Sexual and gonadal function in men after cardiac transplantation
Emmanuele Serra1, Stefano Serra2, Alessandro Oppo1, Francesca Atzeni1, Antonello Cappai1, Maurizio Porcu3 & Stefano Mariotti1
Introduction: Gonadal and erectile function in patients submitted to heart transplantation has not been previously investigated.
Aim of the study: To evaluate gonadal and sexual function in patients successfully submitted to cardiac transplantation.
Materials and methods: Fifty-two patients, aged 2078 years (mean±S.D.: 54±15 years; range 2078 years) transplanted 88±65 (range 4220) months before the present study. All patients were in good haemodynamic compensation (86.5% in NYHA I and 13.5% in NYHA II class). Most patients (88.5%) were on antihypertensive drugs and all patients were on immunosuppressive therapy. In all cases hormonal parameters (LH, FSH, T total), lipid profile, sexual function (questionnaire IIEF) and psychological status (MHQ questionnaire) were assessed. Statistical evaluation was performed by χ2 and by linear regression analysis.
Results: Overall erectile dysfunction (ED) prevalence was 71.1%, with a peak (90%) in patients aged >60 years, while that of hypogonadism (Hypo: T total <3 ng/ml) was 34.6% with a peak (70%) in patients aged 5059 years. ED prevalence was significantly correlated only to depression (as assessed by MHQ) and antihypertensive therapy. Hypo was significantly correlated to prednisone therapy and triglyceride levels. The highest prevalence of Hypo was observed in the first 4 years after transplantation, independently from the patients age, possibly as a consequence of higher doses of prednisone in immunosuppressive therapy. No significant correlation was found between ED and T levels.
Conclusions: The prevalence of Hypo and ED in patients submitted to heart transplantation is very high, in spite of good haemodynamic results. Main factors involved appear to be anti-hypertensive therapy and psychological factors for ED, and prednisone therapy and dyslipidemia for Hypo. The lack of correlation between ED and Hypo indicates that low T does not play a major role in sexual dysfunction of these peculiar patients.