Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 Mar 3;8(3):e250413.
doi: 10.1001/jamanetworkopen.2025.0413.

Exercise and Psychosexual Education to Improve Sexual Function in Men With Prostate Cancer: A Randomized Clinical Trial

Daniel A Galvão  1   2 , Robert U Newton  1   2 , Dennis R Taaffe  1   2 , Prue Cormie  3   4 , Oliver Schumacher  1   2 , Christian J Nelson  5 , Robert A Gardiner  1   6   7 , Nigel Spry  1   2 , David Joseph  1   2   8 , Colin Tang  1   2   8 , Hao Luo  1   2 , Raphael Chee  1   9   10 , Dickon Hayne  9   11 , Suzanne K Chambers  1   12
Affiliations
Randomized Controlled Trial

Exercise and Psychosexual Education to Improve Sexual Function in Men With Prostate Cancer: A Randomized Clinical Trial

Daniel A Galvão et al. JAMA Netw Open. .

Abstract

Importance: Sexual dysfunction is a common adverse effect of prostate cancer treatment, and current management strategies do not adequately address physical and psychological causes. Exercise is a potential therapy in the management of sexual dysfunction.

Objective: To investigate the effects of supervised, clinic-based, resistance and aerobic exercise with and without a brief psychosexual education and self-management intervention (PESM) on sexual function in men with prostate cancer compared with usual care.

Design, setting, and participants: A 3-arm, parallel-group, single-center randomized clinical trial was undertaken at university-affiliated exercise clinics between July 24, 2014, and August 22, 2019. Eligible participants were men with prostate cancer who had previously undergone or were currently undergoing treatment and were concerned about sexual dysfunction. Data analysis was undertaken October 8 to December 23, 2024.

Interventions: Participants were randomized to (1) 6 months of supervised, group-based resistance and aerobic exercise (n = 39 [34.8%]), (2) the same exercise program plus PESM (n = 36 [32.1%]), or (3) usual care (n = 37 [33.0%]). Exercise was to be undertaken 3 days per week.

Main outcomes and measures: The primary outcome was sexual function assessed with the International Index of Erectile Function (IIEF). Secondary outcomes included body composition, physical function, and muscle strength. Analyses were undertaken using an intention-to-treat approach.

Results: In total, 112 participants (mean [SD] age, 66.3 [7.1] years) were randomized. Mean adjusted difference in IIEF score at 6 months favored exercise compared with usual care (3.5; 95% CI, 0.3-6.6; P = .04). The mean adjusted difference for intercourse satisfaction was not significant (1.7; 95% CI, 0.1-3.2; P = .05). PESM did not result in additional improvements. Compared with usual care, exercise also significantly improved fat mass (mean adjusted difference, -0.9 kg; 95% CI, -1.8 to -0.1 kg; P = .02), chair rise performance (mean adjusted difference, -1.8 seconds; 95% CI, -3.2 to -0.5 seconds; P = .002), and upper (mean adjusted difference, 9.4 kg; 95% CI, 6.9-11.9 kg; P < .001) and lower (mean adjusted difference, 17.9 kg; 95% CI, 7.6-28.2 kg; P < .001) body muscle strength.

Conclusions and relevance: In this randomized clinical trial of supervised exercise, erectile function in patients with prostate cancer was improved. PESM resulted in no additional improvements. Patients with prostate cancer should be offered exercise following treatment as a potential rehabilitation measure.

Trial registration: ANZCTR Identifier: ACTRN12613001179729.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. CONSORT Diagram
GP indicates general practitioner; ITT, intention to treat.
Figure 2.
Figure 2.. International Index of Erectile Function Domains Examined by Baseline Score Tertiles
Patients with the lowest tertile scores prior to the initiation of exercise benefited the most following supervised exercise for sexual desire, intercourse satisfaction, and overall satisfaction.
See this image and copyright information in PMC

References

    1. Higano CS. Sexuality and intimacy after definitive treatment and subsequent androgen deprivation therapy for prostate cancer. J Clin Oncol. 2012;30(30):3720-3725. doi:10.1200/JCO.2012.41.8509 - DOI - PubMed
    1. 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;10(suppl 1):102-111. doi:10.1111/j.1743-6109.2012.03005.x - DOI - PubMed
    1. Resnick MJ, Koyama T, Fan KH, et al. . Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med. 2013;368(5):436-445. doi:10.1056/NEJMoa1209978 - DOI - PMC - PubMed
    1. Magheli A, Burnett AL. Erectile dysfunction following prostatectomy: prevention and treatment. Nat Rev Urol. 2009;6(8):415-427. doi:10.1038/nrurol.2009.126 - DOI - PubMed
    1. Downing A, Wright P, Hounsome L, et al. . Quality of life in men living with advanced and localised prostate cancer in the UK: a population-based study. Lancet Oncol. 2019;20(3):436-447. doi:10.1016/S1470-2045(18)30780-0 - DOI - PubMed

Publication types