Sexual Health Q&A

Does sexual orientation alter sexual recovery following prostate cancer?

It’s possible. Research suggests that general support for men with prostate cancer might not always be appropriate for gay or bisexual men.

Sexual dysfunction after prostate cancer treatment is very common. Some treatments, like hormonal therapy, radiation and surgery, can lead to erectile dysfunction (ED), reduced libido, and orgasm-related problems. It’s not unusual for men to feel anxious and depressed. Some worry about how changes in their sex lives will affect their relationships and their masculine identity.

The situation can be difficult for gay or bisexual men. In 2016, a study in the Journal of Sexual Medicine noted that many materials and resources for men with prostate cancer are targeted to heterosexual men, not gay or bisexual men. The latter group may have different concerns and needs.

The study involved 124 gay or bisexual men and 225 heterosexual men who completed questionnaires about their prostate cancer experience and the impact it had on them sexually, socially, and psychologically.

On average, the gay or bisexual men were younger than the heterosexual men. They also tended to have more casual sex partners and were less likely to be in a long-term relationship.

The researchers determined that the gay or bisexual men had a lower health-related quality of life and more psychological distress compared to the heterosexual men.

The dynamic of sex between men may explain these results to some degree. For example, heterosexual men may still be able to penetrate a woman’s vagina with a weak erection. However, many gay or bisexual men engage in anal sex, which needs a firm erection.

Anal sex roles may change for gay or bisexual men, too. Those who are accustomed to penetrating a partner may need to play the receptive role, which may be less satisfying. They may have trouble explaining their situation to new partners.

Gay or bisexual men with prostate cancer should know that they are not alone. While the study authors called for a more targeted approach, patients should still free to speak up if they feel their needs are not being met.