Can You Get an Erection Without Testes?

Kelly Brown MD, MBA

Reviewed by Kelly Brown MD, MBA

Written by Sian Ferguson

Published 02/26/2021

Updated 04/14/2024

Without testicles, your body can’t produce testosterone — and testosterone is essential to erectile function. But can you get an erection without testes? The answer is complicated.

Also known as testicles or balls, the testes have a number of critical functions. Not only do they help form sperm, but they’re also responsible for testosterone production.

For health reasons, some men have one or both testes removed. This may be due to testicular cancer, prostate cancer, testicular torsion or direct trauma to the scrotum. When this happens, it can negatively affect sexual function. 

While you might be able to get an erection after losing one or both testes, many men experience erectile dysfunction (ED) after testes removal. Fortunately, various treatment options can help guys with one or no testes achieve erections.

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A surgery to remove one or more testicles is called an orchiectomy (or orchidectomy). Orchiectomies may be performed to treat health conditions or prevent further health complications.

Here are some of the most common reasons for testicle removal.

Prostate Cancer

Testosterone can worsen the growth of prostate cancer cells. Testicle removal stops the production of testosterone, which may prevent prostate cancer from spreading further. 

Although testicle removal isn’t a common part of prostate cancer treatment these days, your treatment team may recommend it if you have a particularly aggressive case. 

You might also need to have your prostate removed in a surgical procedure called a prostatectomy. Many people experience erectile dysfunction after prostate surgery — but certain medications can help you have satisfying sex after prostatectomy and testicle removal.

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Testicular Cancer

With the right treatment, the outlook for testicular cancer is quite good — especially if you’re diagnosed early. The five-year survival rate is over 95 percent

Often, testicular cancer treatment includes orchiectomy. If only one testicle is affected, your treatment team might only remove that testicle. 

Testicular Torsion

Testicular torsion is a rare yet highly painful condition that mostly affects boys and men under age 25. It occurs when the testes rotate, causing a twist in the spermatic cord. Since the spermatic cord supplies blood to the testes, the torsion can cut off blood supply.

This condition requires urgent treatment, often surgery to untwist the spermatic cord and secure the testicle to prevent future torsion, called an orchiopexy. If blood flow is cut off for more than six hours, your testicular tissue might die — which means the affected testicle might need to be removed. 


Blunt trauma to the genitals is painful enough — but sometimes, it can cause the testes to rupture. Beyond being extremely sore, you might also experience nausea and vomiting.

If you get emergency help ASAP, your testicles might survive. But if medical treatment can’t salvage your testicles, you may need an orchiectomy to remove one or both of them.

Not all testicle removal surgeries are the same. Different types of orchiectomies may be used to treat different conditions.

Simple Orchiectomy

A simple orchiectomy is a procedure where the testes are surgically removed via an incision in the scrotum. This surgery is usually used to remove testicles that are no longer functioning because of trauma or torsion.

Partial Orchiectomy

A partial orchiectomy is a procedure where only part of your testicle is removed. It may be done if you have a benign growth or tumor on your testicle. Your surgery team will remove the part with the mass or tumor while leaving the rest of your testicle intact. 

Since this surgery leaves part of the testes behind, it has less severe side effects than a procedure that totally removes the testes.  

Radical Orchiectomy 

If there’s a suspected cancer in the testicles, a radical orchiectomy may be performed via an incision in the groin. During this surgery, your treatment team will remove the testicles and the spermatic cord.

While a radical orchiectomy might have a more severe impact on reproductive health, it may be a necessary part of cancer treatment. 

Now for the answer to the question you’ve been asking: Can you have an erection without testicles? In short, yes.

It’s possible to get an erection without testicles, although many people experience ED after both of their testicles are removed. Whether you have one or both testicles removed will determine how it impacts your erectile function, sex drive and reproductive health.  

Erectile Function After Unilateral Orchiectomy

A unilateral orchiectomy is a surgery where one testicle is removed. If the other testicle is healthy and functioning, you should still be able to have erections, engage in sexual activity and produce sperm. 

