Hep C Discussion Forum

I totally agree with Turtles post about it being the furthest thing from my mind.  Sx have made it near impossible.  No secretion to speak of anywhere. I do however worry about post treatment. I guess Ill have to cross that bridge when I come to it.

It's sober not somber.  Have a nice day.

I'll give up posting on matters I think are important. Obviously many others don't. Thanks for the genuine replies- replies that are sarcastic or witty belittle the topic and the poster. I'll stick to pleasantries from now on.

I've been having SX three or four times a day since starting treatment. It is almost unbearable to have so much SX and so often.

I certainly hope that after the 48 weeks I can get back to only having SX once or twice a month.

Capt. B. Rash

mallani wrote:

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.....This is just a brief overview of a common, complex subject. Thanks.

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 Malcolm, thanks for opening the topic, it's not only complex but for most men pretty difficult to talk about, in a direct manner...it's just is what it is.      The "is it low T" commercials that bombard the airwaves(West Coast region) every day are painful to view- you suspect that the commercial is irresponsibly peddling a 'snake oil' solution, but still you wonder.     I think that most of us here understand what a double-edged sword that testosterone replacement therapy can be, so as Malcolm's post recommends- giving your physician a shot at exploring possible causes & cures is a prudent starting point.

BTW Vernon- those sx sound pretty rough, hope things get back to normal soon.   

Hi Jim,

Thanks. We'll put you down as an SVR who has ED and a poor attention span.

Sex, hello! whats that lol everything goes against women of a certain age I think or it could just be me :(  but since achieving SVR in 2010 my libido is non existant :( and I really dont think I can be bothered to see therapists ect. Apart from that everything else has returned to normal only better :)

Jan x

Malcolm 

The question I have after reading the piece is, will Testosterone supplementation help with at least the physical aspect SP?

Obviously this is a multi part scenario , physical (chemically?), emotional, and the other persons mate influence on the situation.

Receiving help via counsel and a doctors care for the physical component seems to be a start. Be I am totally out of my league on such areas.

Just a thought no facts

Matt 

WARNING: If offended by the topic, please do not read and press the 'Back' button

This is a topic which is taboo on most Forums and has been rarely mentioned on this Forum. I'm not sure why, as I regard a satisfactory sex life as part of a normal healthy lifesyle.  'Satisfactory' may have different meanings for different people!  Sex problems are common in chronic Hep C, and this post was partly the result of my doc saying he was tired of writing prescriptions for Viagra for his EOT patients. My wife is 21 years younger and this may be part of my interest. The aim of the post is to explain the variety of 'sex problems', the causes, and how help may be obtained.

Sex problems ( let's call them SPs, to save me typing sex all the time) include decreased libido (sex drive), lack of interest in sex, unsatisfactory sex, erectile dysfunction (males) and decreased secretions (females). Patients may have some or all of these, in different degrees. Research has shown that SPs occur in up to 60% of patients with chronic HCV (who are not on treatment).

SPs are common in any chronic disease, particularly when associated with fatigue and depression. Alcoholism, anxiety, cigarette smoking, advancing age, various drugs (eg valium), drug addiction are all part of a very long list. Fatigue is the most common symptom of HCV, and other factors may be present as well.

SPs are caused by an imbalance between testosterone and oestrogen. In males, testosterone is produced by the testes and regulated by the pituitary hormones L.H. and F.S.H. (the names are not important), and oestrogens are produced by the adrenal glands. In females, oestrogens are produced by the ovaries and regulated by F.S.H. from the pituitary, and testosterone again comes from the adrenal glands. Testosterone drives libido in both sexes. Psychological factors are an additional factor and can cause SPs with normal hormone levels. However, in surveys of HCV patients, all who had SPs were found to have low testosterone levels. Patients with advanced liver fibrosis had more severe SPs. Both testosterone and oestrogen are metabolised in hepatocytes. Oestrogen metabolism is most impaired, so males experience the 'feminising' effects of increased oestrogen levels, such as testicular atrophy.

When HCV is treated, SPs worsen or may appear for the first time. This is mostly due to direct action of antivirals, particularly interferon. There is depression of pituitary and adrenal function so levels of testosterone and oestrogen decrease. Anxiety and depression are common during treatment, lethargy increases usually as a result of anaemia so a vicious cycle starts that includes inactivity and overall lack of interest. It is not known how the new DAAs will affect SPs. With the existing antiproteases, drugs like Viagra are contraindicated. SPs due to treatment resolve after treatment finishes.

Patients with SPs are encouraged to discuss them with their doctor. Treatment for depression or anxiety may help, counselling may be useful but it is important to realise this is a common problem and don't stress about it. Unfortunately I could find no reference to the effect of SVR on SPs. Perhaps some Forum members with SVR could help?

This is just a brief overview of a common, complex subject. Thanks.