Will just one testicle tamper with sex life and fatherhood?

Dear Alice,

I was just wondering if having only one testicle would affect my sex life and my ability to have any kids?

— Nineteen Year Old Male

Dear Nineteen Year Old Male,

In most cases, more than enough hormones and sperm are produced in one healthy testicle for both a healthy sex life and the ability to fertilize eggs. This is similar to people who have one lung, kidney, or ovary; only one organ is truly necessary. However, since each person is unique, your health care provider is the best source for info in your particular situation. With her/his assistance, you can find out if everything checks out physically.

A man may have one testicle for a variety of reasons. Some men may have a "buried testicle." Known as cryptochidism, one or both testicles do not descend into the scrotum. This condition is generally, but not always, noticed at birth. Often an infant boy's testicle that has not descended will usually move into the scrotum on its own during the first year of life. If the undescended testicle is noticed, and has not descended during that time, surgery is performed before the boy is five years old. If the situation is not noticed or corrected, the testicle gradually withers away. Others may have a testicle removed as a result of testicular cancer, which has many causes. There's an increased risk of testicular cancer for men who have a history of an undescended testicle, whether or not they have had corrective surgery. For cosmetic reasons, or for a feeling of balance, some men may consider an implant that's surgically placed inside the scrotum to look and feel as though there are two testicles. For more info about sexuality and cancer, check out the American Cancer Society. They offer a free booklet, Sexuality & Cancer: For the Man Who Has Cancer, and His Partner.

Men who are self-conscious may be concerned about how a partner might react, and talking about it can feel strange and risky. If you decide to talk about your body before becoming intimate, you can say something like: "I have one testicle, in case you haven't seen that before," or "You know what they say about quality being more important than quantity? Well..." You could also bring it up if your partner's playing around down there: "Yeah, one that puts out like two, " or something like that. You also don't have to say anything, and a partner who truly cares will be supportive and understanding.

Medically, as long as you're healthy, and producing adequate viable sperm in your remaining testicle, your lone testicle will not impact your sex life or ability to have children. Psychologically, however, some men with one testicle experience feelings of inadequacy, loss of masculinity, or self-consciousness that can interfere with sexual functioning. Some questions to consider include: How are your erections? Have you been able to ejaculate? Have you orgasmed through masturbation? Sex? If you or your provider feels that psychological issues may be factors, speaking with a counselor of sex therapist might be a helpful next step.

Last updated Mar 11, 2015
Originally published May 18, 2001

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