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Male Sexual Function During Hepatitis C Treatment

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A new study presented at the November 2008 Annual Meeting of the American Association for the Study of Liver Diseases painted a grim picture of the sexual health of men with Hepatitis C who undergo treatment. However, further investigation into the details reveals this trial’s weakness and should put most men at ease.

Although sex usually is a source of great pleasure, it can also be the cause of significant stress. Intertwined with aspects of one’s physical, emotional and spiritual health, an adult’s sexuality is complex. Despite the range of possible causes, a reduction in sexual desire, function or satisfaction can be extremely upsetting. Considering the complex union of neurological, psychological and physiological events that must unite for an optimal sexual experience to occur, it is not surprising when things occasionally are amiss.

The Study

Eight health centers across the U.S.A. collaborated on a study to determine the effect Hepatitis C combination therapy has on men’s sexual health. Self-administered sexual health questionnaires were given to over 400 participants with Hepatitis C genotype 1 receiving a 48-week course of combination therapy. Containing five sexual health questions that assessed sexual desire, function (erection and ejaculation) and satisfaction, the questionnaires were given six times throughout a 72-week period.

At the start of therapy, the following was indicated:

  • 37 percent reported an impairment of sexual desire
  • 26 percent reported erectile dysfunction
  • 21 percent reported ejaculatory problems
  • 44 percent reported dissatisfaction with their sex life

Not surprisingly, the respondents reported a worsening in all areas of sexual health during interferon-based therapy:

  • 53 percent reported an impairment of sexual desire
  • 39 percent reported erectile dysfunction
  • 31 percent reported ejaculatory problems
  • 54 percent reported dissatisfaction with their sex life

Most areas of sexual health returned to their original levels at the end of the 72-week period. However, those who endured treatment for the full 48 weeks had a slightly higher erectile and ejaculatory dysfunction compared to before treatment began.

Reality

Although the percentages of men in this study with a lower than desired level of sexual function may seem like a lot, these numbers are meaningless without a comparison.

  • According to a 1999 survey from the University of Chicago and the Robert Wood Johnson Medical School, approximately 30 percent of men report sexual dysfunction. Although a slightly higher proportion of men with Hepatitis C said they had problems with sexual desire, function or satisfaction, the 1999 research based its findings on the general population.
  • According to a Portuguese study published in the June 2008 edition of The Journal of Sexual Medicine, the prevalence of erectile dysfunction is strongly related to age and health status. They concluded that adjusting for age, the total prevalence of erectile dysfunction in men was slightly higher than 48 percent, a statistic that is very close to what was reported by men in the Hepatitis C study.
  • According to a publication in the November 2008 edition of the International Journal of Impotence Research, testosterone levels fall as men age. Because testosterone plays a role in general and sexual health in men, it is no surprise that a higher percentage of older men report sexual dissatisfaction as opposed to younger men. Because the Hepatitis C study did not separate results according to age, its statistics are not specific enough to draw any conclusions.

Besides Age

For normal sexual arousal and function to occur, a person must feel good. Feeling well enough for sex involves feeling confident, being free from anxiety, having stamina for mental and physical stimulation, as well as the ability to focus attention on arousing thoughts or behavior. Anything that interferes with these conditions can disrupt a sexual encounter.

The severe side effects that accompany Hepatitis C therapy definitely have the potential to interfere with feeling good. Those affected who discuss their sexual health concerns with their physician have a greater chance of finding solutions. For more information about sexual dysfunction with chronic Hepatitis C, read How Hepatitis C Can Affect a Patient’s Sex Life.

There are many components that must unite for sexual desire, function and satisfaction to work. Thus, isolating antiviral therapy as a predictor of sexual difficulties is unfair. The study disclosed in late 2008 makes it seem like receiving treatment for Hepatitis C spells trouble for a man’s sex life. However, men over 40 years of age who don’t have Hepatitis C and who are not undergoing combination therapy have a similar rate of sexual dysfunction. Therefore, do not dismiss the prospect of combination therapy on the basis of sex alone. Because, chances are, if the treatment works and you eliminate the virus, you will eventually feel good – and feeling good is the strongest predictor of vibrant sexual health.

References:

http://chronicle.uchicago.edu/990218/dysfunction.shtml, Researchers publish new study on sexual dysfunction, William Harms, Retrieved December 4, 2008, The University of Chicago Chronicle, February 1999.

http://www.healthnews.com/family-health/sexual-health/sexual-
dysfunction-affects-almost-half-american-women-2062.html, Sexual Dysfunction Affects Almost Half of American Women, Madeline Ellis, Retrieved December 3, 2008, HealthNews.com, November 2008.

http://www.hivandhepatitis.com/2008icr/aasld/docs/111408_a.html, Sexual Desire, Function, and Satisfaction in Men Undergoing Treatment with Interferon-based Therapy for Chronic Hepatitis C, Liz Highleyman, Retrieved December 2, 2008, hivandhepatitis.com, November 2008.

http://www.mayoclinic.com/health/sexual-health/HQ01363, Sexual health: How to achieve a fulfilling sexual relationship, David Osborne, PhD, Retrieved December 3, 2008, Mayo Foundation for Medical Education and Research, 2008.

http://www.ncbi.nlm.nih.gov/pubmed/18194181?ordinalpos=12&itool=
EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReport
Panel.Pubmed_RVDocSum, Prevalence, severity, and risk factors for erectile dysfunction in a representative sample of 3,548 Portuguese men aged 40 to 69 years attending primary healthcare centers: results of the Portuguese erectile dysfunction study, Teles AG, et al, Retrieved December 3, 2008, The Journal of Sexual Medicine, June 2008.

http://www.ncbi.nlm.nih.gov/pubmed/19037223?ordinalpos=5&itool=
EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReport
Panel.Pubmed_RVDocSum, Are declining testosterone levels a major risk factor for ill-health in aging men?, Yeap BB, Retrieved December 3, 2008, International Journal of Impotence Research, November 2008.

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