Splenectomy is associated with sexual dysfunctions and decreased libido

Abstract

The removal of the spleen due to disease or trauma may be followed by disorders due to the asplenism, including immunodeficiency, hematological and metabolic diseases, mainly dyslipidemia, which can lead to sepsis, pulmonary embolism and early death. Although patients frequently report sexual disinterest after splenectomy, this feature has been experimentally studied only in a translational investigation performed by the same group of this work. To study libido and other sexual functions after the complete removal of the spleen in humans. This study was performed on 60 healthy adults, 30 men and 30 women, after more than 1 year of total splenectomy to treat isolated splenic trauma. The International Index of Erectile Function was applied to men and the Female Sexual Function Index to women. The analysis compared the responses obtained in the periods before and after the splenectomy. Laboratory tests with hematological and biochemical analyses, including sex hormones, were performed in all patients. The pre- and postoperative results were compared in each group using the paired t-test, with each patient being his or her own control and with significance to p < 0.05. A decrease in libido and an increase in sexual dysfunction was observed after splenectomy in all men and women, p < 0.001. All postoperative laboratory tests showed normal values in both genders. Asplenia is associated with a marked decrease in libido and intense sexual dysfunction in both men and women, with normal hematological and biochemical laboratory tests, including hormonal exams.

Hormones and B-cell development in health and autoimmunity

“…In rats with splenectomy, a decrease in the concentration of 20a-dihydroprogesterone was found, delaying the onset of ovulation (2), while a reduction in the number of pregnancies was observed in splenectomized mice (3). In people who underwent splenectomy, a reduction in sexual activity, such as decreased libido, erectile dysfunction, and sexual dissatisfaction, was observed (4), demonstrating that splenectomy can interfere with the reproductive system possibly by interfering with hormonal regulation. Furthermore, the functions of the spleen are also regulated by the hypothalamic-pituitary-ovarian axis, and there may be feedback between endocrine molecules and the migration of leukocytes from the spleen to the ovaries (5).…”