Endocrine Abstracts

Background: Data on sexual dysfunction (SD) in cirrhotic patients are limited. Our aim was to evaluate the sexual function of patients with end-stage liver disease and to compare it with the results after liver transplant (LT) and with that of a controlled group matched by age and gender.

Methods: Changes in sexual functioning questionnaire were used to evaluate SD in cirrhotic patients awaiting LT and in the post-LT setting 1 year after transplant. Clinical data and a complete set of sexual hormonal profile were obtained. Controls were given the same questionnaires.

Results: 58 patients, 69% men, were included and compared to 58 controls. 92% of men presented SD during the waiting period for LT vs 63% of controls (P<0.01). In women, of whom 88% were in menopausal stage, SD was present in 94 vs 72% of controls (P=0.7). 1 year post-LT 74% of men presented SD (P=0.09), while no changes were detected in women. In men, sex hormones showed a pattern of central hypogonadism during the pre-LT period with a decrease in sex hormones (free testosterone in 83%, testosterone in 53%) and normal values of FSH and LH (72 and 81%). Estradiol and prolactin were increased in 86 and 72% respectively. Levels of DHEA-S were decreased in 97% of men. Results one year after LT showed a decrease of prolactin and estrogen to normal levels. There was an increase in testosterone levels (P=0.05). Levels of DHEA-S remained low.

Conclusion: SD with central hypogonadism is extremely common in cirrhotic patients awaiting LT. The reduced levels of DHEA, possibly due to adrenal dysfunction, is an aspect that deserves further investigation. LT improves SD in men, demonstrated both subjectively (questionnaires) and objectively (improvement in sex hormone levels).