Prostate Cancer: the Effects of Androgen Deprivation Therapy on Intimate Relationships

Intimate relationships with partners may decline when men with prostate cancer start androgen deprivation therapy (ADT).

But there is hope, according to a recent study published by Supportive Care for Cancer.

Androgens, such as testosterone, are male hormones. They give men their masculine traits and fuel their sex drive.

Unfortunately, androgens can also fuel prostate cancer cells. Scientists have found that reducing a man’s androgen levels might shrink tumors and slow down cancer cells’ growth. Androgen deprivation therapy (sometimes called hormone therapy or androgen suppression therapy) – lowering androgen amounts – may be used with other treatments like surgery and radiation.

Sometimes, ADT is done surgically by removing the testes. ADT may also be administered through medications that either lower androgen levels or stop androgens from working.

ADT does have side effects, including sexual ones. Men may find themselves less interested in sex. Some develop erectile dysfunction (ED). Other side effects, like fatigue and depression, can put strain on sexual relationships, too.

In the study, researchers worked with 72 prostate cancer patients and their partners. As the study began, the patients were just about to start ADT. At this time, the couples completed questionnaires on their quality of life, sexual relationships, and mood. They filled out the questionnaires again at 3- and 6-month follow-up points.

After 3 months, couples were experiencing more sexual bother. At the 6-month mark, couples had seen declines in sexual function and relational intimacy. The researchers reported no major mood changes.

The couples also had sex less often as time progressed. At the start of the study, 38% of the couples were sexually active, but this figure dropped to 15% after 3 months. After 6 months, only 7% of the couples were sexually active.

While the results sound discouraging, there are bright spots. Couples rated their emotional intimacy higher when the partners understood how the patients were feeling. And they reported better sexual intimacy when they were more sexually active.

What does this mean for men embarking on cancer treatment now? Couples can work together to keep their relationships strong.

Communicate. Some men become distant or are reluctant to share their feelings. Opening up to a partner can release anxiety and fears.
Stay intimate. Couples may need to adjust their sexual activities or try different positions to see what works best for them.
 Consider sex therapy or counseling. Cancer can be physically and emotionally overwhelming. Some couples struggle to face it as a team. A specialist can help them cope.

Resources

American Cancer Society

“Hormone Therapy for Prostate Cancer”

(Last revised: July 18, 2018)

https://www.cancer.org/cancer/prostate-cancer/treating/hormone-therapy.html

“Sex and the Man with Cancer”

(Last revised: August 19, 2013)

https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-men-with-cancer.html

Oncology Nurse Advisor

Nam, James, PharmD

“ADT Affects Sexual Function, Intimacy in Early Prostate Cancer Treatment”

(May 24, 2018)

https://www.oncologynurseadvisor.com/prostate-cancer/adt-affects-sexual-function-intimacy-in-early-pca-treatment/article/768369/

Supportive Care in Cancer

Walker, Lauren M., et al.

“Mood, sexuality, and relational intimacy after starting androgen deprivation therapy: implications for couples”

(Abstract. First published online: May 18, 2018)

https://link.springer.com/article/10.1007%2Fs00520-018-4251-9

You Might Also Enjoy...

Why Can't I Have an Orgasm?

Everyone deserves a satisfying sex life. And if you can’t orgasm, sexual activity can be frustrating and embarrassing. Instead of suffering in silence, it’s time to learn more about sexual dysfunction and the treatment options to fix it.

What Can I Do About My Impotence?

Struggling to perform in the bedroom is embarrassing. But if you have problems getting or maintaining an erection, you’re not alone. Millions of men suffer from impotence — and treatment can help. Learn what your treatment options are here.

Understanding Male Menopause

Menopause is a process that every woman experiences with age, but did you know hormonal imbalance (and its symptoms) aren’t just a women’s health issue? Male menopause is triggered by low testosterone, and it can impact your life in a number of ways.

How the O-Shot® Can Improve Your Sex Life

Low sex drive. Painful intercourse. Inability to orgasm. Sound familiar? You could be suffering from sexual dysfunction. It’s a real condition, and it’s treatable. Find out how the O-Shot® — a platelet-rich plasma therapy — could help you.

My Hormones Are Out of Balance

Hormones are important chemical messengers in your body. When they’re out of balance, you could experience a range of unpleasant symptoms. Learn the signs of hormone imbalance and what you can do to relieve your symptoms.

Help! I'm Struggling With Low Libido

Low libido can make you feel embarrassed, frustrated, and angry. It’s a common problem, but you don’t have to accept it. Learn more about sexual dysfunction, what causes it, and how you can treat it to revitalize your sex life.