Sexual and marital counseling with men treated for testicular cancer.

Testicular cancer patients are at risk for sexual and marital problems because their cancer and its treatment reduce their fertility and disrupt intimate relationships at a crucial life stage (age 15-34). Chemotherapy, radiotherapy and surgery have successfully increased survival rates, but at the price of infertility and sexual dysfunction. A survey of men treated for nonseminomatous tumors revealed that 20% had low levels of sexual activity, 10% had erectile dysfunction, 6% had difficulty reaching orgasm, and 38% reported decreased orgasmic pleasure. Sexual anxiety related to cancer treatment accounts for much of this dysfunction, but organic factors such as hormonal, vascular or neurologic damage may also contribute. Reactions of couples to infertility and marital conflicts common in this group are discussed. Suggestions for sexual and marital counseling are offered.