No Effect of Oral Testosterone Treatment on Sexual Dysfunction in Alcoholic Cirrhotic Men

Gluud, Christian; Wantzin, Per; Eriksen, J.

doi:10.1016/s0016-5085(88)80081-7

Cited by 43 publications

(31 citation statements)

References 27 publications

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“…Testosterone supplementation did not significantly improve sexual dysfunction, although sustained abstinence from alcohol was associated with improvement. 10,11 Portosystemic shunting appears to play a role in the high incidence of sexual dysfunction. Nolte et al 12 reported that in 17 men who underwent transjugular intrahepatic portosystemic stent shunting, the incidence of erectile dysfunction increased from 30% to 70%.…”

Section: Discussionmentioning

confidence: 99%

Sexual functioning in patients with end-stage liver disease before and after transplantation

Sorrell

Brown

2006

Liver Transpl

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The effects of end-stage liver disease (ESLD) on sexual functioning are complex and often overlooked in the context of chronic illness and the transplantation evaluation. The aim of the present study is to report on the prevalence of sexual dysfunction in patients with ESLD presenting for liver transplantation evaluation, as well as to examine a cohort after transplantation. Participants included 173 consecutive adult outpatients with ESLD who presented for orthotopic liver transplantation evaluation. All transplant candidates underwent a psychiatric evaluation, and a sexual history was taken by the transplant psychiatrist. Patients who received a liver transplant were contacted by telephone for follow-up (n ϭ 39). The following domains were explored: sexual frequency, satisfaction, ability to orgasm, sexual interest, and, for men, erectile dysfunction. Before transplantation, high levels of sexual dysfunction were found, with women showing higher levels of dysfunction than men. Increased age and more severe liver disease were related to lower sexual frequency and satisfaction. Contrary to previous work, the cause of disease (alcoholic liver disease) was not related to sexual functioning before transplantation. Those with erectile dysfunction before transplantation showed continued dysfunction after transplantation. An additional finding was an age and gender bias against taking a sexual history from older women. Overall, for both men and women, the findings point to continued and persistent sexual dysfunction after transplantation. Few areas of human behavior are as complex as sexuality. Experiencing oneself as a sexual being and engaging in sexual activity involves a wide range of psychological processes such as emotions, attitudes, and values integrated with optimal physiological functioning. Sexual function, consequently, is uniquely sensitive to illness, psychological distress, and disequilibrium in interpersonal relationships. Chronic illness is associated with sexual dysfunction and results in diminished sexual activity due to malaise, fatigue, and changes in body image. The effects of end-stage liver disease (ESLD) in this arena can be profound and have been attributed to the constitutional effects of illness. For men, hypogonadism and feminization are associated with cirrhosis.1 The impact on women is unclear. In fact, the literature on sexual dysfunction in ESLD essentially ignores women.In addition to the specific effects of liver disease, patients with ESLD have a host of other factors that are likely to adversely influence sexual functioning. With respect to men, vascular disease, diabetes, hypertension, hyperlipidemia, and neuropathy are associated with erectile dysfunction. 2 A host of medications can contribute to erectile dysfunction, although it is difficult to separate the effects of the underlying condition from the drug used to treat it.3,4 Several of these medication classes are commonly prescribed to treat patients with ESLD. They include diuretics, beta-blockers, and antidepressants. Like...

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Section: Discussionmentioning

confidence: 99%

Sexual functioning in patients with end-stage liver disease before and after transplantation

Sorrell

Brown

2006

Liver Transpl

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“…Erectile dysfunction (ED) is frequently problematic in patients with chronic liver diseases such as hemochromatosis [196] , alcoholic liver disease [197] or liver transplant patients [198] , leading to worsening of quality of life in those patients. Hypogonadism or protein malnutrition found in patients with advanced liver disease may induce ED [199,200] .…”

Section: Sexual Dysfunction In Liver Diseasesmentioning

confidence: 99%

“…Hypogonadism or protein malnutrition found in patients with advanced liver disease may induce ED [199,200] . Removal of causative factors such as iron or ethanol, or administration of testosterone may improve ED in such patients [197,198] . ED is also more frequent in patients with chronic HCV infection than in control subjects (39% vs 14%, respectively) probably due to a direct effect of HCV on neurovascular and hormonal systems (i.e.…”

Section: Sexual Dysfunction In Liver Diseasesmentioning

confidence: 99%

Systemic abnormalities in liver disease

Minemura¹,

Tajiri²,

Shimizu³

2009

WJG

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“…Despite lower levels of testosterone and increased levels of estrogen, supplementing testosterone is not effective at improving erectile dysfunction. 36 Unsurprisingly, sexual dysfunction does improve in alcoholic men who abstain. 37 The incidence of erectile dysfunction more than doubles in men who undergo transjugular intrahepatic portosystemic stenting.…”

Section: Sexual Functionmentioning

confidence: 99%

Autonomic dysfunction in chronic liver disease

Frith

Newton

2009

Liver International

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Abstract:It is becoming increasingly clear that quality of life (QOL) is impaired in those with chronic liver disease (CLD). One of the most important contributors to impaired QOL is the symptomatic burden which can range from slight to debilitating. Autonomic dysfunction accounts for a significant proportion of these symptoms, which can be common, non-specific and challenging to treat. Investigating the autonomic nervous system can be straight forward and can assist the clinician to diagnose and treat specific symptoms. Evidence-based treatment options for autonomic symptoms, specifically in CLD, can be lacking and must be extrapolated from other studies and expert opinion. For those with severely impaired quality of life, liver transplantation may offer an improvement; however, more research is needed to confirm this.

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No Effect of Oral Testosterone Treatment on Sexual Dysfunction in Alcoholic Cirrhotic Men

Cited by 43 publications

References 27 publications

Sexual functioning in patients with end-stage liver disease before and after transplantation

Sexual functioning in patients with end-stage liver disease before and after transplantation

Systemic abnormalities in liver disease

Autonomic dysfunction in chronic liver disease

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