Opinion Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 27, 2022; 14(8): 1530-1540
Published online Aug 27, 2022. doi: 10.4254/wjh.v14.i8.1530
Sexual dysfunctions and their treatment in liver diseases
Rakesh Kumar Jagdish
Rakesh Kumar Jagdish, Department of Hepatology, Gastroenterology and Liver Transplant Medicine, Fortis Hospital Noida, Noida 201301, UP, India
Author contributions: Jagdish RK developed the protocol, conceived, and wrote the literature review, and produced the tables and figures in the manuscript.
Conflict-of-interest statement: All the author declares no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rakesh Kumar Jagdish, MD, Consultant Physician-Scientist, Department of Hepatology, Gastroenterology and Liver Transplant Medicine, Fortis Hospital Noida, Sector 62, Noida 201301, UP, India. dr.rkj.kapil@gmail.com
Received: March 21, 2022
Peer-review started: March 21, 2022
First decision: July 25, 2022
Revised: May 21, 2022
Accepted: July 25, 2022
Article in press: July 25, 2022
Published online: August 27, 2022
Processing time: 157 Days and 19.8 Hours
Abstract

Sexual dysfunction (SD) is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis. The etiology of SD is multifactorial and therefore treatment strategies are complex, especially in females. Phosphodiesterase inhibitors are useful and effective in erectile dysfunction in males but in females, no single drug is available for SD, therefore multimodal treatment is required depending upon the cause. The foremost and fundamental requirement in both genders is to be stress-free and have adequate control of liver diseases. Improved quality of life is helpful in improving SD and vice versa is also true. Therefore, patients suffering from liver diseases should come forward and ask for treatment for SD, and physicians should actively enquire about SD while history taking and evaluating these patients. SD results in deterioration of quality of life, and both are modifiable and treatable aspects of liver diseases, which are never addressed actively, due to social taboos and fears of SD treatment in the presence of liver diseases. The diagnosis of SD does not require costly investigations, as the diagnosis can be established based on validated questionnaires available for both genders, therefore detailed targeted history taking using questionnaires is essential. Data are emerging in this area but is still at an early stage. More studies should be dedicated to SD in liver diseases.

Keywords: Sexual dysfunction; Erectile dysfunction; Female sexual function index; International index of erectile function; Phosphodiesterase inhibitors; Hepatic venous pressure gradient

Core Tip: Liver diseases and cirrhosis related sexual dysfunction (SD) is present in a significantly high proportion of both genders but is often underestimated, ignored, or overlooked. Due to its multifactorial causations, detailed history taking, examination, and addressing potential causes are required for the diagnosis and management of SD. More randomized controlled trials should be planned for both genders regarding the newer treatment options.