The results of a written questionnaire with 44 patients (pilot study) indicated that before the beginning of treatment for advanced prostatic cancer, most subjects had an active sexual life, as illustrated by a normal erotic imagery, an adequate sexual desire and a normal frequency of intercourse. More than three-quarters (80%) of subjects had at least one coitus a week. Slightly more than 50% were able to easily achieve an erection by erotic imagery or by a preferred sexual fantasy; 50% never experienced erectile problems. When compared with their previous sexual functioning, 70% of subjects noticed during the antiandrogenic treatment a major reduction in their interest for sexual intercourse which was maintained in only 18% of patients. It became impossible for 57% to induce an erection by erotic imagery. However, 19% claimed an ability to maintain an erection during sexual activity, as compared to 56% before treatment, but erections usually lacked full rigidity. Twenty-two percent of patients mentioned having nocturnal or morning erections. Despite this dramatic decrease in sexual activity in most patients, complete antiandrogen blockade left sexual activity in approximately 20% of patients. Due to the treatment's excellent tolerance, the findings suggest that such combined androgen blockade could be beneficial for the treatment of sex offenders.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Bancroft, J., Terment, T. G., Lancas, K., and Cass, J. (1974). The control of deviant sexual behavior by drugs: behavioral changes following oestrogenes and anti-androgens.British J. Psychiat. 125: 310–315.
Bancroft, J., and Wu, F. C. W. (1983). Changes in erectile responsiveness during androgen replacement therapy.Arch. Sex. Behav. 12: 1: 59–66.
Bartsch, W., and Voigt, K. D. (1984). Endocrine aspects of aging in the male.Maturitas 6: 243–251.
Berlin, F. S., and Meinecke, C. F. (1981). Treatment of sex offenders with antiandrogenic medication: Conceptualization, review of treatment modalities and preliminary findings.Am. J. Psychiat. 138: 601–607.
Cooper, A. J., Ismail, A. A., Phanjoo, A. L., and Love, D. G. (1972). Antiandrogen (cyproterone acetate) therapy in deviant hypersexuality.Brit. J. Psychiat. 120: 59–63.
Davidson, J. M., Chen, J. J., Crapo, L., Gray, G. D., Greenleaf, W. J., and Catania, J. A. (1983). Hormonal changes and sexual function n aging men.J. Clin. Endocrinol. Metab. 57: 1: 71–77.
Gagné, P. (1981). Treatment of sex offenders with medroxyprogesterone acetate.Am. J. Psychiat. 138: 644–646.
Heim, N., and Hursch, C. J. (1979). Castration for sex offenders: Treatment or punishment A review and critique of recent European literature.Arch. Sex. Behav. 8: 281–304.
Huggins, C., and Hodges, W. (1941). Studies of prostatic cancer. I. Effect of castration, estrogens and androgen injections on serum phosphatases in metastatic carcinoma of the prostate.Cancer Res. 1: 293–295.
Huggins, C., Stevens, R. E., and Hodges, C. W. (1941). Studies on prostatic carcinoma. II. The effect of castration on advanced carcinoma of the prostate gland.Arch. Surg. 43: 209–211.
Labrie, F., Bélanger, A., Cusan, L., Séguin, C., Pelletier, G., Kelly, P. A., Lefebvre, F. A., Lemay, A., and Raynaud, J. P. (1980). Antifertility effects of LHRH agonists in the male.J. Androl. 1: 209–228.
Labrie, F., Dupont, A., Bélanger, A., Cusan, L., Lacourcière, Y., Monfette, G., Laberge, J. G., Emond, J. P., Fazekas, A. T. A., Raynaud, J. P., and Husson, J. M. (1982). New hormonal therapy in prostatic carcinoma: Combined treatment with an LHRH agonist and an antiandrogen.Clin. Invest. Med. 5: 267–275.
