Sexual and relational challenges in men and women affected by prostate cancer: a Project SEXUS study

Objectives To examine, in a nationally representative Danish study, a comprehensive range of sexual characteristics, dysfunctions and relational challenges among men with prostate cancer (PCa) aged ≥50 years and women married to such men, compared with unaffected men and women. Patients/Subjects and Methods We analysed baseline questionnaire data from the Project SEXUS cohort study (2017–2018) for men aged ≥50 years with ( n  = 715) or without ( n  = 13 883) a history of PCa, and women married to such men with ( n  = 345) or without ( n  = 8323) a history of PCa. In sex‐specific analyses, prevalence estimates were calculated for a broad range of sexual and relational outcomes, and logistic regression analyses yielded confounder‐adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results Compared with controls without PCa, men with a history of PCa had substantially higher odds of sexual inactivity (aOR 2.03, 95% CI 1.69–2.43), unmet sexual needs (aOR 1.89, 95% CI 1.58–2.28), poorer self‐rated sex life (aOR 1.82, 95% CI 1.46–2.28), and sexual dysfunctions, with particularly elevated odds of erectile (aOR 5.74, 95% CI 4.25–7.74), orgasmic (aOR 3.20, 95% CI 2.09–4.89), and genital pain (aOR 3.07, 95% CI 1.02–9.25) dysfunctions. Among women, sexual needs did not differ between the two groups. However, women married to men with PCa were more likely to report sexual inactivity (aOR 1.85, 95% CI 1.42–2.39), unmet sexual needs (aOR 1.77, 95% CI 1.34–2.34), and poorer marriage quality (aOR 2.84, 95% CI 1.33–6.08). Conclusion Men with PCa and women married to such men report a substantially increased burden of sexual and relational challenges, underscoring the need for survivorship care that supports sexual well‐being in both patients and their intimate partners.