One of the most challenging side effects of androgen deprivation therapy for both prostate cancer patients and their sexual partners is depression of the male sex drive. It is not uncommon to see postings on prostate cancer chat lists from disgruntled patients on ADT about the death of their sex life. Clinicians may similarly tell patients that ADT will be the end of their sex life.
But is that absolutely true?
Erik Wibowo, who is a member of our core ADT Educational Program team, has just published a marvellously comprehensive review that explores the topic of male sexual activity following androgen deprivation. Along with colleagues in Australia and New Zealand, Dr. Wibowo reviews a wealth of factors that affect sexual performance and interest in not just humans but other species. They review everything from the hormonal influences on brain centres that control sex drive to the use of sex toys.
ADT indeed suppresses libido, but this review shows that a complete loss of sexual interest and performance is not absolutely guaranteed, and various factors can help sustain some level of sexual activity for patients on ADT. These factors are numerous and include the overall health of the patient, his age, his relationship with his partner before ADT, and the willingness of the couple to explore novel sexual practices and aids. All of this is reviewed in detail in the paper.
To be clear, ADT does substantially depress sex drive. However, it does not absolutely guarantee the end of sexual intimacy for a patient and a partner willing to explore alternatives. Couples who are interested in retaining some level of sexual intimacy while on ADT can access the paper here: https://www.sciencedirect.com/science/article/pii/S1040842820302006
Duthie, C.J., Calich, H.J., Rapsey, C.M., & Wibowo, E. (2020). Maintenance of sexual activity following androgen deprivation in males. Critical Reviews in Oncology/Hematology, 153. Epub ahead of print.