From the Journals

Erectile dysfunction appears prevalent with hemophilia



Erectile dysfunction (ED) appears prevalent among men with hemophilia and becomes increasingly common with age, according to results from a recent survey.

Although the findings may not be generalizable because of small sample size (44 respondents), the survey offers a general sense of the sexual health of patients with hemophilia, which is a minimally researched topic, reported lead author Ming Yang, PhD, of the British Columbia Provincial Bleeding Disorders Program at St. Paul’s Hospital in Vancouver and colleagues.

Such data become increasingly important as new hemophilia therapies further extend the lifespan of patients, which thereby exposes them to diseases of old age, the investigators noted in Haemophilia.

Additionally, ED is considered an early sign of endothelial dysfunction in the general population, but data are lacking for patients with hemophilia.

Among the 56 men with hemophilia A or B who were surveyed with the International Index of Erectile Function (IIEF) questionnaire, 44 completed the survey (median age, 49 years). Specifically, respondents completed the “erectile function” component of the questionnaire because this is the only domain that has been validated.

To assess associations between ED and well-established risk factors, the investigators recorded prior surgeries, medications, atherosclerotic diseases, viral infections, and hemophilia-specific factors. To better characterize the population and look for other associations, the investigators had patients undergo baseline laboratory testing and measurements of blood pressure, anthropomorphic indexes, and endothelial function.

According to the IIEF, 38.6% of patients had ED, which was subcategorized as mild and mild to moderate in 4.5% of patients, moderate in 18.2%, and severe in 15.9%.

The investigators found significant associations between ED and coronary artery disease, hypertension, smoking, higher waist/hip ratio, homocysteine level, and age. However, on multivariable analysis, only age was correlated with ED domain score (P = .03). No associations between ED and endothelial dysfunction were reported.

While the findings may offer a rare look at ED rates in patients with hemophilia, they are insufficient for comparisons and generalizations, the investigators cautioned.

“Without comparative studies within the haemophilia population in Canada or elsewhere and due to limited sample size and non‐normalized distribution of our age group, this prevalence cannot reasonably be generalized to the entire haemophilia population,” the investigators wrote.

Instead, the investigators suggested that more studies are needed, especially ones involving customized questionnaires.

The study was funded by Pfizer. Dr. Yang reported having no conflicts of interest. One coauthor reported an unrestricted educational award from the Association of Hemophilia Clinic Directors of Canada/Baxter Canadian Hemostasis Fellowship, and another coauthor reported research funding from Pfizer.

SOURCE: Yang M et al. Haemophilia. 2019 Feb 28. doi: 10.1111/hae.13707.

Next Article: