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Male sexual disturbances in liver diseases: What do we know?

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Abstract

The alterations of sexual function known as the erectile dysfunction are quite frequent among patients affected by liver diseases and they tend to increase in advanced liver failure. This process is directly linked to cirrhosis or its treatments, such as liver transplantation, or to certain drugs (e.g. beta-blockers). Independent of cirrhosis, other factors may cause sexual problems in these patients. Alcohol itself seems to worsen sexual function in the absence of cirrhosis. Viral hepatitis has an uncertain influence on male gonadic function and even antiviral therapy itself can worsen some seminal and hormonal parameters, although it is reversible. Quality of life may be greatly decreased in cases of cirrhosis where these alterations are present, so it is important to value and care for them, if possible. This review investigates the major male sexual disturbances in liver diseases of various origins.

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References

  1. NIH Consensus Conference: Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993, 270: 83–90.

    Article  Google Scholar 

  2. Toda K, Miwa Y, Kuriyama S, et al. Erectile dysfunction in patients with chronic liver disease: its relevance to protein malnutrition. J Gastroenterol 2005, 40: 894–900.

    Article  PubMed  Google Scholar 

  3. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999, 281: 537–44.

    Article  PubMed  CAS  Google Scholar 

  4. Parazzini F, Menchini Fabris F, Bortolotti A, et al. Frequency and determinants of erectile dysfunction in Italy. Eur Urol 2000, 37: 43–9.

    Article  PubMed  CAS  Google Scholar 

  5. Cornely CM, Schade RR, Van Thiel DH, Gavaler JS. Chronic advanced liver disease and impotence: cause and effect? Hepatology 1984, 4: 1227–30.

    Article  PubMed  CAS  Google Scholar 

  6. Jensen SB, Gluud C. Sexual dysfunction in men with alcoholic liver cirrhosis. A comparative study. Liver 1985, 5: 94–100.

    Article  PubMed  CAS  Google Scholar 

  7. Wang YJ, Wu JC, Lee SD, Tsai YT, Lo KJ. Gonadal dysfunction and changes in sex hormones in postnecrotic cirrhotic men: a matched study with alcoholic cirrhotic men. Hepatogastroenterology 1991, 38: 531–4.

    PubMed  CAS  Google Scholar 

  8. Simsek I, Aslan G, Akarsu M, Koseoglu H, Esen A. Assessment of sexual functions in patients with chronic liver disease. Int J Impot Res 2005, 17: 343–5.

    Article  PubMed  CAS  Google Scholar 

  9. Huyghe E, Kamar N, Wagner F, et al. Erectile dysfunction in end-stage liver disease men. J Sex Med 2009, 6: 1395–401.

    Article  PubMed  Google Scholar 

  10. Wetterling T, Veltrup C, Driessen M, John U. Drinking pattern and alcohol-related medical disorders. Alcohol Alcohol 1999, 34: 330–6.

    Article  PubMed  CAS  Google Scholar 

  11. Ronis MJJ, Wands JR, Badger TM, de la Monte SM, Lang CH, Calissendorff J. Alcohol-induced disruption of endocrine signaling. Alcohol Clin Exper Res 2007, 31: 1269–85.

    Article  CAS  Google Scholar 

  12. Purohit V. Can alcohol promote aromatization of androgens to estrogens? A review. Alcohol 2000, 22: 123–7.

    Article  CAS  Google Scholar 

  13. Soykan A, Boztas H, Idilman R, et al. Sexual dysfunctions in HCV patients and its correlations with psychological and biological variables. Int J Impot Res 2005, 17: 175–9.

    Article  PubMed  CAS  Google Scholar 

  14. Ferri C, Bertozzi MA, Zignego AL Erectile dysfunction and hepatitis C virus infection. JAMA 2002, 288: 698–9.

    Article  PubMed  Google Scholar 

  15. Danoff A, Khan O, Wan DW, et al. Sexual dysfunction is highly prevalent among men with chronic hepatitis C virus infection and negatively impacts health-related quality of life. Am J Gastroenterol 2006, 101: 1235–43.

    Article  PubMed  Google Scholar 

  16. Gluud C, Wantzin P, Eriksen J. No effect of oral testosterone treatment on sexual dysfunction in alcoholic cirrhotic men. Gastroenterology 1988, 95: 1582–7.

    PubMed  CAS  Google Scholar 

  17. Van Thiel DH, Gavaler JS, Sanghvi AJIT. Recovery of sexual function in abstinent alcoholic men. Gastroenterology 1982, 84: 677–82.

    Google Scholar 

  18. Lonardo A, Carani C, Carulli N, Loria P. ‘Endocrine NAFLD’ a hormonocentric perspective of non-alcoholic fatty liver disease pathogenesis. J Hepatol 2006, 44: 1196–207.

    Article  PubMed  CAS  Google Scholar 

  19. Villanova N, Moscatiello S, Ramilli S, et al. Endothelial dysfunction and cardiovascular risk profile in non-alcoholic fatty liver disease. Hepatology 2005, 42: 473–80.

    Article  PubMed  Google Scholar 

  20. Huang JM, Huang TH, Qiu HY, et al. Effects of hepatitis B virus infection on human sperm chromosomes. World J Gastronterol 2003, 9: 736–40.

    Google Scholar 

  21. Collodel G, Baccetti B, Capitani S, Moretti E. Necrosis in human spermatozoa. I. Ultrastructural features and FISH study in semen from patients with uro-genital infections. J Submicrosc Cytol Pathol 2005, 37: 67–73.

