The unique needs of couples experiencing androgen deprivation therapy for prostate cancer

Androgen deprivation therapy (ADT) is being increasingly used to treat men with prostate cancer. ADT has been associated with many side effects that may persist for the lifetime of the patient and can have potentially devastating effects on the quality of life of both men and their intimate relationships. Despite U.S. estimates that more than 40,000 men begin ADT each year and live on average for 10 years, there have been few studies examining the effect of ADT on couples. This article reviews the emerging literature on the challenges faced by men and their partners while undergoing ADT. Loss of libido, erectile dysfunction, genital shrinkage, low self-esteem, and diminished masculinity are commonly associated with undergoing ADT. These losses frequently lead to changes in the marital relationship in areas such as roles and responsibilities, communication, and intimacy. Intervention strategies for helping couples maintain a strong relational bond need to be selected carefully for this population because of these unique and profound changes. Couples who succeed in maintaining sexuality and intimacy have been shown to have higher quality of life and more satisfying relationships.