One study surveyed men who experienced testicular torsion at a young age. Out of 72 respondents, 49 had undergone orchiectomy, while 23 had an orchiopexy to untwist the spermatic cord and secure the testicle to prevent future torsion.

Of the 49 men who had undergone orchiectomy, 41 had experienced a successful first pregnancy — though some took longer to conceive. 

Another study looked at 60 men who underwent unilateral orchiectomy to treat testicular cancer. At the start of the study, 36 patients were producing normal levels of sperm, seven produced no sperm, and 17 produced only small amounts of sperm. 

After a year, 45 patients were producing sperm normally, two patients who initially produced low amounts normalized, and 28 had conceived. 

With that said, living with only one testicle can still affect your hormone levels and overall well-being. Research shows that testosterone levels decrease significantly after a unilateral orchiectomy. The procedure also results in a decrease in other hormone levels, including hcG and estradiol.

If your hormone levels are too low, you might benefit from hormone replacement therapy.

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Erectile Function After Bilateral Orchiectomy

Whenever possible, medical professionals try to avoid removing both testicles. But in some situations, it’s necessary to perform a bilateral orchiectomy in which both testicles are surgically removed.

What happens if you lose both testicles? How does it affect erectile function, and can you ejaculate without testicles? All good questions.

After a bilateral orchiectomy, you might experience:

  • Decreased libido

  • Low levels of testosterone

  • Low semen volume

  • Sexual disorders, like erectile dysfunction

A 2021 review looked at sexual function in testicular cancer survivors. It found that those who had both testicles removed were more likely to experience erectile dysfunction. This is likely because testosterone plays an essential role in erectile function, and your sex drive might decrease as a result of lower testosterone levels.

One study evaluated sexual function in 98 people who had both testicles removed. Only a minority experienced difficulties getting or maintaining an erection. However, some participants were receiving testosterone replacement therapy.

Out of the 98 men, 25 percent experienced low libido, and 24 percent had lower semen volume after surgery. Although you can ejaculate without testicles, an orchiectomy can affect this bodily function. The study noted that 14 percent of participants experienced premature ejaculation, while 2 percent had late ejaculation or no ejaculate. 

Research has also shown that orchiectomy may cause psychological stress. While having testicular cancer or another condition is stressful on its own, many men also deal with body image issues and a feeling of not being “normal” after surgery. This may, in turn, affect your self-esteem, which can negatively affect your sex life.

Though it’s possible to get an erection without testicles, many men struggle with erectile dysfunction after an orchiectomy. This could be because of hormonal factors (namely, low testosterone levels) or psychological implications.

The good news is that there are ways to treat erectile dysfunction after an orchiectomy. Depending on your health, the cause of your ED and your current erectile function, some treatments may be more suitable than others.

Common treatment options include:

  • Testosterone replacement therapy. Testosterone is an androgen (male sex hormone) that affects sex drive and erectile function. If you have low levels of testosterone, hormone therapy may improve erectile dysfunction. 

  • Erectile dysfunction medications. Most of these are PDE5 inhibitors, which help you get an erection by increasing blood flow to your penis. Popular erectile dysfunction meds include sildenafil (the generic version of Viagra®), tadalafil (the generic version of Cialis®), Stendra® (and its generic avanafil) and our hard mints chewable ED meds.

  • Vacuum erection devices. By boosting blood flow to the penile tissue, vacuum erection devices can help you become erect. One option is the Eddie® by Giddy device.

  • Injection therapy. Certain drugs can be injected into the penis to improve erectile function. Common ED injections include Trimix, Caverject, and alprostadil.

  • Talk therapy. Testicular health issues can be traumatic, and an orchiectomy might affect your body image and self-esteem. If you’re experiencing psychological ED, mental health counseling can make a major difference.

Beyond the above treatments, you can try implementing some lifestyle changes for erectile function. A healthy diet, regular exercise and a decent sleep schedule can help. It’s also a good idea to quit smoking, reduce your alcohol and drug intake, and manage any chronic conditions like high blood pressure. 

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Yes, you can get an erection without testes. Many men experience erectile dysfunction after having one or both testicles removed, but hormone therapy and ED treatments can help. 

