Prevalence of sexual dysfunction in male patients with chronic liver disease

Background: Chronic liver disease, especially cirrhosis, can cause endocrine, morphological, and psychological changes that impair sexual health. Despite its impact on quality of life, sexual health remains insufficiently studied in hepatology. This study aimed to evaluate the prevalence of sexual dysfunction in male patients with chronic liver disease and identify associated risk factors. Materials and Methods: We conducted a single-center, comparative, descriptive, and analytical study in 2023. Male patients with chronic liver disease (Group 1) were compared to controls without liver disease (Group 2). Exclusion criteria were overt hepatic encephalopathy, cognitive impairment, and active alcohol abuse. Sexual function was assessed using the International Index of Erectile Function (IIEF). Results: The study included 120 participants: 60 with chronic liver disease and 60 controls, with a mean age of 44.6 years. Among patients with liver disease, 65% had cirrhosis, 18% HBV, 18% HCV, 8% NAFLD, and other etiologies. Sexual dysfunction was significantly more frequent in patients with liver disease compared to controls: erectile dysfunction (66.6% vs. 26.6%), orgasmic dysfunction (58.3% vs. 23.3%), decreased desire (68.3% vs. 16.6%), reduced intercourse satisfaction (63.3% vs. 30%), and reduced overall satisfaction (75% vs. 28.3%) (all p<0.05). Cirrhosis was the only independent risk factor (OR 7.9; p=0.019). Conclusion: Sexual dysfunction is frequent in male patients with chronic liver disease, with cirrhosis as the main risk factor. Systematic screening and a multidisciplinary approach are needed to improve care.