Unmet Sexual Health Resource Needs and Preferences for Interventions to Address These Needs Among Female Partners of Patients with Prostate Cancer - Natasha Gupta

March 6, 2024

Ruchika Talwar hosts Natasha Gupta to explore the overlooked perspective of female partners in prostate cancer care. Dr. Gupta delves into her study on the unmet sexual health needs of female partners of prostate cancer patients, revealing that these partners crave more information and support regarding sexual dysfunction challenges arising from the disease's treatment. Conducting a mixed-methods study with qualitative interviews and a survey of 200 female partners nationwide, they identify a strong desire for technology-based interventions for better education and support. Key findings include a need for information on dealing with male libido problems, erectile dysfunction, and support group resources specifically for female partners and couples. Dr. Gupta emphasizes the importance of including female partners in the care process, proposing the development of technology-based sexual health interventions and the enhancement of support mechanisms throughout the prostate cancer journey.


Natasha Gupta, MD, Research Assistant Professor, Department of Urology, NYU Langone Grossman School of Medicine, New York, NY

Ruchika Talwar, MD, Urologic Oncology Fellow, Department of Urology, Vanderbilt University Medical Center, Nashville, TN

Read the Full Video Transcript

Ruchika Talwar: Hi everyone, and welcome back to UroToday's Health Policy Center of Excellence. As always, my name is Ruchika Talwar, and today, I'm excited to be joined by Dr. Natasha Gupta, who is a urologist at NYU. She's here with us discussing some of her work in the prostate cancer space, except this time, from the partner's perspective. Thank you, Dr. Gupta, for being here with us today.

Natasha Gupta: Thank you for having me. Today, I'll be talking about our study: Unmet Sexual Health Resource Needs and Preferences for Interventions to Address These Needs Among Female Partners of Patients with Prostate Cancer.

The reason that we are studying this topic is that prostate cancer has a significant impact on sexual health; as each step of the prostate cancer journey can negatively impact sexual function, due to the sexual side effects of diagnostic biopsy and all forms of treatment. In fact, up to 85% of survivors report sexual dysfunction, including erectile dysfunction, ejaculatory dysfunction, penile deformity, and/or reduced libido.

And survivors' sexual dysfunction can negatively impact their intimate partners. For example, there's ongoing work on sexual health issues among gay couples facing prostate cancer. And our prior work has focused on female partners of prostate cancer survivors and has demonstrated that female partners experience sexual dysfunction as a result of prostate cancer, as a couple's disease, and also report a lack of partner-directed sexual health education and support.

So based on our prior findings, we sought to further characterize the specific unmet sexual health resource needs and preferences for interventions to address these needs among female partners. To do this, we conducted a mixed-methods study consisting of 12 qualitative interviews and a 200 cross-sectional survey of female partners recruited nationwide.

Major emergent themes from our qualitative study included the benefits and drawbacks of technology-based sexual health interventions. Specifically, female partners described a desire for technology-based interventions and they described the benefits of technology in terms of facilitating face-to-face interactions with other prostate cancer survivors, female partners, and providers. However, they also described concerns about online misinformation related to sexual health and prostate cancer. Female partners also emphasized the importance of sexual health resources throughout the prostate cancer journey and also described a desire for sexual health support groups that include female partners.

In terms of our 200 survey responses, we asked partners about their specific sexual health resource needs. And the most common sexual health topics that partners wanted more information about were male libido problems, erectile dysfunction, female libido problems, and problems with male orgasm. Additionally, 35% of partners wanted information about partners-only support groups pertaining to sexual health and prostate cancer, and about 30% of partners wanted information about support groups for couples.

Additionally, about 23% wanted more information about sexual medicine providers specializing in male sexual dysfunction, and about 20% wanted more information about erectile aids. Notably, 40% of female partners wanted website recommendations for online resources about sexual health.

So based on these findings, we have outlined some specific recommendations for urologists and prostate cancer providers, specifically that we should develop technology-based sexual health interventions, including websites with evidence-based sexual health education, video testimonials from other partners and couples that have successfully navigated sexual dysfunction, and websites that include a platform for virtual interaction with peers and providers to discuss sexual health.

Online resources and all sexual health education material should also focus most on topics that are relevant to female partners, including libido and arousal problems, erectile dysfunction, access to sexual medicine specialists, and erectile aids. Additionally, we should increase the involvement of female partners in prostate cancer support groups that focus on sexual health, and this should include female partner-specific support groups, as well as couples-based support groups. And additionally, provide such resources to partners throughout the prostate cancer journey, which can be accomplished through easy-to-find links to online, publicly available, evidence-based sexual health resources. Thank you very much.

