ADT Affects Sexual Function, Intimacy in Early Prostate Cancer Treatment

Researchers report on a study investigating effects of ADT on prostate cancer health-related quality of life, sexual function, sexual bother, and mood for patients with prostate cancer and their partners.

Sexual and relational intimacy was found to be reduced throughout the first 6 months among patients with prostate cancer (PCa) undergoing androgen deprivation therapy (ADT), according to a study published in Supportive Care in Cancer

Some of the most common side effects of ADT — a frequently used treatment for prostate cancer that lowers testosterone to castration levels — include mood depression and sexual dysfunction. Although the impact on individual patients has been well established, the impact on the patient-partner sexual relationship and intimacy has not been fully explored. 

For this study, researchers evaluated the outcomes of 72 men on ADT and their partners. Couples completed questionnaires evaluating prostate cancer health-related quality of life, sexual function (eg, desire, erection, orgasm, overall function), sexual bother (bother associated with aspects of sexual function), and mood (eg, tension, depression, anger, vigor, fatigue, confusion). Measures were assessed over time, starting at baseline, then 3 months and 6 months after initiating ADT.

Results showed that there were declines in sexual function, frequency, and relational intimacy during the first 6 months of ADT; 37.5% of couples were sexually active at baseline, 15.3% at 3 months, and 6.9% at 6 months. Sexual bother significantly increased between baseline and 3 months only.

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No significant changes in mood were observed, but couples reported that emotional intimacy was higher when partners understood the other’s mood state. Patient and partners rated sexual intimacy as being higher when they were more sexually active.

The authors concluded that “this study confirms declined sexual function and activity and increased sexual bother for patients, as well as declined relational intimacy for both patients and partners. Better understanding of these changes, and their impact within the couple, may assist in identification of interventions to preserve patient and partner QOL and relationship quality.”

Reference

Walker LM, Santos-Iglesias P, Robinson J. Mood, sexuality, and relational intimacy after starting androgen deprivation therapy: implications for couples [published online May 18, 2018]. Support Care Cancer. doi: 10.1007/s00520-018-4251-9