22 as vibrators, masturbatory aids or penetrative aids to induce orgasm. Referral to a sexual therapist can also aid in experimentation with other sources of stimulation (i.e., new breast sensitivity, perineal or perianal stimulation). Men should also be instructed that prolonged stimulation will be required to achieve orgasm with a accid penis, and that the use of a lubricant can help protect the skin from potential irritation. Sensate focus therapy This behavioural therapy involves gradual and structured exercises to enhance sensory awareness and improve sexual response. Sensate focus therapy can be benecial in addressing orgasmic dysfunction in men undergoing ADT Medication Adjustments In some cases, adjusting the dosage or type of ADT medication may help alleviate orgasmic (15) dysfunction and other sexual side effects . Consulting with a healthcare provider to explore alternative treatment options is essential. 4. Sexual Aversion Some men on ADT may develop aversion to sexual activity due to the physical and psychological changes associated with the treatment. The impact of ADT on sexual function, body image, and emotional well-being can contribute to sexual aversion, leading to avoidance of intimate relationships and sexual encounters. Couples Therapy In cases where sexual aversion is impacting intimate relationships, couples therapy can be benecial. Addressing communication barriers, emotional concerns, and relationship dynamics can help improve sexual intimacy and reduce aversion. Mindfulness and Relaxation Techniques Incorporating mindfulness practices and relaxation techniques can help reduce anxiety and stress related to sexual activity, promoting a more positive and relaxed approach to intimacy. By tailoring treatment strategies to address specic sexual dysfunctions induced by ADT, healthcare providers can optimize the management of these challenges and improve the sexual health and overall well-being of prostate cancer patients undergoing this treatment. Conclusion Reframing sexuality after prostate cancer constitutes a multifaceted process whereby individuals confront and adapt to the physical, emotional, and relational impacts of cancer treatment on their sexual well-being. This endeavour necessitates a comprehensive understanding of the nuanced changes in sexual function, intimate dynamics, and self-perception that ensue following prostate cancer diagnosis and treatment interventions. Central to this reframing process is the recognition of the diverse array of challenges and adjustments individuals may encounter, ranging from alterations in erectile function and libido to shifts in body image and selfesteem. In navigating this terrain, individuals are confronted with the task of redening their sexual identities and renegotiating their intimate relationships within the context of their altered bodily capabilities and experiences. This often entails a process of introspection and self-discovery, wherein individuals grapple with the psychological and emotional ramications of sexual dysfunction and bodily changes, including feelings of loss, grief, and inadequacy. Moreover, it necessitates the cultivation of open and honest communication with both healthcare providers and partners to facilitate mutual understanding, support, and collaboration in addressing sexual concerns and optimizing sexual well-being. In conclusion, addressing sexual dysfunctions associated with ADT in men with prostate cancer requires a comprehensive approach that considers both the physiological and psychological aspects of sexual health. The management of the sexual dysfunctions caused by prostate cancer treatment is a multifaceted issue that requires strategies to address the impact on the quality of life of survivors. By integrating information about sexual side effects into routine care and by implementing a multidisciplinary management strategy that includes exercise, diet, psychosocial interventions, and targeted therapies, providers can enhance the quality of life and well-being of men undergoing ADT for prostate cancer. References 1. Donovan KA, Walker LM, Wassersug RJ, A. Thompson LM, Robinson JW. Psychological Effects of Androgen?deprivation Therapy on Men With Prostate Cancer and Their Partners. Cancer. 2015; 2. Schover LR, Fouladi RT, Warneke CL, Neese L, Klein EA, Zippe CD, et al. Dening Sexual Outcomes After Treatment for Localized Prostate Carcinoma. Cancer. 2002; 3. Chung E, Brock G. Sexual Rehabilitation and Cancer Survivorship: A State of Art Review of Current Literature and Management Strategies in Male Sexual Dysfunction Among Prostate Cancer Survivors. J Sex Med. 2013; 4. Badr H, Carmack Taylor CL. Sexual Dysfunction and Spousal Communication in Couples Coping With Prostate Cancer. Psychooncology. 2008; 5. Bokhour BG, Clark JA, Inui TS, Silliman RA, Talcott JA. Sexuality After Treatment for Early Prostate Cancer. Exploring the Meanings of “Erectile Dysfunction.” J Gen Intern Med. 2001; 6. Albaugh J, Sufrin N, Lapin B, Petkewicz J, Tenfelde S. Life After Prostate Cancer Treatment: A Mixed Methods Study of the Experiences of Men With Sexual Dysfunction and Their Partners. BMC Urol. 2017; 7. Wittmann D, Northouse L, Foley S, Gilbert SM, Wood DP, Balon R, et al. The Psychosocial Aspects of Sexual Recovery After Prostate Cancer Treatment. Int J Impot Res. 2009; 8. Grondhuis Palacios LA, Hendriks N, den Ouden MEM, UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE
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