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Men who are taking anti-androgens for prostate cancer don’t necessarily have to say goodbye to sex. Australian sports scientists at Edith Cowan University come to this conclusion in a human study published in Prostate Cancer and Prostatic Diseases. If men on anti-androgens also do strength training, their sex life can continue as normal.

Men who are taking anti-androgens for prostate cancer don’t necessarily have to say goodbye to sex. Australian sports scientists at Edith Cowan University come to this conclusion in a human study published in Prostate Cancer and Prostatic Diseases. If men on anti-androgens also do strength training, their sex life can continue as normal.

One in every six men will at some point hear from his doctor that he has prostate cancer. After this news many will start treatment with anti-androgens. These deactivate testosterone, thus inhibiting the growth of androgen-sensitive forms of prostate cancer.

Many men with this form of prostate cancer live for many more years, but they pay a price. Their muscle mass decreases and their fat mass increases. In a recent study, in which researchers followed prostate cancer patients who were taking anti-androgens for 33 months, the men lost 1.3 kg lean body mass and their fat mass increased by 2.3 kg. [Prostate Cancer Prostatic Dis. 2013 Mar;16(1):67-72.] Other developments include feminisation of the body, and breasts may also start to form. Bones become weaker; libido declines, as does the ability of the penis to have an erection.

The study that sports scientist Prue Cormie published in Prostate Cancer and Prostatic Diseases is interesting for these reasons. Cormie investigated whether a training programme could reduce the effects of anti-androgens on sexuality.

Cormie works at Edith Cowan University, where researchers are studying whether training programmes can help to reduce the side effects of anti-androgens. [Prostate Cancer Prostatic Dis. 2007;10(4):340-6.] One of the findings the researchers recently came up with is that a combination of strength and cardio training can help maintain muscle mass in men with prostate cancer [J Clin Oncol. 2010 Jan 10;28(2):340-7.] – even if the cancer has already spread to the bones. [Prostate Cancer Prostatic Dis. 2013 Dec;16(4):328-35.]

Some doctors are worried that strength training increases testosterone production, and as a result undermines anti-androgen therapy. The Australians discovered that this is not the case. [Prostate Cancer Prostatic Dis. 2008;11(2):160-5.]

Cormie studied a group of 57 men with prostate cancer who were just starting anti-androgen therapy. Of these 29 started training [Exercise] and the other 28 did not, forming the control group [Control].

Cormie got her subjects to train twice a week for an hour in a gym. Each workout started with a 5-minute warming up and finished with a 10-minute cool down, during which the men did low-intensity cardio training and stretches. The strength part of the workout consisted of eight exercises for the most important muscle groups. The men used weights with which they could manage 8-12 reps.

The researchers also encouraged the men in the Exercise group to walk or do exercises at home for 30 minutes on each non-training day.

In the 12 weeks that the experiment lasted, the libido and sexual activity of the men in the group that trained increased – despite the anti-androgen treatment. The effects were not statistically significant, however. The sexual interest of the men in the control group declined, but again the effects were not significant.

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When the researchers specifically asked about the presence of strong sexual interest and sexual intercourse, they did find a significant effect. The number of men with a high libido went down to zero in the Control group; in the Exercise group the number remained stable.

Moreover, the men in the Control group had sex less often, and the men in the Exercise group had sex more often. These effects were not statistically significant either.

According to a review article that Cormie has published in Nature Reviews – Urology [Nat Rev Urol. 2013 Dec;10(12):731-6.], training improves sexual capabilities largely because it helps men regain a feeling of manliness. What’s more, strength training reduces fatigue and improves cardiovascular condition.

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“Participation in a short-term exercise program resulted in the maintenance of sexual activity in prostate cancer patients undergoing androgen-suppression therapy”, the researchers conclude.

Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: a randomized controlled trial.

Cormie P, Newton RU, Taaffe DR, Spry N, Joseph D, Akhlil Hamid M, Galvão DA.

Abstract

BACKGROUND:

Previous research has shown exercise to be an effective method to mitigate many adverse treatment-related effects of androgen suppression therapy (AST) but the potential impact of exercise on sexual activity remains unknown. The purpose of this investigation was to report the effect of a 12-week exercise program on sexual activity in prostate cancer patients undergoing AST.

METHODS:

Fifty-seven prostate cancer patients undergoing AST were randomly assigned to an exercise program (resistance and aerobic modes; n=29) or usual care control (n=28). Sexual activity was assessed by the European Organization for Research and Treatment of Cancer prostate cancer-specific quality of life questionnaire (QLQ-PR25).
RESULTS:

QLQ-PR25 data were log transformed and analysis of covariance was used to compare sexual activity between groups following the intervention adjusted for baseline activity. No differences in sexual activity were observed between the exercise and control groups before the intervention. There was a significant (P=0.045) adjusted group difference in sexual activity following the 12-week intervention. Patients undergoing usual care decreased sexual activity while patients in the exercise program maintained their level of sexual activity. At baseline, 20.6 and 22.2% of participants in the exercise and control groups reported a major interest in sex (that is, high libido). Following the intervention, the exercise group had a significantly higher percentage of participants reporting a major interest in sex (exercise=17.2% vs control=0%; P=0.024).
CONCLUSIONS:

Participation in a short-term exercise program resulted in the maintenance of sexual activity in prostate cancer patients undergoing AST.

PMID: 23318529 [PubMed - indexed for MEDLINE]

Source: http://www.ncbi.nlm.nih.gov/pubmed/23318529

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