Prostate cancer and its treatments can result in discouraging sexual health changes for both patients and their partners. Radical prostatectomy, a surgery to remove the prostate and some of the surrounding tissues, can result in erectile dysfunction (ED), altered penile sensation, changes in orgasm, penile shortening, and possible incontinence during sexual activity.
While some steps have been taken to study and address these changes in sexual health for prostate cancer patients, the needs of their sexual partners are not always considered. Therefore, a team of researchers recently designed and carried out a qualitative study on the unmet sexual needs of female partners of prostate cancer patients. (Further research is underway to look at the sexual needs of gay and bisexual partners).
For this study, the researchers used the Inspire Us TOO Prostate Cancer Online Support and Discussion Community, an online support community for prostate cancer patients, families, and caregivers.
In the discussion forum, they identified 661 posts about sexual health from female sexual partners. They then randomly selected 10% of these posts for a total of 66 posts. After a thorough qualitative analysis of these posts, four main themes emerged regarding the sexual health needs of female partners of prostate cancer survivors: finding new ways to be sexually intimate, feeling overlooked when it comes to sexual needs, viewing survival as more important than sex, and experiencing relationship issues.
Theme 1: Expanding the Sexual Repertoire
Many of the female partners in this discussion forum highlighted how they have found new ways to enjoy intimacy with their partners after prostate cancer.
“We are now 4 y post diagnosis and treatment, and we have a great sex life. I would say it is even better than pre cancer. The reason being we learned many more ways to be intimate and connected while working our way back to intercourse.”
Theme 2: Needs for Intimacy and Sexuality Overlooked
Other partners felt “invisible” or overlooked regarding their sexual needs.
“His idea is that we will be brother and sister, I guess. Extremely saddened by all this and would like to try for a sex life of some kind again. Does not look like it will happen as he is set in this mind set.”
Theme 3: Survival > Sex
Several female partners regarded sex as relatively unimportant when viewed in the context of survival.
“He is not just my husband of 14 years, but my best friend, so who am I to worry about sex when ADT [androgen deprivation therapy] has been proven…to give him/us more time?”
Theme 4: Relationship Concerns
Nonetheless, many partners expressed sadness and concern about the stress that sexual dysfunction has put on their relationships.
“I know the last few years have been very stressful for my marriage. My husband doesn't discuss his feelings…He recovered from the ED from the surgery and the radiation, but ‘it isn't the same’ and it stresses him out (which stresses me out)…”
Adjusting to the sexual health changes brought on by prostate cancer and its treatments can be very difficult for couples and can put a strain on their relationship. Nevertheless, there is help.
The researchers noted that despite the major psychosocial impacts of prostate cancer and its treatments, psychosocial treatments were rarely mentioned in the posts in this forum. This could mean that couples are not seeking or receiving treatment such as sex therapy, counseling, or other psychosocial support that could help them adjust to these significant changes.
Prostate cancer patients and their partners are not alone in their struggles and should feel empowered to seek support from sexual medicine specialists and mental health professionals.
Li, R., Wittmann, D., Nelson, C.J., Salter, C.A., Mulhall, J.P., Byrne, N., Nolasco, T.S., Ness, M., Gupta, N., Cassidy, C., Crisostomo-Wynne, T., & Loeb, S. (2022). Unmet Sexual Health Needs of Patients and Female Partners Following Diagnosis and Treatment for Prostate Cancer. The journal of sexual medicine, 19(12), 1797–1803. DOI: https://doi.org/10.1016/j.jsxm.2022.08.195