Androgen Deprivation Therapy in Prostate Cancer: Focusing on Sexual Side Effects

The document reviewed the impact of Androgen Deprivation Therapy (ADT) on sexual side effects in prostate cancer patients, noting that while ADT can improve disease-free and overall survival in certain cases, it is associated with increased cardiovascular problems and a negative impact on sexual health, including reduced libido and erectile, ejaculatory, and orgasmic disorders. It discussed the "saturation hypothesis" and the timing of therapy, suggesting that intermittent ADT may have better tolerability regarding sexual function. The document also examined the role of testosterone in sexual function, indicating that testosterone replacement therapy can moderately improve sexual function in hypogonadal men. It highlighted that ADT is linked to a significant decrease in quality of life due to sexual side effects, and patients should be counseled about these effects and the possibility of intermittent therapy. Additionally, the document reviewed the effects of chemoprevention with 5-alpha-reductase inhibitors on sexual function, concluding that while ADT is essential for advanced prostate cancer, its potential misuse should be avoided, and patients must be informed of all possible side effects.