Liver Health and Sexual Dysfunction

What is Sexual Dysfunction?

Sexual dysfunction is defined as the persistent, recurrent inability for a male or female to experience satisfaction through sexual response and desire. Fortunately, most cases are treatable, so it is important to share any concerns with a physician if one is experiencing problems.

Sexuality is a basic attribute of being human. Studies show that sexual intimacy in conjunction with love and affection has many health benefits. Among the benefits listed are:

  • it helps to build and sustain healthy relationships and
  • contributes to individual physical and psychological well-being – especially for those with liver disease


Sexual dysfunction can be caused by mental, emotional or physical problems for both males and females. Any chronic illness may be associated with sexual dysfunction. This is particularly true for liver disease.

Individuals with chronic liver disease often experience fatigue and depression, which quite naturally contribute to a decreased interest in sex. In addition, medications used in the treatment of liver disease are known to cause sexual dysfunction and decreased interest in sex – especially in men. It is also known that many of the antidepressant medications prescribed to treat depression and anxiety cause sexual dysfunction, a common side effect. Finally, when one doesn’t feel well, the desire for sex is likely to wane if not disappear altogether.

Who is at Risk?

While most people with chronic liver disease experience a normal desire for sex as well as normal sexual function, any male or female with chronic liver disease is at risk for experiencing sexual dysfunction.

Statistics show about 2% of healthy, middle-aged males, without liver disease, experience erectile dysfunction and decreased interest in sex which is about the same for males with early stage liver disease. Females with liver disease appear to experience normal sexual function with the exception of those with liver disease caused by excessive consumption of alcohol.

However, depending on the cause of the liver disease, medications used to treat the disease and the mental and emotional state of the patient, when sexual dysfunction occurs, it can be moderate to severe.


The most common symptoms in females are:

  • Lack of desire to have sexual intercourse
  • Lack of arousal during sexual intercourse or the inability to maintain arousal
  • Inability to have an orgasm (the climax or peak of sexual pleasure which occurs during sexual activity)
  • Pain during sexual intercourse – usually due to vaginal dryness

The most common symptoms in males are:

  • Ejaculation disorders – premature ejaculation (ejaculation that occurs too soon); inhibited or retarded ejaculation (ejaculation that is slow to occur); and retrograde ejaculation (at ejaculation, semen is forced back into the bladder rather than exiting through the penis at orgasm)
  • Erectile dysfunction (impotence) – the inability to attain and/or maintain an erection suitable to perform the act of intercourse
  • Inhibited sexual desire – decrease in desire or loss of interest in sexual activity

How is it Diagnosed?

A thorough physical examination to rule out specific problems such as nerve disorders and Peyronie’s disease (scar tissue in the penis) in males and pelvic infection and neurological disorders in females, along with a history of symptoms will likely begin the process of diagnosing sexual dysfunction.


Once a medical assessment has been made, depending on the severity of the problem, common treatments may include:

  • Surgery – in some cases, a mechanical aid such as a  penal pump will be surgically implanted in a male to enable an erection
  • Hormones – men with low levels of testosterone will benefit by testosterone replacement therapy; likewise for females, estrogen (female hormone) replacement therapy or androgen (male hormone) replacement therapy will be prescribed
  • Psychological counseling – to determine the underlying psychological cause, if any, for the sexual dysfunction
  • Medications – for a man, Viagra, Cialis, Levitra, or Staxyn may be prescribed to enable more blood flow to the penis; for a woman, Viagra has shown limited results in treating sexual dysfunction, however, at this time there is no drug on the market that has proven safe and beneficial for females

While remedies such as prescription medications and hormone replacement therapy are the most common treatments for sexual dysfunction, individuals with chronic liver disease must use caution and work closely with his or her physician when considering such treatment. Because drugs such as Viagra and the like are metabolized through the liver, careful monitoring by a physician, preferably a liver specialist is essential for anyone with liver disease.

Studies have failed to conclusively determine whether testosterone replacement treatment improves sexual function in men with chronic liver disease. Furthermore, testosterone may even be dangerous for those with liver disease. There­fore, this type of treatment cannot be recommended until further research has confirmed its effectiveness.

Safe Alternative Treatments

Besides the pleasure derived physically from a satisfying sexual encounter, individuals with chronic liver disease are also in need of the health benefits that having sex affords such as a sense of well-being, stress relief, and strengthening the immune system.

For individuals with liver problems who are not currently enjoying an active sex life, finding an alternative treatment that contains safe, effective sex-enhancing, liver-friendly herbal ingredients should be seriously considered.

While research shows that sexual dysfunction is common, it is a topic many people are hesitant to discuss due to embarrassment or shame. By putting aside any feelings of embarrassment or shame, those experiencing sexual dysfunction, who discuss their sexual health concerns with their physician, have a greater chance of finding solutions.

Seeking the advice of one’s physician, when considering any treatment for sexual problems, is always advisable. Missing out on the enjoyment of safe sex and its many benefits is unnecessary.

This information is for educational purposes only and should not be used in any other manner. This information is not intended to substitute for informed medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider.

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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.

Cohen, O.M.D., L.Ac Misha Ruth, Gish, M.D Robert G. with Doner Kalia The Hepatitis C Help Book. St. Martin’s Griffin, 2001 "Sexual Dysfunction in Women"
Retrieved October 2, 2018 "Female Sexual Dysfunction"  Retrieved October 2, 2018 "Sexual Health Basics"   Retrieved October 2, 2018

Palmer, M.D. Melissa "Sex and Liver Disease" Retrieved April 8, 2011 "Sexual dysfunction: overview of prevalence, etiological factors, and treatments" Retrieved October 2, 2018 "Sexual Problems in Men" Retrieved October 2, 2018

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