Sexual health and treatment-related sexual dysfunction in sexual and gender minorities with prostate cancer

Nat Rev Urol. 2023 Jun;20(6):332-355. doi: 10.1038/s41585-023-00778-3. Epub 2023 May 22.

Abstract

Prostate cancer treatment has substantial effects on sexual health and function. Sexual function is a vital aspect of human health and a critical component of cancer survivorship, and understanding the potential effects of different treatment modalities on sexual health is crucial. Existing research has extensively described the effects of treatment on male erectile tissues necessary for heterosexual intercourse; however, evidence regarding their effects on sexual health and function in sexual and gender minority populations is minimal. These groups include sexual minority - gay and bisexual - men, and transgender women or trans feminine people in general. Such unique effects in these groups might include altered sexual function in relation to receptive anal and neovaginal intercourse and changes to patients' role-in-sex. Sexual dysfunctions following prostate cancer treatment affecting quality of life in sexual minority men include climacturia, anejaculation, decreased penile length, erectile dysfunction, and problematic receptive anal intercourse, including anodyspareunia and altered pleasurable sensation. Notably, clinical trials investigating sexual outcomes after prostate cancer treatment do not collect sexual orientation and gender identity demographic data or outcomes specific to members of these populations, which perpetuates the uncertainty regarding optimal management. Providing clinicians with a solid evidence base is essential to communicate recommendations and tailor interventions for sexual and gender minority patients with prostate cancer.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Gender Identity
  • Humans
  • Male
  • Prostatic Neoplasms* / therapy
  • Quality of Life
  • Sexual Behavior
  • Sexual Dysfunction, Physiological* / etiology
  • Sexual Dysfunction, Physiological* / therapy
  • Sexual Health*
  • Sexual and Gender Minorities*