Sexual dysfunction, a common side effect of prostate cancer treatment, is known to impact quality of life. Treatments like prostatectomy (surgery to remove all or part of the prostate), external beam radiation therapy, brachytherapy (internal radiation) and hormone therapy can all lead to sexual problems, including erectile dysfunction and loss of sexual desire, in a substantial proportion of people with prostate cancer. Previous research has found that physical activity has been linked to improved sexual function in prostate cancer patients.
Freerk Baumann, PhD, of the University of Cologne in Germany, and colleagues conducted a systematic review to assess the impact of exercise on sexual dysfunction in men with prostate cancer. The team surveyed scientific literature across a variety of databases, including the Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Embase, Medline and Web of Science. They included randomized controlled trials that studied the link between sexual function and exercise, alone or in concert with other interventions.
The team analyzed results from 22 randomized controlled trials, published between 2006 and 2021, that enrolled 1,752 people with prostate cancer. These studies included 10 exercise-only intervention trials, four trials of exercise along with supportive therapy and eight trials focused on pelvic floor muscle exercises. Exercise interventions included aerobic, resistance and flexibility exercises, yoga and/or pelvic floor therapy. Supportive therapy included nutritional, psychological and cognitive interventions. A variety of questionnaires were used to assess sexual dysfunction in these trials. Only six of 22 studies considered sexual dysfunction a primary outcome.
Of the 22 trials, nine showed improvements in sexual activity, sexual function, libido, erectile function and/or erection frequency in people with prostate cancer in the intervention group. These included six of the exercise-only trials, one trial of exercise plus supportive therapy and two trials of pelvic floor therapy.
“Preliminary data from a small number of studies suggest that certain exercise interventions may improve sexual dysfunction in prostate cancer patients, however further trials involving sexual dysfunction as a primary outcome and more comprehensive assessment tools are needed to confirm the rehabilitative and preventive effects of exercise on sexual dysfunction in prostate cancer patients,” wrote the researchers.