Liver health is intricately related to sexual health and functioning.
A myriad of chronic health conditions are linked to erectile dysfunction (ED). However, the negative impact of liver disease on sexual health and functioning is rarely discussed. Liver disease, specifically cirrhosis of the liver, dramatically increases the risk of ED in men.
Men with liver disease should not have to suffer from persistent ED symptoms. This article discusses the relationship between liver health and erectile dysfunction (ED).
Erectile Dysfunction Causes and Diagnosis
Erectile dysfunction (ED) is the inability to achieve or maintain an erection. Further, men with ED may also experience reduced sexual desire. Occasional difficulty achieving or maintaining an erection is not sufficient for diagnosis, but if the problem is ongoing, a doctor will most likely recommend treatment for ED.
Identifying the cause of erectile dysfunction can be tricky. Male sexual arousal requires participation between the brain, hormones, mental state, nerves, muscles, and blood vessels to achieve and maintain an erection. What’s more, ED is often rooted in both physical and mental health conditions.
Potential causes of erectile dysfunction (ED) include:
|Cardiovascular conditions||Heart disease, high blood pressure, high cholesterol, atherosclerosis (clogged blood vessels)|
|Chronic health conditions||Diabetes, Parkinson’s disease, multiple sclerosis|
|Certain medications||Medications for depression or chronic health conditions|
|Hormonal imbalance||Low testosterone|
|Lifestyle||Limited exercise, obesity, tobacco use|
|Psychological||Anxiety, depression, sleep disorders, chronic stress|
|Physical damage||Any physical damage to the penis or Peyronie’s disease, resulting in scar tissue inside the penis|
|Substance use||Substance use disorder, alcohol use disorder, illicit substance use|
Patients will most likely be asked questions about their lifestyle habits, medication use, stress levels, and overall health history to pinpoint the correct approach to ED treatment. Treatment of an underlying chronic condition may be sufficient to treat ED. However, physicians often recommend a combination of lifestyle changes and prescription medication use for those experiencing persistent ED symptoms.
Effective ED Treatment
Treatment for ED often begins with management of underlying health conditions and lifestyle changes. Non-invasive treatments, such as oral medication, are often the first line of medical treatment for ED. More invasive treatment methods, such as surgery or penile implants, are the last lines of defense against ED.
The Food and Drug Administration (FDA) has approved four oral prescription lifestyle medications for ED, available in both brand name and generic versions. These drugs are known as phosphodiesterase type-5 (PDE5) inhibitors that work by improving blood flow to the penis. The drugs have been widely tested and deemed safe for most men.
The list of FDA-approved drugs includes:
- Viagra (sildenafil citrate)
- Levitra (vardenafil HCl)
- Cialis (tadalafil)
- Stendra (avanafil)
How Alcohol Impacts Erectile Dysfunction
Many wonder if excessive drinking is the sole cause of their ED, but it is much more likely to be attributed to multiple underlying causes. Moderate drinking does not influence erectile health as strongly as excessive alcohol consumption. Chronic alcohol use can have a cumulative negative effect on the liver, resulting in negative sexual function outcomes.
Alcohol use disorder or excessive alcohol consumption is associated with erectile dysfunction in men. Excessive alcohol use is linked to chronic conditions such as heart disease or liver disease, specifically cirrhosis of the liver. Most chronic conditions negatively impact erectile health, especially those that impact the cardiovascular system or liver.
Alcohol can prevent men from achieving or maintaining an erection because it impacts the brain and the body’s blood flow. Excessive alcohol consumption can decrease blood flow to the penis, compromising the ability to achieve an erection. Men who drink to higher levels of intoxication are also more likely to experience decreased sensation, which can make it more difficult to climax.
Diseases of the Liver and ED
Diseases of the liver, such as Hepatitis B or any form of liver cirrhosis, increase a patient’s risk of erectile dysfunction. Research consistently demonstrates that a majority of patients with cirrhosis of the liver will also experience ED. Severity of liver function and existing comorbidities (e.g. hypertension) will in turn impact the severity of ED symptoms.
One research study demonstrated 24.6 percent of participants with Hepatitis B-related liver disease met the criteria for erectile dysfunction. Participants diagnosed with early-stage Hepatitis B-related liver cirrhosis demonstrated an increased risk for ED, as 41.2 percent met the criteria for ED during the study. Researchers recommend additional support be provided to patients with early-stage liver cirrhosis who also meet the criteria for depression, hypertension, or decreased albumin levels.
A similar study found ED to be present in 40 percent of participants diagnosed with chronic viral hepatitis. Researchers also found that men with chronic viral hepatitis and ED were more likely to score higher on scales for depression. Age, depression, and liver cirrhosis are each associated with ED.
Management of sexual dysfunction is complex in patients with liver disease, because the root cause is often multi-faceted. The greater the severity of the liver disease, the more likely a patient is to suffer from ED. Men with end-stage liver disease overwhelmingly report a lack of sexual activity and ED symptoms.
Are ED Medications Safe for People with Liver Disease?
It is important to speak to a medical provider before taking medication for ED. Oral ED medications are deemed safe for most patients, but underlying conditions or current medications may result in adverse effects if not taken under a physician’s supervision.
ED medications may be dangerous for:
- Someone living with severe liver disease
- Someone who takes nitrate drugs
- Someone who has very low blood pressure
- Someone with kidney disease
Research shows that men with alcohol dependence or alcohol use disorder are more likely to suffer from ED than men who do not. In a study of men with alcohol dependence, sildenafil citrate (generic of Viagra) was effective at improving sexual function. Those who used sildenafil citrate also reported improved quality of life and reduced emotional distress. No adverse outcomes were reported in the study.
Those with liver disease or who struggle with alcohol use disorder should speak with their doctor before taking ED medications. Treatment for erectile dysfunction can be conveniently ordered online. Visit eDrugstore.com today to learn more about treatment options for sexual health and sexual dysfunction.
Shelby is a public health professional with research and field experience in sexual and reproductive health. She holds a Master of Public Health (MPH) and is a Certified Health Education Specialist (CHES).