Male Sexual Function after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood: A Multicenter Study

Abstract

<jats:p>There are many known endocrine complications after allogeneic hematopoietic stem cell transplantation (HSCT) in childhood including increased risk of biochemical hypogonadism. However, little is known about sexuality in adulthood following childhood HSCT. In this multicenter study, sexual functions and possible risk factors were assessed comprehensively in two national cohorts (Finland and Denmark) of male adult survivors of childhood HSCT. Compared to a healthy control group (n = 56), HSCT survivors (n = 97) reported less sexual fantasies, poorer orgasms, lower sexual activity with a partner and reduced satisfaction with their sex life, even in the presence of normal erectile functions and a similar frequency of autoerotic acts. Of the HSCT survivors, 35% were cohabitating/married and 66% were sexually active. Risk factors for poorer self-reported sexual functions were partner status (not cohabitating with a partner), depressive symptoms, CNS and testicular irradiation. Sexual dysfunction increased by age in the HSCT group with a pace comparable to that of the control group. However, because of the lower baseline level of sexual functions in the HSCT group, they will reach the level of clinically significant dysfunction at a younger age. Hence, male survivors of childhood HSCT should be interviewed in detail about their sexual health beyond erectile functions.</jats:p>

Significance of men’s health in long-term survivors of allogeneic stem cell transplantation

“…However, patients who survive beyond these 2 years after aSCT have also an increased risk of long-term complications, which may impact on their survival and quality of life [ 2 , 3 ]. Reported long-term complications in this special patient population include chronic kidney disease, viral infections, e.g., BK polyomavirus (BKPyV) associated nephropathy (BKVAN) or even hypogonadism [ 2 , 4 – 10 ]. Unfortunately, the knowledge about chronic kidney disease, urological complications as well as infections is very limited, especially in adult aSCT and in long-term survivors (more than 5 years after aSCT) [ 2 , 4 ].…”

“…Unfortunately, the knowledge about chronic kidney disease, urological complications as well as infections is very limited, especially in adult aSCT and in long-term survivors (more than 5 years after aSCT) [ 2 , 4 ]. Furthermore, data about men’s health including hypogonadism as well as male sexual function are even more sparse in this special patient population [ 10 , 11 ].…”

Physical Fitness and Frailty in Males after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood: A Long-Term Follow-Up Study

“…This study is part of a larger cross-sectional cohort study addressing long-term gonadal function, metabolism, physical fitness, sexual health and quality of life [ 10 , 11 , 12 , 13 ]. Male survivors treated with pediatric myeloablative allogeneic HSCT between 1980 and 2010 in Denmark or Finland were eligible to participate if they were ≤16 years of age at HSCT and ≥18 years of age at the time of the study [ 12 ].…”

International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update

“…Sexual health, fertility, and pregnancy concerns of HCT survivors are summarized in Table 8 and Supplementary Table S10 . Approximately one-third of survivors report the inability to perform sexually, inability to derive pleasure from sex, and/or little or no interest in sex [ 182 , 183 ]. Women are more likely than men to report being sexually inactive in the preceding year (39% versus 27%) and among those sexually active, to report low sexual function (64% versus 32%) [ 184 ].…”