    PubMed  CAS  Google Scholar 

  22. Heathcote J, Cameron CH, Dane DS. Hepatitis-B antigen in saliva and semen. Lancet 1974, 1: 71–3.

    Article  PubMed  CAS  Google Scholar 

  23. Qian WP, Tan YQ, Chen Y, et al. Rapid quantification of semen hepatitis B virus DNA by real-time polymerase chain reaction. World J Gastroenterol 2005, 11: 5385–9.

    PubMed  CAS  Google Scholar 

  24. Hadchouel M, Scotto J, Huret JL, et al. Presence of HBV DNA in spermatozoa: a possible vertical transmission of HBV via the germ line. J Med Virol 1985, 16: 61–6.

    Article  PubMed  CAS  Google Scholar 

  25. Leruez-Ville M, Kunstmann JM, De Almeida M, Rouzioux C, Chaix ML. Detection of hepatitis C virus in the semen of infected men. Lancet 2000, 356: 42–3.

    Article  PubMed  CAS  Google Scholar 

  26. Levy R, Tardy JC, Bourlet T, et al. Transmission risk of hepatitis C virus in assisted reproductive techniques. Hum Reprod 2000, 15: 810–6.

    Article  PubMed  CAS  Google Scholar 

  27. Durazzo M, Premoli A, Di Bisceglie C, et al. Alterations of seminal and hormonal parameters: an extrahepatic manifestation of HCV infection? World J Gastroenterol 2006, 12: 3073–6.

    PubMed  CAS  Google Scholar 

  28. Moretti E, Federico MG, Giannerini V, Collodel G. Sperm ultrastructure and meiotic segregation in a group of patients with chronic hepatitis B and C. Andrologia 2008, 40: 173–8.

    Article  PubMed  CAS  Google Scholar 

  29. Levy R, Bourlet T, Maertens A, et al. Pregnancy after safe IVF with hepatitis C virus RNA-positive sperm. Hum Reprod 2002, 17: 2650–3.

    Article  PubMed  CAS  Google Scholar 

  30. Garrido N, Meseguer M, Remohí J, Simón C, Pellicer A. Semen characteristics in human immunodeficiency virus (HIV)- and hepatitis C (HCV)-seropositive males: predictors of the success of viral removal after sperm washing. Hum Reprod 2005, 20: 1028–34.

    Article  PubMed  Google Scholar 

  31. Barton JC, Acton RT, Leiendecker-Foster C, et al; Hemochromatosis and Iron Overload Screening (HEIRS) Study Research Investigators. Characteristics of participants with self-reported hemochromatosis or iron overload at HEIRS Study initial screening. Am J Hematol 2008, 83: 126–32.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Tarnacka B, Rodo M, Cichy S, Członkowska A. Procreation ability in Wilson’s disease. Acta Neurol Scand 2000, 101: 395–8.

    Article  PubMed  CAS  Google Scholar 

  33. Soto Alvarez J, Sacristan JA, Alsar MJ. Interferon alfa-2a-induced impotence. Ann Pharmacother 1991, 25: 1397.

    CAS  Google Scholar 

  34. Kraus MR, Schäfer A, Bentink T, et al. Sexual dysfunction in males with chronic hepatitis C and antiviral therapy: interferon-induced functional androgen deficiency or depression? J Endocrinol 2005, 185: 345–52.

    Article  PubMed  CAS  Google Scholar 

  35. Kartal ED, Alpat SN, Ozgunes I, Usluer G. Adverse effects of high-dose interferon-alpha-2a treatment for chronic hepatitis B. Adv Ther 2007, 24: 963–71.

    Article  PubMed  CAS  Google Scholar 

  36. Dove LM, Rosen RC, Ramcharran D, et al; Virahep-C Study Group. Decline in male sexual desire, function, and satisfaction during and after antiviral therapy for chronic hepatitis C. Gastroenterology 2009, 137: 873–84.

    Article  PubMed  CAS  Google Scholar 

  37. Sorrell JH, Brown JR. Sexual functioning in patients with end-stage liver disease before and after transplantation. Liver Transpl 2006, 12: 1473–7.

    Article  PubMed  Google Scholar 

  38. Foresta C, Schipilliti M, Ciarleglio FA, Lenzi A, D’Amico D. Male hypogonadism in cirrhosis and after liver transplantation. J Endocrinol Invest 2008, 31: 470–8.

    Article  PubMed  CAS  Google Scholar 

  39. Burra P. Sexual dysfunction after liver transplantation. Liver Transpl 2009, 15: S50–6.

    Article  PubMed  Google Scholar 

  40. Forgue ST, Phillips DL, Bedding AW, et al. Effects of gender, age, diabetes mellitus and renal and hepatic impairment on tadalafil pharmacokinetics. Br J Clin Pharmacol 2007, 63: 24–35.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  41. Nolte W, Schindler CG, Figulla HR, et al. Increase of serum estradiol in cirrhotic men treated by transjugular intrahepatic portosystemic stent shunt. J Hepatol 2001, 34: 818–24.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to M. Durazzo MD.

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Durazzo, M., Premoli, A., Di Bisceglie, C. et al. Male sexual disturbances in liver diseases: What do we know?. J Endocrinol Invest 33, 501–505 (2010). https://doi.org/10.1007/BF03346632

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  • DOI: https://doi.org/10.1007/BF03346632

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