Sexual dysfunction and spousal communication in couples coping with prostate cancer

Abstract

Objective To characterize the sexual function of both prostate cancer patients and their partners, and to examine whether associations between sexual dysfunction and psychosocial adjustment vary depending on spousal communication patterns. Methods In this cross-sectional study, 116 prostate cancer patients and their partners completed psychosocial questionnaires. Results Patients and partners reported high rates of sexual dysfunction. Within couples, patients’ and their partners’ sexual function was moderately to highly correlated (r = 0.30–0.74). When patients had poor erectile function, their partners were more likely to report that the couple avoided open spousal discussions; this in turn was associated with partners’ marital distress (Sobel's Z = 12.47, p = 0.001). Patients and partners who reported high levels (+1SD) of mutual constructive communication also reported greater marital adjustment, regardless of their own sexual satisfaction. In contrast, greater sexual dissatisfaction was associated with poorer marital adjustment in patients and partners who reported low levels (−1SD) of mutual constructive communication (p<0.05). Conclusion Our findings underscore the need for psychosocial interventions that facilitate healthy spousal communication and address the sexual rehabilitation needs of patients and their partners after prostate cancer treatment. Although some couples may be reluctant to engage in constructive cancer-related discussions about sexual problems, such discussions may help alleviate the negative impact that sexual problems have on prostate cancer patients’ and their partners’ marital adjustment.

The Quality-of-Life Impact of Prostate Cancer Treatments

“…Similar to other studies, Badr and Taylor [29] reported that within couples, patients' and their partners' sexual function and satisfaction were very similar.…”

The Effects of Age, Ethnicity, Sexual Dysfunction, Urinary Incontinence, Masculinity, and Relationship with the Partner on the Quality of Life of Men with Prostate Cancer

“…Studies that have included partners of men with prostate cancer have described their experiences in terms of decreased intimacy, emotional burden similar to that of caregivers, and a change of role. Women reported that they were no longer the lovers in the relationship, and romance was replaced by the resultant stress from the sexual issues (Badr & Carmack Taylor, 2009;Giarelli et al, 2003). Additionally, resultant psychological and physical distress were reported to be major burdens on intimate relationships Couples with prostate cancer reported stressful relationships and distress that were affected by avoidant coping behaviors (Lavery & Clarke, 1999;Wootten et al, 2007).…”

“…For men with prostate cancer, studies have documented that sexual dysfunction resulting from treatment led to emotional distress and distancing between couples . Sexual functioning was found to be related to relationship satisfaction; therefore, men with prostate cancer with resultant sexual dysfunction reported decreased satisfaction with their intimate relationships (Badr & Carmack Taylor, 2009). The contribution of men's perceptions of their relationship dynamics on their QOL is not well understood.…”

“…These couples' relationships are influenced by the responses of men to their sexual dysfunction. Sexual dysfunction as a result of prostate cancer was reported to influence the psychological status of couples and generate feelings of social isolation, emotional distress, anxiety, and depression (Badr & Carmack Taylor, 2009). As a result, the relationships of couples had suffered from decreased intimacy and emotional burden (Badr and Carmack Taylor, 2009;Giarelli et al, 2003).…”

“…Communication between couples was identified as an integral component to the survival of the relationship (Badr & Carmack Taylor, 2009). However, many couples did not have the information or guidance to manage their relationship after prostate cancer (Sanders et al, 2006).…”