  • Testicle removal can affect erectile function. You may or may not experience erectile dysfunction after having one or both testicles removed. There’s no way to predict how an orchiectomy will affect sexual function, but it can decrease it.

  • Different types of orchiectomies have different effects. While having one healthy testicle is usually enough to maintain erections and even become pregnant, losing both testes is more likely to cause sexual dysfunction.

  • Treatments are available. The good news? Various erectile dysfunction medications and devices can improve erectile function. You might also want to try talk therapy and healthy lifestyle changes.

Treating ED after an orchiectomy often starts with reaching out for help. While your sexual health may be a difficult thing to discuss, healthcare providers are trained to assist people experiencing these kinds of issues.

When you’re ready to take that step, we can connect you with a qualified professional through our telehealth platform. Fill out our quick sexual health questionnaire to get started.

19 Sources

  1. Caffo, Amichetti. (2001). Evaluation of sexual life after orchidectomy followed by radiotherapy for early-stage seminoma of the testis.
  2. Cancer Research UK. (2022). Your sex life and testicular cancer.
  3. Cancer Research UK. (2022). Managing erection problems.
  4. Castela, A., Vendeira, P., & Costa, C. (2011). Testosterone, endothelial health, and erectile function.
  5. Gaddam SJ, Chesnut GT. (2023). Testicle Cancer.
  6. Jacobsen, K. D., Theodorsen, L., & Fossa, S. D. (2001). Spermatogenesis after unilateral orchiectomy for testicular cancer in patients following surveillance policy.
  7. Kerie S, Workineh Y, Kasa AS, Ayalew E, Menberu M. (2021). Erectile dysfunction among testicular cancer survivors: A systematic review and meta-analysis.
  8. Okoye E, Saikali SW. (2022). Orchiectomy.
  9. Pallotti, F., Petrozzi, A., Cargnelutti, F., Radicioni, A. F., Lenzi, A., Paoli, D., & Lombardo, F. (2019). Long-Term Follow Up of the Erectile Function of Testicular Cancer Survivors.
  10. Pierorazio, P. M., Ferrucci, L., Kettermann, A., Longo, D. L., Metter, E. J., & Carter, H. B. (2010). Serum testosterone is associated with aggressive prostate cancer in older men: results from the Baltimore Longitudinal Study of Aging.
  11. Podlasek, C. A., Mulhall, J., Davies, K., Wingard, C. J., Hannan, J. L., Bivalacqua, T. J., Musicki, B., Khera, M., González-Cadavid, N. F., & Burnett, A. L., 2nd (2016). Translational Perspective on the Role of Testosterone in Sexual Function and Dysfunction.
  12. Randhawa, H., Blankstein, U., & Davies, T. (2019). Scrotal trauma: A case report and review of the literature.
  13. Schick MA, Sternard BT. (2023). Testicular Torsion.
  14. Sizar O, Pico J. (2022). Androgen Replacement.
  15. Tiwana MS, Leslie SW. (2023). Anatomy, Abdomen and Pelvis, Testicle.
  16. Treatment for Erectile Dysfunction. (2017).
  17. Wiechno, P. J., Kowalska, M., Kucharz, J., Sadowska, M., Michalski, W., Poniatowska, G., Jońska-Gmyrek, J., Rzymkowska, J., Nietupski, K., & Demkow, T. (2017). Dynamics of hormonal disorders following unilateral orchiectomy for a testicular tumor.
  18. Woo, L. L., & Ross, J. H. (2020). Partial orchiectomy vs. radical orchiectomy for pediatric testis tumors.
  19. Zhang, X., Zhang, J., Cai, Z., Wang, X., Lu, W., & Li, H. (2020). Effect of unilateral testicular torsion at different ages on male fertility.
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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kelly Brown MD, MBA
Kelly Brown MD, MBA

Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown is a founding member of Posterity Health where she is Medical Director and leads strategy and design of their Digital Health Platform, an innovative education and telehealth model for delivering expert male fertility care.

She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.

Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.

Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.

Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.

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