19 Prostate cancer is a prevalent malignancy in men, and androgen deprivation therapy (ADT) is a cornerstone in the management of advanced disease. Testosterone, the principal androgen, plays a crucial role in male sexual behaviour, and its deprivation can lead to decreased libido as well as other sexual dysfunctions in men with prostate (1) cancer . The management of sexual dysfunction caused by androgen deprivation therapy (ADT) and prostate cancer treatment is a critical aspect of prostate cancer survivorship. Sexual dysfunction is a common adverse effect of prostate cancer treatment, with rates approaching 80-90% in men undergoing antiandrogen therapy for advanced (2) prostate carcinoma . It is essential to provide stateof-the-art review and management strategies for (3) sexual rehabilitation in prostate cancer survivors . The impact of sexual dysfunction extends to the partners of prostate cancer patients, and understanding the spousal communication and relationship factors is crucial for developing interventions to improve the quality of life for both (4) partners . The assessment of sexual function in prostate cancer patients tends to focus largely on erectile function, but it is important to consider other aspects such as interest, desire, satisfaction, arousal, and orgasm, along with the rating of how much of a problem sexual dysfunction presents(5). Men and their partners require individualized help and guidance to manage sexual dysfunction, indicating the need for personalized approaches to (6) address this issue . Additionally, the psychosocial aspects of sexual recovery after prostate cancer treatment, including the impact on couples' relationships, should be considered when (7) developing management strategies . The adverse effects of prostate cancer treatment on sexual function should be taken into consideration in routine clinical practice, and healthcare professionals should be equipped with adequate information and resources to address sexual (8) dysfunction . Sexual health is a multifaceted aspect of well-being that encompasses not only reproductive function but also emotional, psychological, and relational dimensions. The provision of comprehensive healthcare in the management of prostate cancer necessitates the inclusion of sexual health services. Laan et al. proposed a new denition of sex as a ”Sexually pleasurable activity affectionately shared (9) among equals” . International comparative research consistently shows that diverse forms of sexual pleasure improve both individual happiness and overall health, as well as relationship quality, which can contribute to the health and well-being (9) of individuals, couples, families and communities . But once an individual suffers with sexual difculties, the benets of sexual pleasure can be affected in several ways. Sexual dysfunctions are characterised by disturbances in sexual desire, sexual arousal or orgasms and in the psychophysiological changes (10,11) associated with the sexual response cycle . ADT is associated with various sexual dysfunctions that signicantly impact the quality of life of patients. Understanding the different types of sexual dysfunctions caused by ADT is crucial for effective management and support of prostate cancer patients undergoing this treatment Dr Jireh Serfontein – Medical doctor and sexologist MBChB (University of Pretoria, SA) Dip HIV Managment (College of Medicine, SA) MMed Sexual Health (Univ. Sydney) Reframing sexuality for men on androgen deprivation therapy: managing sexual side effects Jireh Serfontein is a medical doctor who has a special interest in sexual health and HIV management. She is a qualied medical doctor and sexologist with over 10 years of experience in the eld of sexual medicine. Dr Serfontein is dedicated to providing the highest standard of medical care, focusing on a holistic approach to sexual health that takes into consideration the physical, mental and emotional health of patients. UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE
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