Labrie, F., Dupont, A., Bélanger, A., Lacoursière, Y., Raynaud, J. P., Husson, J. M., Gareau, J., Fazekas, A. T. A., Sandow, J. Monfette, G., Girard, J. G., Emond, J., & Houle, J. G. (1983). New approach in the treatment of prostate cancer: complete instead of only partial withdrawal of androgens.The Prostate 4: 579–594.
Labrie, F., Bélanger, A., Dupont, A., Emond, J., Lacourcière, Y., and Monfette, G. (1984). Combined treatment with an LHRH agonist and a pure antiandrogen in advanced carcinoma of the prostate.Lancet, p. 1090.
Labrie, F., Dupont, A., and Bélanger, A. (1985a). Complete androgen blockade for the treatment of prostate cancer. In De Vita, V. T., Hellman, S., and Rosenberg, S. A. (eds.),Important Advances in Oncology J.B. Lippincott, New York, pp. 193–217.
Labrie, F., Dupont, A., Bélanger, A., Lachance, R., and Giguère, M. (1985b). Long-term treatment with luteinizing hormone releasing hormone agonists and maintenance of serum testosterone to castration concentrations.Brit. Med. J. 291: 369–370.
Labrie, F., Dupont, A., Bélanger, A., St-Arnaud, R., Giguère, M., Lacourcière, Y., Emond, J., and Monfette, G. (1986). Treatment of prostate cancer with gonadotropin-releasing hormone agonists.Endocrinol. Rev. 7: 67–74.
Martin, C. E. (1981). Factors affecting sexual functioning in 60–79 year-old married males.Arch. Sex. Beh. 10: 5: 399–420.
Murphy, G. P., and Slack, N. H. (1980). The questionable use of hormone therapy in advanced carcinoma of the prostate.Urol. Clin. N. Am. 7: 631–638.
Nesbit, R. M., and Baum, W. C. (1950). Endocrine control of prostatic carcinoma: Clinical and statistical survey of 1818 cases.J. Am. Med. Assoc. 143: 1317–1320.
Resnick, M. I., and Grayhack, J. T. (1975). Treatment of stage IV carcinoma of the prostate. In Symposium on the Prostate.Urol. Clin. N. Am. 2: 141–161.
Salmimies, P., Kockott, G., Pirke, K. M., Vogt, H. J., and Schill, W. B. (1982). Effects of testosterone replacement on sexual behavior in hydrogonadal men.Arch. Sex. Behav. 11: 345–353.
Skakkebaek, N. E., Bancroft, J., Davidson, D. W., and Warner, P. (1981). Androgen replacement with oral testosterone undecanoate in hypogonadal men: A double blind controlled study.Clin. Endocrinol. 14: 49–61.
Todarello, P., and Boscia, F. M. (1985). Sexuality in aging: A study of a group of 300 elderly men and women.J. Endocrinol. Invest. 8(suppl. 2): 128–130.
Tsitouras, P. D., Martin, C. E., and Harman, S. M. (1982). Relationship of serum testosterone to sexual activity in healthy elderly men.J. Gerontol. 37: 288–293.
Veterans Administration Cooperative Urological Research Group. (1967). Carcinoma of the prostate: Treatment comparisons.J. Urol. 98: 516–522.
Weizman, A., Weizman, R., Hart, J., Maoz, B., Wijsenbeek, H., and David, M. B. (1983). The correlation of increased serum prolactin levels with decreased sexual desire and activity in elderly men.J. Am. Geriat. Soc. 31: 8: 485–488.
About this article
Cite this article
Rousseau, L., Dupont, A., Labrie, F. et al. Sexuality changes in prostate cancer patients receiving antihormonal therapy combining the antiandrogen flutamide with medical (LHRH agonist) or surgical castration. Arch Sex Behav 17, 87–98 (1988). https://doi.org/10.1007/BF01542054
- sexual behavior
- prostatic cancer
- medical castration
- LHRH agonist
- sexual desire
- erectile problems
- sex offenders