Differences in perception of sexual side effects from treatment of prostate cancer by sexual orientation

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Previous work has shown that men who have sex with men (MSM) with prostate cancer (PCa) are less likely to be satisfied with PCa care compared to heterosexual men (HSM). PCa treatment can lead specifically to sexual side effects. While the impact of these side effects has been studied extensively in HSM, data on how MSM perceive sexual side effects associated with PCa treatment is lacking. Our objective was to determine if differences exist in how PCa treatments are perceived by MSM and HSM.


618 men (285 MSM, 333 HSM) between 50-89 years old from across the US were administered a self-reported online survey regarding perceptions of the sexual side effects associated with PCa treatment. Continuous variables were analyzed with a t-test, and a chi-square test was utilized for categorical variables.


The two cohorts were well matched with regard to demographics, including age, race, and education. MSM placed greater importance than HSM on having ejaculate with climax (41.6% vs 25.85%, p<.0001 and="" preservation="" of="" penile="" length="" vs.="" p=".0005)." msm="" felt="" more="" strongly="" about="" erections="" being="" a="" part="" their="" sense="" masculinity="" vs="" were="" likely="" to="" be="" bothered="" by="" erectile="" dysfunction="" there="" was="" no="" difference="" in="" the="" perceived="" bother="" climacturia="" between="" two="" groups.="" terms="" sexual="" relationships="" than="" hsm="" that="" not="" monogamous="" had="" greater="" number="" partners="" preceding="" year="" or="" sexually="" active="">


MSM are more likely to than HSM to feel bothered by erectile dysfunction, ejaculatory dysfunction and loss of penile length, all of which can be affected with prostate cancer treatment. MSM are less likely to be in monogamous relationships, are more likely to have a greater number of sexual partners, and are more likely to be sexually active. Knowledge gaps in expectations and relationship status in MSM are not well elucidated and may play an important part in helping MSM with prostate cancer maintain sexual satisfaction.


Funding: None