Counseling helps sex life after prostate cancer

Even a few counseling sessions on sex after prostate cancer can help improve a couple's sex life, at least in the short term, research hints.

Researchers found that among 84 prostate cancer survivors, those who completed four therapy sessions - whether they attended alone or with their partners - reported better sexual functioning 3 months later. Similarly, their wives and partners said their sex lives were more satisfying.

These improvements, however, began to wane 6 months after therapy.

The bottom line, according to the study authors, is that while counseling can help couples rekindle their sexual relationship after prostate cancer, a lingering question is how to make the benefits last.

Dr. Andrea L. Canada and her colleagues at the University of Texas M.D. Anderson Cancer Center in Houston report the findings in the journal Cancer.

Sexual dysfunction is a common side effect of surgery and radiation treatment for prostate cancer. Studies have consistently found that the large majority of men have erectile dysfunction (ED) after treatment, while many may also have a low libido and trouble reaching orgasm.

Medications, like Viagra, can help some patients, but ED caused by prostate cancer treatment does not respond as well to drugs as other forms of ED do, Canada and her colleagues note.

To see whether counseling sessions could help couples improve their sex life, the researchers randomly assigned 84 men and their partners to one of two groups. In one group, men attended counseling alone, while couples in the second group went to sessions together.

Counseling focused on open communication between partners, treatment options for ED and how to enjoy sex despite ED. Both groups received four sessions plus "homework" assignments.

Immediately following treatment and 3 months later, both men and their partners reported improvements in their sex life, regardless of which group they were in. In addition, more men began using ED treatments - more than 50 percent after counseling, versus 31 percent before.

However, the improvements both partners reported in their sex life had begun to wane by the 6-month mark, the study found. Women, in particular, seemed happiest immediately after the counseling sessions ended.

It's possible, the researchers speculate, that over time, couples went back to their "perfunctory" sexual routine, especially as more men received treatment for their erectile problems.

But the success of counseling, according to Canada and her colleagues, depends on men being able to shed their beliefs about the all-importance of the erection and the ability of a "magic pill" to restore their sex life.

"It is not surprising that men and women prefer the magic pill," the researchers write, "but if we can create more realistic expectations, perhaps they will be willing to try interventions that focus less on penile rigidity and more on relationship flexibility."