When liver disease complicates physical intimacy
Conditions like MASH may contribute to sexual health problems
Written by |
Something nobody knows about me is what a romantic I secretly am. Nothing makes me happier than being surprised with flowers, finding a thrifted treasure, especially if it’s from the art nouveau or art deco era, and cuddling up with my partner.
It’s been more than a month since we spent time together, but we’ve called and texted a lot. We both live busy, full lives as two 50-something Gen X adults. It’s a challenge to make time for each other, but we do our best.
I’ve had a lot on my plate. I’m working on returning to school to become a counselor; my partner works nights as a deeply devoted nurse. I have my co-parented teenage daughter to manage, and he helps his two elderly parents.
Just as we were finally ready to leap into each other’s arms again, I was struck down by a cold sore. I’m finishing antiviral medication, hopefully in time for my favorite guy’s birthday.
It really blows.
While our relationship is sometimes complicated, I’m glad we’re connected enough to weather the storms, including having to wait patiently before spending time alone together. I’m also glad that when it comes to intimacy, there isn’t an issue we can’t talk about.
But for people living with metabolic dysfunction-associated steatohepatitis, or MASH, and especially those with more advanced liver disease, intimacy may become complicated by something besides scheduling.
Navigating sexual dysfunction in MASH
Sexual dysfunction is common but often overlooked in people with chronic liver disease and cirrhosis. Hormonal changes are one possible contributor, along with medications, fatigue, depression, other health conditions, and the severity of liver disease.
A few years ago, my own sex drive was almost nonexistent. I felt slightly thankful at the time since I had no partner and so many other things going on that it didn’t seem to matter much.
Still, I went on a string of very unproductive dates that made me wonder if something was wrong. Even the most charming men couldn’t interest me enough to consider them potential partners.
I must say, though, many of those dates were just bad.
During a doctor’s appointment, I told my doctor how weird I was beginning to feel. Where had my arousal triggers gone?
Her assessment was that my liver disease might be contributing, so she ordered tests, including a thyroid panel and tests to check my insulin and hormone levels. It turned out my estrogen was low thanks to menopause, which can also affect sexual desire and function, along with some other key factors. My doctor determined hormone replacement therapy was appropriate for me, and I was back on the road to romance.
One thing I can tell you about discussing your sex life with your doctor is this: Just be honest.
I grew up in a very conservative family in a very conservative state. That came with weird body issues because I was often reminded that sex before marriage was wrong and touching your own body was something the big guy in the sky didn’t approve of.
I’m not saying this to make anyone who holds those beliefs feel bad. I just want to give you permission to enjoy your life as you see fit. If you’re experiencing sexual dysfunction, your doctor can be an ally. I’ve written before about why talking openly with your doctor matters when living with MASH.
Women with chronic liver disease may experience low desire, difficulty with arousal or orgasm, painful intercourse, and menstrual changes. Men may experience erectile dysfunction, low libido, reduced morning erections, fertility issues, testicular changes, or gynecomastia. These are among the sexual health problems researchers have documented in people with chronic liver disease.
And sexual dysfunction isn’t always purely hormonal. The causes can overlap, which is one more reason to talk to someone who can help sort them out.
But all is not lost.
Talk to your doctor. Be as honest as you possibly can. Trust me when I say there is very little under the sun that hasn’t already been done and then run past a doctor for review. Even your most embarrassing question is probably old hat to a trained physician. My doctor has yet to blush at anything I’ve told her.
Today, my cold sore seems almost gone. Once this outbreak has healed, I’ll be reaching for my lip gloss, fixing my hair, and, finally, locking lips with the man who makes my heart sing.
I can hardly wait!
Note: Liver Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Liver Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to liver disease.
Leave a comment
Fill in the required fields to post. Your email address will not be published.