Sexual and relational challenges in men and women affected by prostate cancer: a Project SEXUS study

Abstract

OBJECTIVES: To examine, in a nationally representative Danish study, a comprehensive range of sexual characteristics, dysfunctions and relational challenges among men with prostate cancer (PCa) aged ≥50 years and women married to such men, compared with unaffected men and women. PATIENTS/SUBJECTS AND METHODS: We analysed baseline questionnaire data from the Project SEXUS cohort study (2017-2018) for men aged ≥50 years with (n = 715) or without (n = 13 883) a history of PCa, and women married to such men with (n = 345) or without (n = 8323) a history of PCa. In sex-specific analyses, prevalence estimates were calculated for a broad range of sexual and relational outcomes, and logistic regression analyses yielded confounder-adjusted odds ratios (aORs) with 95% confidence intervals (CIs). RESULTS: Compared with controls without PCa, men with a history of PCa had substantially higher odds of sexual inactivity (aOR 2.03, 95% CI 1.69-2.43), unmet sexual needs (aOR 1.89, 95% CI 1.58-2.28), poorer self-rated sex life (aOR 1.82, 95% CI 1.46-2.28), and sexual dysfunctions, with particularly elevated odds of erectile (aOR 5.74, 95% CI 4.25-7.74), orgasmic (aOR 3.20, 95% CI 2.09-4.89), and genital pain (aOR 3.07, 95% CI 1.02-9.25) dysfunctions. Among women, sexual needs did not differ between the two groups. However, women married to men with PCa were more likely to report sexual inactivity (aOR 1.85, 95% CI 1.42-2.39), unmet sexual needs (aOR 1.77, 95% CI 1.34-2.34), and poorer marriage quality (aOR 2.84, 95% CI 1.33-6.08). CONCLUSION: Men with PCa and women married to such men report a substantially increased burden of sexual and relational challenges, underscoring the need for survivorship care that supports sexual well-being in both patients and their intimate partners.