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How Liver Disease and Depression Can Impact Relationships and Sexual Function

Your liver is so essential to your body that it has a big impact on both your physical and mental health. Unfortunately, that includes even the most intimate areas of our lives.

A significant percentage of men and women who suffer from liver disease also experience depression and sexual dysfunction. Sometimes one leads to the other, sometimes they happen simultaneously, and sometimes these symptoms are the result of the medications that are supposed to make us feel better. In this article we’ll examine how liver disease, depression, and sexual dysfunction are interlinked.

Depression Is a Common Symptom of Liver Disease

There are many kinds of liver disease (chronic hepatitis, cirrhosis, non-alcoholic fatty liver disease), each with its own unwelcome symptoms. However, one psychological symptom is common to them all. In a 2017 study published in Frontiers in Molecular Neuroscience, Dr. Xiaoqin Huang and his colleagues noted that “chronic liver disease [CLD] has been long recognized and associated with depression,” and that the occurrence of depression is higher in patients suffering from CLD.

Depression in CLD sufferers can be due to several factors, including but not limited to:

  • the long-term pain of the disease and its treatment
  • the resulting sexual dysfunction and feelings of guilt
  • the fear of the disease’s progression

These feelings are further exacerbated by social and economic pressures, such as social discrimination and the high cost of medical treatment.

Against this tumultuous backdrop, sexual dysfunction can be painted as a relatively minor complaint. But that discounts the importance of sex to our physical and emotional well being.

Believe It or Not, Sex Matters

Sexual intercourse with a loving partner is, of course, an intimate and enjoyable act, but it can also be good for your health. As we’ve discussed before, sex can boost your immunity. An impending orgasm causes a spike in the level of DHEA, a hormone that improves brain function, balances your immune system, and helps to maintain and repair tissues in your body. A Wilkes University study found that having sex just once or twice a week can boost levels of immunoglobulin A by almost one-third!

And don’t forget, the sexual act is a form of exercise. It can burn roughly 150 calories per hour, during which time fresh blood is pumped to organs and muscles throughout your body. That saturates your tissues with fresh oxygen and helps to flush toxins from your liver.

Sex can also be a great confidence booster. The rush of endorphins, combined with the emotional jolt of intimacy and passion, is an unparalleled experience.

How Depression and Dysfunction Cause a Negative Feedback Loop

By this point, the link between liver disease and depression should be clear. When you feel sick and worry about getting sicker, both your mental and emotional health suffers. As for the link between disease and sexual dysfunction, when a compromised liver isn’t the direct result, the medications used to treat it can be. But even apart from the liver – depression and sexual dysfunction often go hand in hand.

In cases where depression is caused by sexual dysfunction, the medications used to treat depression may only worsen the problem. Because arousal begins in your brain, sexual behavior and performance are affected by alterations in brain chemistry. That’s exactly what you’re doing when you take antidepressants: altering the way your neurotransmitters communicate with each other. In the end, you may be less depressed, but your libido isn’t what it used to be.

Compassion First

For those suffering from sexual dysfunction, the greatest pain may derive from the mistaken belief that they have lost worth as a romantic partner. That belief may sink even deeper, to damage their self worth as a human being. When this depression strikes, there is no greater medicine than compassion. A person may get sick, but that does not render them less of a person or diminish their value.

Emotional understanding is an excellent first step on the path to healing. The next step is physical. There are a few things you can try to improve your sexual health, the first of which is a conversation with your doctor. Ask about the side effects of your current medication and, if they include changes in libido or function, find out if there are alternatives. Your doctor may suggest waiting to see if the side effects reduce over time, or possibly adjust your dosage.

In addition to these steps, you can try supplements to restore your vigor. Ginseng can ease sexual fatigue and deer antler velvet may restore sexual imbalance. The aptly named “horny goat weed” can also increase sensation in the genital region, which may increase sexual responsiveness. And, of course, supplements that cleanse and strengthen your liver, naturally boost energy, and combat stress, can’t hurt!

Cutler, Nicole (2010). Yes! Those with Liver Disease Can (and Should) Be Sexually Active. Retrieved on 1/1/18 from

Hall-Flavin, Daniel K. I'm worried about the sexual side effects from antidepressants. What can be done to prevent or reduce such side effects? Retrieved on 1/1/18 from

Huang, Xiaoqin, Liu, Xiaoyun, & Yu, Yongqiang (2017). Depression and Chronic Liver Diseases: Are There Shared Underlying Mechanisms? Retrieved on 1/1/18 from

WebMD (2016). Sexual Problems and Depression. Retrieved on 1/1/18 from

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About the Author

Stephen Holt, MD, PhD, FACP

Stephen Holt, M.D. is a Distinguished Professor of Medicine NYCPM (Emerite) and a medical practitioner in New York State. He has published many peer-review papers in medicine and he is a best-selling author with more than twenty books in national and international distribution. He has received many awards for teaching and research. Dr. Holt is a frequent lecturer at scientific meetings and healthcare facilities throughout the world. He is a best selling author and the founder of the Holt Institute of Medicine.

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