Sexual behavior in women with liver disease was examined in 150 women to determine whether liver disease influenced sexual desire, frequency or performance. The average age of women studied was 53 years (range: 26 to 76 years), and a wide variety of liver diseases were represented. Sexual desire was reduced in 33%. Difficulty in becoming sexually aroused was noted by 18%. Orgasm during intercourse was not experienced by 25%. The frequency of sexual intercourse decreased since onset of disease in 27%. Dyspareunia was a complaint by 21%, most often attributed to decreased vaginal lubrication. Liver disease was considered a significant factor interfering with sexual function in 17%. No statistical difference was found between sexual desire or function in our study and in large studies of sexual behavior in women. Each category was subdivided by presence or absence of cirrhosis, pre-or postmenopausal state, laboratory values and duration of disease. Except for a greater number of postmenopausal women with complaints of painful intercourse, no statistical differences or trends were found. Nonalcoholic liver disease does not affect sexual desire, function or performance. Variables other than liver disease influence sexuality. Women with liver disease can thus be reassured that they can maintain normal sexual relations.
Sexual dysfunction has been reported in men with liver disease, predominantly alcohol-related. Some authors have suggested that liver disease itself is responsible for the sexual dysfunction, with amplification by alcohol (1, 2). Others have attributed sexual dysfunction in these men to alcohol, with a partial but minor contribution from the liver disease itself (3). T o our knowledge, however, no study of sexual desire or function has been performed in women with liver disease. Sexual performance has been examined in other disease entities including cerebrovascular accidents, coronary heart disease, irritable bowel syndrome, celiac disease and diabetes (4-9).
Studies of hormonal status in postmenopausal women with cirrhosis of various etiology, including alcohol, hepatitis B, primary biliary cirrhosis and cryptogenic cirrhosis, have revealed an increase in estradiol levels. Other