**5. Conclusions**

*Male Reproductive Health*

of cancer treatment [34–36].

in men with prostate carcinoma who receive hormone therapy. The study at hand showed that more than 95% of men treated with this method reported subjective sex drive disorders [6]. However, DiBlasio et al. [13] demonstrated that more than 95% of men receiving hormone therapy reported libido and sex drive disorders. The loss of libido is frequently observable in patients with Hodgkin disease (Hodgkin lymphoma), where more than 40% of men reported this side effect [14]. The loss of libido was also observable in patients with hematologic cancers [15, 16]. Different results were obtained by Olsson et al. [33] who argued that low libido may originate from fatigue and/or feeling unwell. Furthermore, this condition may be associated

Our study showed that among sexually active men, pretreatment and posttreatment patients as well as patients on cancer treatment were satisfied or very satisfied with their sexual life. The level of satisfaction with sexual life was also affected by the type of treatment, while the patients' age had no effect on their satisfaction with sexual life (p > 0.05). Given that good mental well-being depends on many factors, it cannot be stated without ambiguity that men can achieve sexual satisfaction only through a successful sexual intercourse. However, for men with chronic erectile disorders, inability to achieve penetration may be a source of considerable difficulties and frustration. For example, couples open to changes and willing to cooperate were able to adapt to the needs of the affected partner and to accept the side effects

However, our studies showed that men receiving treatment or radiotherapy have considerable or major difficulties in achieving or maintaining erection. Other study [3] shown that erectile disorders were observed in 77% of men treated for prostate carcinoma who underwent radical prostatectomy and in 60% of patients receiving radiotherapy. It was also observed that post-radiotherapy erectile disorders were usually delayed (1 or 2 years after therapy) in contrast to a quick response achieved in a group of patients immediately after surgical treatment [28]. Erectile disorders were also observed in other populations, for example, in patients treated for anal diseases or rectal and testicular cancer [9, 11]. Difficulties with ejaculation were not correlated with the age of patients (p > 0.05). Problems with ejaculation were least frequent among patients prior to cancer treatment, while all the posttreatment patients reported having such difficulties. Patients who received surgical treatment, hormone therapy or both radiotherapy and hormone therapy had no problems with ejaculation. Sullivan et al. [37] determined that radiotherapy, especially if it is focused on the prostate gland, may be associated with anejaculation (inability to ejaculate). A study in 364 men diagnosed with prostate carcinoma and undergoing radiotherapy showed that as many as 72% of the patients experienced anejaculation. However, elderly men and patients receiving lower doses of radiation were less exposed to this side effect. This situation may lead to an intentional avoidance of orgasm by men suffering from prostate carcinoma. On the other hand, Wassersug et al. [12] noticed that the lack of ejaculation in men having homosexual relations caused particular discomfort. However, in our study, a feeling of embarrassment during intimate contact (in sexually active men) was not correlated with age but with the stage of cancer treatment and the type

Embarrassment during sexual contact was not experienced by pretreatment patients, patients receiving surgical treatment, hormone therapy, or radiotherapy combined with hormone therapy. Additionally, none of the discussed aspects of sexual activity, in relation to all the patients or only those sexually active during the last 4 months, had no impact on the quality of life score (p > 0.05 for all cases). Harrington et al. [38] showed that men who underwent hormone therapy are exposed to verbal abuse due to changes in their appearance as a side effect of the

with the stage of disease and intensive cancer therapy.

**184**

of therapy.


### **Conflict of interest**

All authors declare no conflict of interests.

### **Funding**

The study was financed from own funds.

### **Ethical approval (animals)**

This article does not contain any studies with animals performed by any of the authors.
