Sexual Dysfunction in Males with End-Stage Liver Disease: Partial Recovery after Liver Transplantation

Sexual Dysfunction in Males with End-Stage Liver Disease: Partial Recovery after Liver Transplantation

Sexual dysfunction occurs in 70% to 89% of males with end-stage liver disease and reduces significantly the quality of life of the patient and his partner. The pathogenesis is multifactorial and includes hypothalamic-pituitary-gonadal axis dysfunction, psychological stress, associated diseases and use of medications. Hypogonadism is more pronounced in patients with alcoholic cirrhosis and primary hemochromatosis. Sexual dysfunction correlates with the intensity of hepatic dysfunction and is more pronounced in patients with higher Child-Pugh or MELD scores. Although successful liver transplant may improve erectile function and libido, sexual dysfunction frequently persists in many patients. Additional risk factors such as diabetes, arterial hypertension, smoking, alcohol intake, and psychological stress should be identified and adequately treated in order to reduce sexual dysfunction.