Testosterone therapy after testicular cancer

Testosterone therapy

Testosterone therapy is a consideration for many men and their doctor’s after the removal of testicles due to cancer, torsion, injury or in an extreme STI situation.  Testosterone is the primary sex hormone found in men and is also an anabolic steroid. It is paramount in the development of testis, the prostate and sperm production.  As secondary sexual characteristics, testosterone helps promote growth of body hair as well as denser muscle and bone mass.  Sex-drive and mental health also go hand in hand with healthy testosterone production, but like Dr. Dean Elterman says in our Balls documentary, “There is a range of normal for everything, and too much of a good thing, is a bad thing”. More is not necessarily better.

Dr. Dean Elterman discusses testosterone
Dr. Dean Elterman explains testosterone’s function in the male body.

Body builders might use anabolic steroids to help increase their muscle mass, and it works. That said, prolonged and overuse of anabolic steroids can lead to a complete shut down of natural testosterone production in the body with the end result being testicular atrophy, thus forcing these men to rely on testosterone hormone therapy for the rest of their lives. The damage is irreversible.

Bodybuilding with steroid use.
Many bodybuilders use steroids in pursuit of their physical ideal.

Interestingly enough, testosterone is also produced in female ovaries, but to a lesser extent.  The average adult male will produce about 8 times more testosterone compared to the average female.

A bodybuilder administering a self-dosage of steroids.
A bodybuilder administering a self-dosage of steroids.

Some might even venture to say that testosterone therapy is the fountain of youth for aging men. After the age of 35, men lose about 1 percent of testosterone production every year.  This is a natural part of a male’s physiology.  As a result of declining testosterone, men might experience: reduced sexual desire, sleep disturbances (like insomnia), physical changes (like increased body fat, reduced muscle density and strength, hair loss, gynecomastia, lethargy and changes in mental health (like depression, low self-confidence, trouble concentrating and memory loss).  Though testosterone therapy can help reverse the effects of hypogonadism (an actual hormonal disease that effects testosterone production in the testicles or the pituitary gland), there is little evidence that testosterone therapy for older men, who are otherwise healthy, is of any benefit.  Quite frankly, until we can actually reverse the effects of aging, the degradation of the body and mind is a natural function of being alive.  Instead of chasing the fountain of youth, as a culture we need to accept and prepare for the process of death.  It will happen to all us.  This is a healthier and much needed approach.

Shawn discusses testosterone therapy with Dr. Dean Elterman.
Shawn discusses testosterone therapy with Dr. Dean Elterman.

Shawn, who has suffered through hypogonadism, cancer and erectile dysfunction, needed testosterone therapy on his path to healing and recovery.
Shawn is very courageous to share his long and involved testicular journey with us.  Like Peter, not only has Shawn had BOTH his testicles removed (replaced by 2 prosthetic testicles) because of cancer, but he has also had a penile implant.  Because Shawn is now unable to produce any testosterone, he is using testosterone gel.  Though testosterone shots are covered by OHIP (Ontario Health Plan in Canada), he found them painful and inconvenient.

Instead, he opted for the gel (at a cost of $150/month), which is easier to manage and as simple to apply as body cream.  Shawn jokingly calls himself the bionic man.  His openness and honestly to reveal his process is beautiful, especially that his story ends on such a positive note.
I don’t want to reveal too much about Shawn’s fascinating story.  Instead, sit back and watch the documentary episode about him.  It’s quite inspiring.

WATCH the unblurred, unbleeped, balls out version here:

Vimeo: https://vimeo.com/ondemand/balls

Amazon: http://a.co/2F4txPh

Border2Border Entertainment: http://bit.ly/2xoSpjW

~ Nico Stagias, Balls documentary director

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Testicle Implants

Testicle Implants

After losing a testicle (or two), due to cancer, infection, injury or torsion, do you consider getting testicle implants?  What if you are a trans-man?  According to our documentary subjects, the opinions vary and are split down the middle.

To replace, or not to replace.  This is the question.
In the case of Matt Perry, who lost his testicle to testicular torsion, he has no interest in replacing the excided ball with a testicle implants.  Now in his fifties, Matt had his ball removed in his early twenties because the twisted testicle had cut off all blood supply to his left nut rendering it dead.  Not only is testicular torsion a medical emergency but it is also very difficult to diagnose.  If the diagnosis and “un-twisting” is not made within the first 8 hours, the testicle will likely be lost.  

Matt’s trauma of undergoing an orchiectomy over 25 years ago is so great, that the thought of having to undergo surgery once again to have testicle implants is even further traumatizing. Besides, he is much older now and in a long-term committed relationship with a partner who is comfortable and supportive of Matt’s body.  Matt jokes, “If you could click your fingers and have testicle implants with no effort required, I would probably do that”. Sadly, it is not that simple.

