Sexual dysfunctions and their treatment in liver diseases

Table 1 Erectile dysfunction prevalence studies

Disease etiology and age	Prevalence	Study	Ref.	Journal, year	Method used
Cirrhosis of liver	70.3%. ED increases with increase in CTP score	Tadalafil improves erectile dysfunction and quality of life in men with cirrhosis: A randomized placebo controlled trial	Jagdish et al[1], India	Hepatology International, 2021	IIEF-5
Chronic viral liver diseases	60%, age < 50 years, 88% age > 50 years. ED	Erectile dysfunction in patients with chronic viral liver disease: Its relevance to protein malnutrition	Toda et al[4], Japan	J Gastroenterology, 2005	IIEF-5 and medical outcomes study short form 36 (SF-36)
Hepatitis B-aged 40-59 yr (SD 50.2 ± 5.7)	Total 24.6%, (CHB-8.6%, HBV-LC-41.2%)	Erectile dysfunction in patients with liver disease related to chronic hepatitis B	Kim et al[5], Korea	Clinical and Molecular Hepatology, 2015	Erectile function of patients was evaluated by the Korean version of IIEF-5
Hepatitis C, age -20-80 yr (SD; 50 ± 17.19) yr	30%	Erectile dysfunction in patients with chronic hepatitis C virus infection	Hunter et al[6], Egypt	Arab J Gastroenterol, 2014	An Arabic validated version of the five-item IIEF-5
Alcoholic liver diseases (age < 56 yr)	61%	Sexual dysfunction in men with alcoholic liver cirrhosis. A comparative study	Jensen et al[7], UK	Liver, 1985	All groups had a significantly (P less than 0.025) raised prevalence of sexual dysfunction when compared to men without chronic disease
Chronic liver disease (mean age 54.8 ± 10.8 yr)	50.6%	Assessment of sexual function in patients with chronic liver disease	Simsek et al[8], Turkey	Int J Impot Res, 2005	International index of erectile function

CHB: Chronic hepatitis B; ED: erectile dysfunction; HBV: Hepatitis B virus; IIEF-5: International index of erectile function.

Table 2 Studies of hepatic venous pressure gradient changes with phosphodiesterase-5 inhibitors

HVPG change	Intervention	Ref.
No significant change in HVPG	Tadalafil 10 mg	Jagdish et al[1], 2021, Hept International
N = 10, in seven patients, HVPG decreased and in three it increased but the decrease was not significant	Sildenafil 50 mg	Clemmesen et al[43], 2008, World J Gastroenterology
Lowers portal pressure in the acute setting by about 20%	75-100 mg of the phosphodiesterase-5-inhibitor udenafil	Kreisel et al[44], 2015, Dig Liver Dis
Decreased HVPG in 4/5 patients	Vardenafil 10 mg	Deibert et al[45], 2006, Aliment Pharmacol Ther
No effect on HVPG	Sildenafil	Tandon et al[46], 2010, Clin Gastroenterol Hepatol
HVPG decrease from 10 mmHg to 7 mmHg (case report)	Sildenafil 20 mg bd	Bremer et al[47], 2007, J Med Case Rep
HVPG decreased by 13%, and portal flow increased by 28% (case report)	Vardenafil	Deibert et al[48], 2018, World J Gastroenterology

HVPG: Hepatic venous pressure gradient.