Ruchika Talwar: Thanks, Dr. Gupta. I think this is such an important topic. Obviously, there is not a lot of prior work in this space. I mean, your group certainly has laid the foundation of what we know, but there is still a long way to go.

I'm curious, what was the genesis of your interest in looking at the patient partner experience through the prostate cancer journey?

Natasha Gupta: Yeah. So as you mentioned, there's not much research in this space. And due to the reciprocal nature of sexual relationships, we hypothesized that female partners would be negatively impacted by sexual dysfunction in the context of prostate cancer. And we actually conducted some foundational studies, including qualitative interviews with female partners, and analysis of online posts on support group forums, that demonstrated that there really is a significant impact on female partners and a lot of unmet needs. So that was the genesis of my interest in delving into this further, to figure out exactly what types of resources female partners need, and their preferences for those types of resources, so that we can actually remedy some of these gaps.

Ruchika Talwar: And this is a really sensitive space. Even when we do these sorts of analyses with patients themselves about their own experience, often there's hesitation to open up, and a lot of times, that results in a lack of ability to ask these questions, even to their own provider. So I'm curious, during your experience with interviewing female partners, did you all run into issues with hesitation regarding participation in the interviews?

Natasha Gupta: Actually, that's a really interesting question, and I actually found that all the female partners we interacted with were really excited to share their experience and were eager to discuss it, and actually, were eager to connect with other female partners to discuss their experience and receive support, and even participate in future research projects related to the topic. They were quite passionate about bringing awareness to this issue as they often did feel invisible. That was another major theme from one of our prior studies, is that they felt invisible to the healthcare system. So bringing up these topics actually was a relief to many, and I found that all the partners we've interacted with and spoken to were actually very forthcoming.

Ruchika Talwar: That's great, and that should really be a point of encouragement to, I think, the broader urologic community, that when we have patients who do bring their partners to the clinic, I think it's great to be able to engage with them, and to make sure that we're assessing that both people in the relationship feel prepared for the treatment course and what they can expect in all aspects of prostate cancer care, but particularly, the sexual health considerations. You just touched upon an important theme, I think, that theme of feeling invisible. And you presented quite a few important common themes that you all assessed, but let's do a little bit of a deep dive into those. Which do you think were perhaps the most significant or the most surprising?

Natasha Gupta: Yeah. So I think the two most significant ones were the female partners' preference for technology-based interventions. Although they do describe some concerns about online misinformation, I think technology is a really wonderful tool to connect female partners and also disseminate accurate information about sexual health in prostate cancer. And many individuals in the most common age groups who are affected by prostate cancer actually are savvy in using the internet, so I think that that's a really wonderful tool to connect.

I also think it was interesting that female partners wanted both partners-only support groups and couples-based support groups because many of them have described, both in this study and some of our prior studies, that they also want an avenue to discuss some of these issues without their male partner there, for example. Because some of these, as you mentioned, topics are very sensitive, and so speaking to other female partners about how they've navigated some difficult conversations about prostate cancer and sexuality is important, just as important as also being able to discuss those issues with their actual partner.

Ruchika Talwar: Yeah, that's interesting. Another thing that's important for us to be aware of is that we should be giving patients information on partners-only groups, although our focus traditionally has been mostly in the patient and survivorship kind of space.

Another point you bring up is this idea of online resources. I think it's another point that we should be highlighting. There are various trusted sources through the Prostate Cancer Foundation and the Urology Care Foundation, just to name two of many. We certainly can be pointing our patients and their loved ones toward those vetted resources, and reemphasizing the fact that those are written by experts. Often, urologists are the ones checking the material, and so it is trusted. Because you're right, there's a lot of concern about misinformation given all that we see right now in the world, but we can do a better job of collating that.

In addition to those points, what would you say your biggest takeaways are for urologists who see prostate cancer patients?

Natasha Gupta: That prostate cancer is a couple's disease for patients who are partnered, and so to keep that in mind throughout each step of the journey. Whether it's about counseling about side effects, discussing the post-op course, long-term follow-up, I think that keeping that framework in mind is really critical, and sexual health is one aspect of that.

Ruchika Talwar: Great. Well, thank you so much for sharing your expertise with us today. This is such an important topic, and I think it's really high time that we ensure that our patients, as well as their partners, are included in treatment discussions regarding prostate cancer care. So we appreciate you taking the time to chat with us.

Natasha Gupta: Thank you.

Ruchika Talwar: And to our UroToday audience, thank you for joining us. We'll see you next time.