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The effect of estrogen on the sexual interest of castrated males: Implications to prostate cancer patients on androgen-deprivation therapy

Critical Reviews in Oncology/Hematology, 3, 87, pages 224 - 238

Abstract

Androgen deprivation therapy (ADT) for prostate cancer (PCa) treatment causes sexual dysfunction. We review here the effects of estrogen on the sexual performance of androgen-deprived males. The major findings are:

  • 1. Estrogen receptors are present in brain centers that are important for sexual behavior; as well as in male reproductive organs, in a pattern suggesting that estrogen may have some role in orgasmic function and genital skin sensitivity.
  • 2. Estrogen restores sexual interest above castrate levels in many vertebrates including reptiles, birds and mammals; but multiple factors contribute to the magnitude of this effect.
  • 3. Data from castrated men, aromatase-deficient men, male-to-female transsexuals, and men on antiandrogens all suggest that estrogen can maintain some libido in androgen-deprived men.

We discuss the general benefits of estrogen therapy to quality of life of men on ADT, the potential risks of this treatment, and possible treatment regimes for estrogen therapy in males. Unless contraindicated, we propose that PCa patients on ADT would benefit from supplemental parenteral estrogen.

Keywords: Androgen deprivation therapy, Prostate cancer, Libido, Estrogen, Male sexual function, Castrated animals, Orgasm, Skin sensitivity.

Footnotes

a Department of Anatomy & Neurobiology, Dalhousie University, Room 13-J, 5850 College Street, PO Box 15000, Halifax, NS B3H 4R2, Canada

b Men's Health Initiative of B.C., Department of Urologic Sciences, Gordon & Leslie Diamond Care Centre, 2775 Laurel St., 6th Floor, University of British Columbia, Vancouver, BC V5Z 1M9, Canada

c Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Victoria 3000, Australia

lowast Corresponding author at: Men's Health Initiative of B.C., Department of Urologic Sciences, Gordon & Leslie Diamond Care Centre, 2775 Laurel St., 6th Floor, University of British Columbia, Vancouver, BC V5Z 1M9, Canada. Tel.: +1 604 875 4111x62338; fax: +1 604 875 5024.