Prostate cancer affects gay and bisexual (GB) men in different ways than their heterosexual counterparts, according to a new study in the Journal of Sexual Medicine.
Clinicians should consider these differences when treating GB men and align their treatment approach accordingly, the authors said.
Most men experience sexual dysfunction after prostate cancer treatment. Erectile dysfunction, low sex drive, and weaker orgasms are common. As a result, many men also develop anxiety, depression, and relationship issues. Some men start to feel that their masculinity has been diminished.
GB men make up an estimated 3% to 5% of prostate cancer survivors, the study reported. However, support targeted to this population is not always available.
To learn more, researchers from Australia and the United States used a number of validated assessment tools to evaluate the prostate cancer experiences of 124 GB men and 225 heterosexual men. These tools provided insight on the men’s health-related quality of life, psychological distress, sexual function, partner communication, sexual confidence, and self-esteem.
The GB men (mean age 64 years) were generally younger than the heterosexual men (72 years). They were also less likely to have a partner and more likely to have casual sex partners. Those who did have partners were less likely to have been in a relationship for over two years.
After comparing the results of the two groups, the researchers found that GB men had lower health-related quality of life, lower masculine self-esteem, and more psychological distress than the heterosexual men.
The authors noted that changes in sexual function impact GB and heterosexual men differently. Using erectile function as an example, they explained that heterosexual men may still be able to have penetrative vaginal intercourse with a partial erection. However, anal intercourse, common among GB men, requires a rigid erection.
Also, GB men may need to change their sexual role, as receptive anal sex may become less enjoyable or uncomfortable. Such a change may affect their sexual identity and be a challenge to manage with new or casual sex partners.
Changes like these may deepen the psychological distress felt by GB men, the authors wrote.
The authors called for “targeted support services” for GB men, adding that “general health service providers need to be sensitive to the needs and concerns of GB men. This includes awareness and inclusion of GB relational support, attention to GB-specific sexual concerns and identity issues after [prostate cancer], and avoidance of heterocentric language in consultations.”
The Journal of Sexual Medicine
Ussher, Jane M., et al.
“Health-Related Quality of Life, Psychological Distress, and Sexual Changes Following Prostate Cancer: A Comparison of Gay and Bisexual Men With Heterosexual Men”
(Full-text. March 2016)