed with nervous look

ANSWER:

Sean, great question.  There are a couple of reasons men have “bedroom issues” following treatment for testicular cancer whether its following their orchiectomy, chemotherapy or a retroperitoneal lymph node dissection.
The first is an organic cause, hypogonadism, which is the medical term for low testosterone levels.  While it is not common, some men, even with one good testicle left, can have low testosterone levels that can lead to low energy levels, libido (sexual desire) and occasionally erectile function, which can translate into poor “bedroom performance.”  Technically, a fraction of one testicle should produce enough testosterone to give you a beard, erection and chase your partner around the bedroom.  Occasionally, surgery, chemotherapy and even testicular cancer itself, can cause suboptimal testosterone levels.  Checking an early morning testosterone level with your doctor (testosterone release is cyclic and highest in the early morning) can assess your hormone function.
man-insomnia
The second cause has to do with self-confidence.  It takes a lot more than an erection to perform well in the bedroom.  Comfort, confidence and self-assuredness can all help performance – and the lack of thereof can have negative impacts.  Whatever your treatment course was, you are now missing a testicle, have at least one surgical scar and just went through the biggest scare of your life.  For most young men, the diagnosis and treatment of testicular cancer is a strong blow to confidence and the sense of invincibility that most young men have.  Surviving testicular cancer takes a lot more than just checking labs, CT scans and xrays – it also has to do with resolving the emotional and psychological issues surrounding the disease.  For some men, a testicular prosthesis helps them feel more normal.  For others, a short course of anti-depressant medication under the supervision of a doctor may help.  For some its a tattoo to commemorate their ordeal.  In Baltimore, we have regular “Beers, Bros and Balls” events, where testicular cancer survivors can meet, share their stories, common problems and solutions.  So finding a group of TC survivors in your area may also help you “recover” from this life-changing diagnosis.
So my advice: First, check a testosterone level.  If its abnormal its an easy fix.  If its normal it may give you the confidence to “perform well” in the bedroom.  Second, I would also connect with a testicular cancer expert and survivors (whether through social media or in person) – it will let you know you are not alone and help you through these issues.  A physician can help you navigate the medical side of this and other survivors can help you navigate the rest.  Good luck, you will be back to your studly self soon!
Doctor P