Sexual health and treatment-related sexual dysfunction in sexual and gender minorities with prostate cancer.
Daniel R DicksteinCollin R EdwardsEric J LehrerElizabeth S TarrasMatthew GallittoJohn SfakianosMatthew D GalskyRichard StockJoshua D SaferB R Simon RosserDeborah C MarshallPublished in: Nature reviews. Urology (2023)
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.
Keyphrases
- prostate cancer
- mental health
- men who have sex with men
- clinical trial
- human health
- radical prostatectomy
- end stage renal disease
- risk assessment
- chronic kidney disease
- hiv testing
- physical activity
- gene expression
- ejection fraction
- multidrug resistant
- randomized controlled trial
- palliative care
- combination therapy
- pregnant women
- young adults
- peritoneal dialysis
- clinical practice
- weight loss
- prognostic factors
- machine learning
- replacement therapy