Sexual activity in men undergoing ADT for localized prostate cancer: a narrative literature review.

Laeticia CREIDY; Daniel TAUSSKY; Frederic POULIOT; Fred SAAD; Fabian FALKENBACH

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Sexual activity in men undergoing ADT for localized prostate cancer: a narrative literature review.

Author: Laeticia CREIDY ¹ ; Daniel TAUSSKY ¹ ; Frederic POULIOT ² ; Fred SAAD ³ ; Fabian FALKENBACH ⁴
Author Information

1. Department of Radiation Oncology, Montreal University Hospital Centre, Montréal H2X 0C1, Canada.
2. Department of Surgery, Faculty of Medicine, Laval University, Quebec QC G1V, Canada.
3. Division of Urology, Department of Surgery, Montreal University Hospital Centre, Montréal H2X 0C1, Canada.
4. Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg 20251, Germany.
Publication Type:Review
Keywords: androgen deprivation therapy; erectile function; prostate cancer; quality of life; sexual function
MeSH: Humans; Male; Prostatic Neoplasms/drug therapy*; Androgen Antagonists/therapeutic use*; Sexual Behavior/drug effects*; Quality of Life; Aged
From: Asian Journal of Andrology 2025;27(5):581-585
CountryChina
Language:English
Abstract: Androgen deprivation therapy (ADT) can negatively affect sexual function, and only a minority of patients report sexual activity. We reviewed the existing literature regarding the proportion of men who remained sexually active during and after ADT. The PubMed database was searched for studies published over the past 20 years. We selected and reviewed randomized clinical trials that provided sexual function data at baseline and during and after ADT. The primary outcome measure was the sexual function. Studies assessed sexual function using quality of life patient-reported outcome measures, which included sexual potency/activity evaluation. Information from 2947 patients was analyzed in this review. The median age of patients was 70 years. At baseline, a median of 49.9% (95% confidence interval [CI]: 49.1%-50.7%) of the patients reported being sexually active. At 6 months, 12 months, and 2 years or later of ADT treatment, a median of 10.3% (95% CI: 10.2%-10.5%), 8.9% (95% CI: 8.6%-9.2%), and 8.3% (95% CI: 8.2%-8.5%) of the patients reported being sexually active, respectively. Considering that half of the patients were sexually active at baseline, it seems probable that more than 10% of the patients who were sexually active before starting ADT remained sexually active when undergoing ADT. In conclusion, despite the common belief that ADT eliminates sexual activity, this analysis found that approximately 1 in 10 men are sexually active when on ADT, and this proportion is likely increased in men who are sexually active before starting ADT. Attention to sexual activity should not be dismissed in men on ADT.