Sexual Health in Men and Women with Wilson’s Disease: A Cross-Sectional Study

BACKGROUND AND OBJECTIVES: Wilson's disease (WD) is a systemic copper toxicity disorder, manifesting as hepatic and neurological symptoms. Sexual health in WD is not well studied. This study aimed to understand sexual health impairment and its related factors in men and women with WD. METHODS: Men with WD (MeWD) and women with WD (WoWD) were classified as being in the disease-active phase (DAP) or disease maintenance phase (DMP). Disease-related disability was assessed using the Global Assessment Scale for Wilson's Disease (GAS for WD). Sexual health was assessed with the Arizona Sexual Experience Scale (ASEX). Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales, respectively. Healthy men (MeH) and healthy women (WoH) underwent similar assessments for comparison. RESULTS: The study included 48 MeWD (11 DAP, 37 DMP), 39 WoWD (12 DAP, 27 DMP), 29 MeH, and 34 WoH. In MeWD, ASEX scores (median [Q1-Q3]) were 13 (10-16) in DAP, 13 (11-14) in DMP, and 14 (12-16) in MeH, with no significant differences. However, in WoWD, ASEX scores were more impaired in DAP 19.5 (15.25-24.75) than in DMP 15 (14-17) ( P = 0.029) and WoH 14 (13-18) ( P = 0.025). ASEX scores correlated with GAS for WD in both MeWD ( P = 0.023) and WoWD ( P < 0.001), but not with 24-hour urinary copper excretion at diagnosis. CONCLUSIONS: Men and women with WD experience impaired sexual health, which may be related to disease-associated disability. Longitudinal disease registries are required to understand the role of copper metabolism in sexual health impairment in WD.