title: Maintaining intimacy for prostate cancer patients on androgen deprivation therapy.
abstract: OBJECTIVE
  Androgen deprivation therapy (ADT) causes erectile dysfunction and increases patients' emotionality while diminishing their sexual interest. ADT has been linked to erosion of spousal bonds; however, this is not an invariant outcome. Understanding the factors that lead to these various outcomes may help couples deal with ADT.
  
  
  RESULTS
  A subset of couples report that they became closer as a result of the patients going on ADT. Recent data suggest that what helps couples most is preemptive awareness of ADT's side-effects and congruence in how patients and their partners understand and accept the psychosexual impact of ADT. Sex therapy for prostate cancer patients divides along gendered lines, with distinctly 'male' (recovery of erections) and 'female' (promoting sexual practices that are not erection dependent) approaches. Unfortunately, neither is very effective for couples when the patient is on ADT. Options beyond the standard gendered framework, such as use of an external penile prosthesis, may be worth offering to ADT patients trying to find a 'new normal' that is sexually rewarding for them.
  
  
  CONCLUSIONS
  Intimacy is sharing something with someone that one shares with no one else. Exploring novel sexual practices can help couples stay intimate, even when the patient is on ADT.
authors.affiliation: aDepartment of Medical Neuroscience, Dalhousie University, Nova Scotia, Canada bAustralian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wassersug
mesh_terms: D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000139:chemically induced* / Q000523:psychology*; D015444:Exercise; D006801:Humans; D007398:Interpersonal Relations; D007989:Libido; D008297:Male; D054526:Men's Health; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D019529:Sexuality / Q000523:psychology*
chemical_list: D000726:Androgen Antagonists