Prostate cancer and its treatments can lead to discouraging sexual health changes for both patients and their partners. Radical prostatectomy, a surgical procedure to remove the prostate and some of the surrounding tissue, can lead to erectile dysfunction (ED), altered penile sensation, changes in orgasm, penis 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 group of researchers recently designed and conducted a qualitative study on the unmet sexual needs of female partners of prostate cancer patients. (Further research is underway to examine the sexual needs of gay and bisexual partners).
For this study, 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 publications, four main themes emerged regarding the sexual health needs of female partners of prostate cancer survivors: finding new ways of sexual intimacy, feeling misunderstood when it comes to sexual needs, seeing survival as more important than sex and you are having relationship problems.
Topic 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 years post diagnosis and treatment and have a great sex life. I’d say it’s even better than precancerous. The reason is that we have learned many more ways to be intimate and connected while returning to intercourse.”
Theme 2: Needs for intimacy and sexuality are overlooked
Other partners felt “invisible” or ignored about their sexual needs.
“His idea is that we’re going to be brothers, I guess. I am very sorry for all this and would like to try again for a sex life. It doesn’t look like it’s going to happen as he’s in that frame of mind.”
Topic 3: Survival > Sex
Several female partners viewed sex as relatively unimportant when considered in the context of survival.
“He’s 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 it been proven…to give him/us more time?’
Theme 4: Concerns about relationships
However, many partners expressed sadness and concern about the stress that sexual dysfunction has placed on their relationships.
“I know the past few years have been very stressful for my marriage. My husband does not discuss his feelings… He has recovered from the ED from the surgery and radiation, but it is “not the same” and it is stressing him (which is stressing me)…”
Basic Takeaways
Adjusting to the sexual health changes caused by prostate cancer and its treatments can be very difficult for couples and can put a strain on their relationship. However, help is available.
The researchers noted that despite the large psychosocial impact of prostate cancer and its treatments, psychosocial treatments were rarely mentioned in posts on this forum. This could mean that couples do not seek or receive 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.
Bibliographical references:
Li, R., Wittmann, D., Nelson, CJ, Salter, CA, Mulhall, JP, Byrne, N., Nolasco, TS, Ness, M., Gupta, N., Cassidy, C., Crisostomo-Wynne, T., & Loeb, S. (2022). Unmet sexual health needs of patients and female partners after prostate cancer diagnosis and treatment. The Journal of Sexual Medicine, 19(12), 1797–1803. DOI: