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Avatar universal

A question for the men out there

I am curious about the effects of HCV and Tx on sexual function in men.  Various articles have described erectile dysfunction and low libido as a result of HCV, interferon tx, and/or liver damage.

The biggest factor seems to be the HCV itself, and several controlled studies have been done looking at variables like liver damage, viral load, interferon history, etc.  It seems that about 35% to 40% of men with HCV have regular erectile issues, regardless of the other factors.  Duration of infection may also be a factor, and has only been studied in small groups.

What has been the experience of the male population on this forum?

Has interferon made any existing problems worse?  Or has interferon initiated sexual problems, if you had no problems before tx?  After ending therapy, have any sexual dysfunction problems changed significantly?

This issue gets little attention in the literature, and deserves more study, I believe.  

Responses are appreciated.

DoubleDose
26 Responses
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Avatar universal
Thanks, main reason I started this was to get rid of the tiredness. I've heard different views, but mine is that extra-hepatic symptoms can exist, regardless of liver damage. Nearly everything I've ever read about Hep C symptoms mentions fatigue. The liver might not be damaged, but swelling, evidenced by high enzymes, means it's not going to be working at its best, and considering the big job it does, the effect is going to be felt somewhere. Doesn't make sense to me to say it's all imagination, or caused by something else when so many people report the same problems.
Think it's shot 40 tonight, thanks for letting me know how things are post-treatment.
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86075 tn?1238115091
what kind of mouse do you use? I find that my carpal tunnel got much better when I switched to the turbo whatever (I'm still asleep) the one you manage with your thumb instead of your wrist, help me out here guys...anyway, don't get that pain at all anymore...think CTS comes with menopause too cause lots of ladies complain of it, but of course, everything is hormonally related, it's all one big happy stew!!!mixed with god knows what else!
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Avatar universal
you know, if I was in my 20's or 30's when dx, and stage one, I am not sure I would have treated. Good thing the tx was not as horrible as I have read, ;-)



lt; you asked me something, somewhere, I hope you see this.  I do feel better after tx, than before, less fatigue, less gloom and doom feeling, and most of the joints are fine. the only thing persisting is the herniated disc(runs in the family) & the carpal tunnel syndrome, but  that is not as bad, given that I have been seeing drs for almost 10 yrs prior to dx, due to the arthritis complaints.  stay well
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92903 tn?1309904711
To DD on raising the flag: Are you kidding me? That intereferon has me going morning, noon, and night. When the wife's not available I visit the neighbor down the street, and when she's not home the bullfrogs out back start to get nervous! Nahhh - all kidding aside - seems at the ripe age of 47, my system needs regular cardio exericise to 'keep up' my reputation. As the cardio has declined, so has the morning wood pile. But we can still get the job done, 'push come to shove', LOL.
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To Jim: Here's what my Doc emailed on the subject...

Interferon has a side effect we call "cognitive disorder" which people describe.  Like being in a cloud. This should get better after meds stopped, but there are rare cases where it does not fully resolve.  This is part of the risk:benefit analysis. If this is getting any worse the risk starts to outweigh benefit. Please keep me updated.

As you may remember he and I also had a risk/reward discussion when we evaluated the merits of going past 24 weeks. While his practice is known for their aggressive treatment approaches, they are at the same time loathe to expose patients to more tx risk than warranted.
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To Cuteus: You said to PK telling people that they should only treat when their liver has started rotting away, is denying the most fundamental right of choice

Not to put too fine a point on it, but that's that's pretty extreme. Members offering opinions and advice is a fundamental aspect of the discussions here. I don't see doing so as denying one's right of choice.

Add me to the list who feel the negative aspects of tx are under-considered. These are not benign drugs we take. Neither the primaries nor the supporting blood boosters. We've come to consider supporting drugs such as ADs and pain medications (sometime narcotic) as though they were Chicklettes - because they are compared to the heavier hitters.

We've seen board members loose jobs, marriages, hair, cognitive function, libido and more as a result of treating. Sometimes permanently. Let's not dismiss that.    

