Objective Androgen deprivation therapy (ADT) for the magement of prostate cancer results in a range of side effects including sexual dysfunction. Exercise is proposed as a potentially effective therapy to counteract changes in sexual function. The current study explored the impact of ADT on men's sexuality and the effect of exercise on this experience. Methods Semi-structured, in-depth interviews were conducted with 18 men (age?=?63.1?ῳ.8) who were on ADT for prostate cancer for =12 months and who were part of a pre-existing exercise intervention trial. Results Sexual concerns for men included changes in body image, partner relationships, sex drive, sexual performance and masculinity. In coping with these concerns, men described a sense of persol acceptance of sexual changes through a shift in priorities and values away from penetrative sexual intercourse, knowledge and understanding about ADT, and partner support. Exercise in a group-based setting contributed to the acceptance of sexual changes through affirming strength-based aspects of masculinity and peer support. Conclusion Exercise appears to have utility as a strategy to assist men to mage the negative impact of ADT on sexuality and masculinity more broadly.