Siavash, on the other hand, who also lost a testicle to torsion in more recent years, is definitely considering re-balancing his body with testicle implants.  As a younger man in his late twenties, he would like his body to look more symmetrical.  At the moment, he is researching clinics and doctors.
For Peter Bovolaneas, who lost both testicles to cancer, it was a no brainer.  He was thankful for the modern day medical technology and elected to get 2 prosthetic testicle implants.  Peter is a remarkable human being who has such a great sense of humor and amazing coping skills.

Sometimes when he is out at the bars, he will approach acquaintances (who do not know his testicular history) and ask them to flick his balls.  If he doesn’t flinch, they buy him a drink; if Peter flinches, he buys the drink.  It’s a win-win situation for tipsy Peter, leaving the “flicker” scratching his or her head.  

It should also be noted that Peter, who presents as a VERY masculine/muscular man, can no longer produce testosterone because both testicles were removed due to cancer. Because of this fact, Peter must inject himself with testosterone every 2 weeks to maintain sex drive, bone mass, muscle mass and mental health.  He humorously accepts this shot in the buttocks as his “pain in the ass”.

Peter takes testosterone because without biologically intact testicles, as a man he needs it.  This is different than when men with functioning testicles take testosterone for purely aesthetic reasons.

The decision to get testicle implants after the required removal of one or both balls really comes down to choice and comfort.  And as Maggie Cassella jokes, “I’m not going to judge a guy for getting a fake ball any more than I’m going to judge a woman for getting a fake boob. It’s your choice and we have the technology!”

testicle implants sizingDifferent sizes of testicle implants are measured against the patient’s real testicles to get as close a match as possible.
There are different types of prosthetic testicle implants.  The ultimate goal is to match the prosthetic as much as possible to the remaining, natural testicle.  Testicular prostheses are made of silicone gel or saline (salt water) with a silicone rubber covering.  The surgeon makes a small incision in the lower groin where the prosthesis is inserted and then placed in the empty scrotum and secured with a stitch, or suture. You can usually go home the same day of the surgery.  Often testicular prosthesis surgery can be done at the same time as the orchiectomy, or during a later surgery.  It all depends on what the patient wants.

As a trans-man, Carey is not interested in getting prosthetic testicle implants.  His genitals do not define his masculinity, though he jokingly claims to have “psychic balls”.  Interestingly enough, once Carey started to take testosterone, his genitals started to change.  His clitoris and labia started to grow, so much so that he often feels as though he has a penis and balls.

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Testicular Self-Exam video with Johnny Rapid

testicular self-exam video

Learn how to do a monthly step-by-step check-up on your balls with this NSFW testicular self-exam video starring Johnny Rapid.

We have been exploring all things related to Balls and if the topic interests you, I invite you to read some of our other articles and watch the documentary for further insight.

Some of the topics we look at include the importance of etymology, that is being specific in the words we use, like in the case of gender reassignment and gender confirmation.

Beyond testicular cancer, we discover lesser known complications a person can have with testicles such as testicular torsion or varicocele. 

We even speak with some drag queens to discover just where the balls go when they tuck.

It’s easy to do so there’s no excuses!   Just follow along in this NSFW testicular self-exam video and do what Johnny does.

JOHNNY RAPID: My balls are my moneymaker so it’s important that I check them at least once a month to make sure they’re in prime condition.

So, how do I check that my balls are ready to play and stay that way? Pull your pants down guys and go through the steps with me to make sure your balls are healthy and strong.

Check your testicles just after you’ve had a bath or shower. When the muscles in the scrotum are relaxed making it easier for you to feel any lumps, growths or tenderness.

Stand in front of a mirror. Look for any swelling on the skin of your scrotum. Hold your scrotum in your hands and feel the size and weight of each testicle. Don’t worry if one ball is a little bigger or one hangs lower than the other that’s normal.

Feel each ball and roll it between your thumb and finger. It should feel smooth, it’s normal to feel a soft, tender tube towards the back of each testicle, that’s where your sperm are made. You shouldn’t feel any pain when checking your testicles.

Once you get to know your balls keep an eye out for any changes If you detect a change, don’t freak out just see a doctor as soon as possible.

My balls have stayed the same since my last self exam so that means I’m ready to go to work. Make sure you check your balls at least once a month and if you notice any changes go see your doctor right away.

If you would like to know more, please check out the film, Balls.

You can also watch Balls on Vimeo, Amazon, or on the Border2Border Store.

Working with Johnny Rapid to make the Testicular Self-Exam video was definitely fun but it wasn’t a ‘one take wonder’.  Take a look at some of the goof ball antics that we went through to get the video.

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