Though there are not many men living without testes, in some cases, doctors may remove them for medical reasons. The most common reason for testes removal could be tumors or other malignant formations (1).
However, it is not easy to predict the life of a man without testicles. Some might think that one cannot get an erection without testes, but it is far from true. Loss of testes will undoubtedly have an impact on sexual performance and desire, but not in all cases. Therefore, this question is more complicated than it seems, and the reply is less apparent (2).
Role of Testes in Male Wellbeing
What is clear to science is that testes have many functions; it not only influences sex life but may have a much broader impact on male health.
The two most essential functions of testes are the production of testosterone and sperm (3).
It means that anyone without testes would be infertile, though not essentially impotent. This is because testosterone is just one of the hormones responsible for hard erections. A fall in testosterone levels is only one of the factors for falling libido and erection quality, but many men with normal levels of testosterone may also have erectile dysfunction.
Removal of testes will undoubtedly have an impact on the quality of erection and libido, but perhaps most men will maintain some erection. How severely will the removal of testes affects sexual health may depend significantly on the genetics and age at which testes were removed.
Usually, the younger the age at the time of removal of testes, the graver would be the impact.
Understanding the Role of Testosterone in Erectile Function
It may come as a surprise to many readers that testosterone, though significant, is not vital for getting hard erections.
Perhaps the most significant proof that testosterone, though necessary, is not essential for hard erections is the fact that researchers discovered testosterone more than 100 years ago. Researchers could produce testosterone in 1935. However, injecting testosterone did not help most men living with erectile dysfunction (4).
Nevertheless, this does not mean that testosterone or testicles have no role in the treatment of erectile dysfunction. Testosterone does improve erection quality, and rejection of testis for various reasons will lower the quality of erection in most men.
Testosterone And, Consequently, Testes Have a Much Broader Role in the Wellbeing
It would be unwise to see testis as something that is for producing sperm and testosterone. If both testes are removed, resulting in zero production of testosterone will cause havoc on male health.
For those living with impotence, it is vital to understand that libido and erectile dysfunction are two different terms.
Libido is all about sexual desire. Many men may have adequate erection quality but may not want to have sex as libido is lacking. Erectile dysfunction, on the other hand, is the inability to have an erection hard enough for satisfactory sex, though in most cases, the desire is there.
Men without testes would not only have inferior erection quality, but they will have a severe problem of lack of libido. They will feel tired all the time. Lack of testosterone will also cause mood issues, considerably increasing the risk of depression and sleep disorders. Testicles are vital for stronger muscles and bones. Thus, those without testes will have not just poor erection quality but also poor general health (5).
Role of Testosterone in the Treatment of Erectile Dysfunction
It is a complicated question, even for medical specialists. Though testosterone hormone therapy is irreplaceable in those living without testicles, its role is less evident in those who have functional testicles (6).
Here are some of the critical things that science knows about the role of testosterone and testes in maintaining erection quality (7):
- Studies in men in whom both the testicles are absent for various reasons show that it does impact erection quality, but it does not result in complete loss of erection in many men. Usually, most will have poor erection quality.
- Testosterone is essential for maintaining erectile function and having fulfilling sexual life, and thus testicles play a vital role. Fall of testosterone below certain levels may hurt erection quality in all men.
- Regretfully, to date, science does not know the minimum amount of testosterone needed for maintaining an adequate quality of erection.
- Many men would have more or less preserved sexual function if just one of the testes is missing.
- 65% of men living with severe hypogonadism will benefit from testosterone replacement therapy.
- Testosterone therapy may help many men improve their response to PDE5 inhibitors like Viagra or Cialis.
It means that testosterone therapy has a place in the treatment of erectile dysfunction, particularly in those living with deficient levels of testosterone. The use of testosterone therapy is justified in men living with either hypogonadism or without testes.
Why Is Testosterone Therapy Not for All?
There are well-known medical reasons for not using testosterone replacement therapy widely. It seems that such use has many potential risks. It may increase the risk of heart diseases, alter lipid profile, cause fluid retention, may be toxic to the liver, and cause skin reactions and gynecomastia (8).
Due to numerous health risks associated with testosterone replacement therapy, it is rarely prescribed by medical specialists, though it might help.
To conclude, one will see a worsening of libido and erection quality without testes for sure, though it will not necessarily lead to impotence in all cases.