MS-N316 · Exercise and rehabilitation · Sexual health · Prostate cancer · Human evidence · Appraised 12 November 2026

Does six months of supervised aerobic and resistance exercise improve sexual function after or during prostate cancer treatment, and does brief psychosexual education add benefit?

Evidence at a glance

• Evidence label: Randomized trial; small erectile-function improvement, with no added benefit from the tested education module
• Benefit: Erectile-function scores favored exercise by 3.5 points; several other sexual-function measures were not significantly different.
• Certainty: Low to moderate. The single-center trial stopped at 112 participants rather than the planned 240 and may be underpowered.
• Risk: No major exercise-related adverse event occurred; nonserious musculoskeletal events were reported.

What was studied

Design: A three-arm Australian trial randomized 112 men concerned about sexual dysfunction after or during prostatectomy, radiotherapy or androgen-deprivation therapy to exercise (39), exercise plus brief psychosexual education/self-management (36), or usual care (37).

Regimen: Supervised group aerobic and resistance exercise three times weekly for six months. Aerobic work was 20–30 minutes at about 60%–85% estimated maximum heart rate, plus a goal of 150 weekly minutes; resistance training used six to eight major-muscle exercises, one to four sets at 6–12 repetition maximum. The education arm added one brief session and self-management resources.

What the evidence found

The adjusted difference in International Index of Erectile Function erectile-function score favored pooled exercise by 3.5 points (95% CI 0.3–6.6; P=.04). Intercourse satisfaction was borderline (1.7 points, 95% CI 0.1–3.2; P=.05), while orgasmic function, desire, overall satisfaction, EPIC sexual function and EORTC sexual activity did not significantly differ.

Adding the brief psychosexual module did not improve erectile function beyond exercise (adjusted difference 1.1, 95% CI −2.7 to 4.8). Exercise improved fat mass by −0.9 kg, chair-rise time by −1.8 seconds, and upper- and lower-body strength.

Exercise attendance was 81%–82%. No major exercise-related adverse event occurred; reported program-related events were nonserious and musculoskeletal.

How to interpret it

The signal is modest and does not replace established evaluation or treatments for erectile dysfunction. The trial’s early closure, motivated participants and single-center setting limit generalizability.

The educational component was brief; its null result should not be generalized to all sex therapy, couples counselling or medication/device-based rehabilitation.

Practical safety context

Medical clearance and professional supervision are important with cardiovascular disease, recent surgery, urinary incontinence, bone metastases or ADT-related frailty. Musculoskeletal pain may require load or exercise changes.

Exercise can complement, but should not delay, assessment for vascular, hormonal, neurologic, medication-related or psychological contributors to sexual dysfunction.

Questions for the care team

• Which part of sexual function is most affected, and what treatments have evidence for that mechanism?
• Is supervised exercise appropriate after my surgery or with current bone and cardiovascular risks?
• Would pelvic-floor therapy, medication, devices or specialist sexual counselling add more than the brief module tested here?

Funding and conflicts

Supported by Australia’s National Health and Medical Research Council, the NHMRC Centre for Research Excellence in Prostate Cancer Survivorship, Cancer Council WA, Prostate Cancer Foundation of Australia and Victorian Cancer Agency. Funders reportedly had no study role; authors reported no conflicts.

Sources

• Randomized sexual-rehabilitation trial (PMID 40072437; DOI 10.1001/jamanetworkopen.2025.0413)
• Full report (PMCID PMC11904736)
• Published protocol and ANZCTR identifier ACTRN12613001179729 (PMID 24641777)

Last literature search: 12 November 2026. Record appraisal: 12 November 2026. The full open-access report was appraised. This page is educational and does not replace individualized medical advice. These supportive-care outcomes do not establish tumor shrinkage, delayed recurrence or longer survival.