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Preliminary study with bicalutamide in heterosexual and homosexual patients with prostate cancer: a possible implication of androgens in male homosexual arousal
Author(s) -
Motofei Ion G.,
Rowland David L.,
Popa Florian,
Kreienkamp Drew,
Paunica Stana
Publication year - 2011
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2010.09764.x
Subject(s) - bicalutamide , prostate cancer , sexual arousal , libido , sexual function , medicine , testosterone (patch) , sexual desire , androgen , psychology , clinical psychology , gynecology , human sexuality , hormone , cancer , sexual behavior , androgen receptor , gender studies , sociology
Study Type – Symptom prevalence (case series)
Level of Evidence 4 What’s known on the subject? and What does the study add? A recent published paper regarding sexual and cognitive duality presents that androgens act synergic with female sexual pheromones while estrogens would act synergic with male sexual pheromones in normal potent men. The same authors found in this study that bicalutamide disfavours sexual function predominantly in homosexual rather than heterosexual men suffering with prostate cancer. The results of this study are interpreted alone in this article, the similarities and differences with results corresponding to younger and normal potent men following to be discussed recently in a review regarding psychosexual dualism. OBJECTIVE • Not only has a precise characterization of libido and sexual arousal in men as a central neural process been lacking, but the interactive role of gonadal hormones and sexual orientation in such processes has never been investigated. We investigate the relationships among sexual hormones, sexual arousal, and sexual orientation in men by comparing the self‐reported sexual response of heterosexual and homosexual men with locally advanced prostate neoplasm, receiving the non‐steroidal anti‐androgen bicalutamide as monotherapy. PATIENTS AND METHODS • 29 Romanian men participated in this study: 17 heterosexual and 12 homosexual. Patients were undergoing treatment for prostate cancer consisting of a standard daily dose of 50 mg bicalutamide, a fast acting non‐steroidal anti‐androgen with action comparable to other anti‐androgen drugs but with reportedly fewer sexual side effects. • Patients retrospectively provided information regarding their sexual functioning measured by the IIEF prior to commencing bicalutamide treatment. • Then, about five weeks later, patients were asked to prospectively provide information regarding their current sexual functioning while undergoing bicalutamide treatment. RESULTS • Overall IIEF scores as well as the Erectile Function, Orgasmic Function, Sexual Desire, and Overall Satisfaction subscales showed group, treatment, and group by treatment effects. • The Intercourse Satisfaction subscale showed group and group by treatment effects. • On most subscales, homosexual men showed lower functioning than heterosexual men, primarily in response to treatment with bicalutamide. CONCLUSIONS • Treatment with an anti‐androgen in a clinical population of men undergoing therapy for prostate cancer affected homosexual men more than heterosexual men, although not all heterosexual men were un affected. • These results are discussed in the context of dual sexual natures, a concept recently developed in the sexual literature. • Furthermore, these findings reiterate the importance of incorporating such variables as sexual orientation into studies investigating medical treatments on sexual response.