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Avatar universal
goof, I never said that meds are benign, none of them are, or for that matter even food is not benign. I am not denying his right to an opinion, that is why I stated that each time he states it, to expect an opposing opinion. the side effects of almost anything prescribed are under reported if you ask me, only the extreme cases are heard of.  The fact that I will state that most folks do not suffer long term severe side effects, is not underestimating the effects of tx.  Drs and patients can report side effects to the FDA on medications taken. If enough folks report the same severe symptoms after taking the same med, it will raise the flag with someone, somewhere. pegInterferon and riba have been around for over 6yrs, given that most of us are treating in our 50's, how much into the future are you willing to go, to assign the condition to tx? If you develop numbness in your arms 15 yrs from now,
are you going to blame the tx?  
The fact also is, that some of these board folks might come in, three months post tx, stating how bad tx has left them, then get better 3 months later, but never come back to the boards to say so.  So the first anecdotal story is all that remains and gets passed on.
We also don't know how much is the meds themselves and how much is the anemia allowed to linger by some drs.  
If someone develops a condition while on tx and persists after it ends, you could say it was tx related, but 15 yrs later? How?  And besides, most of the folks that have lost the thyroid function on tx, posting in this board, found ridding themselves of hcv worthy.
we are all stating opinions and nothing more, and challenging others opinions. My peeve is for someone to tell me, that there is no way I can feel ill with stage one damage.  Maybe stage 4 has Liver manifestations, and maybe stage one has extra hepatic ones, his opinion carries no more wt than mine. nes pas?
stay well
Helpful - 0
92903 tn?1309904711
<i>...you were putting your heart in jepordy</i>

Well he was a little more emphatic about my potential early demise, but that was the general msg, yeah :) BTW, hgb is stable at 10 and it's a whole new world out there!
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Avatar universal
I thought your doctor also told you that given your hgb, etc, you were putting your heart in jepordy, plus didn't he also say something like the rewards of extending past 24 weeks are outweighed by the risks. This is a pretty common statement by hepatologists and to me it acknowledges the real risks of the treatment drugs. If there was only a rare chance of permanent sides, then I think doctors would be more likely to treat longer.
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92903 tn?1309904711
<i>goof, I never said that meds are benign, none of them are, or for that matter even food is not benign.</i>

OK. I'll clarify my position. I believe these meds are a lot harder on ones body and soul than food. Wait, better narrow that a bit. Make that meds as normally prescribed and food as normally consumed by sensible human beings in the daily course of their lives. A Hemlock salad would not be a fair comparison.

Cuteus, we obviously have a different bias towards when tx is appropriate, and that's OK. In my case, I could have chugged along quite happily w/o tx, had my liver not headed towards Hell in a handbasket. If I had the opportunity to wait for friendlier treatments, I most certainly would. Others would not. To each their own.
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Avatar universal
like snook asked; 'where is the beef"? no pun, DD.
Are you shielding behind the statement that the big bad pharmas do not want anyone to know the bad long term effects? if that is so, why bother to list the warnings in the inserts? and yes, I did read each one of them, and I also read that they are obligated to disclose ANY sympton the subjects experienced during the trial, whether they thought it was related to the meds or not. And they have to print it also. I guess you have to look at the % with the placebo to reason if they are a true side effect.  
Andy where are you with that article/parody on the placebo?
You will not find a breakdown by liver damage in most of the studies out there, so you can not make a statement for extrahepatic signs by stage, you can not deny it either.  So, if you are going to accept anecdotal info to back the long term effects, why are you stopping at extra hepatic symptoms? a double standard at best.
saying to people 'you can't possibly be feeling hcv in your body at stage one, is like telling people with the cold virus that they should not be feeling any symptoms because the cold virus is not lethal. Please!
Any invading organism, that the body perceives as an attack, will yield a response, and that response will make you feel ill. Or are you denying the most basic immune response of fever, fatigue, etc?  
guess who?
an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
    
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Avatar universal
It affected me. It didn't for the first round of TX because I remember the transplant people getting freaked out that Karen and I were not using protection. They weren't worried about the riba cause Karen was on the pill. They were worried about the organ and if they might have missed something there. That freaked us both right out after hearing their tales and fears. The second round of TX may have depressed me a bit bit I don't recall being that concerned. My last TX was the one - I was without hardly any drive for the 73 weeks of TX and for a while thereafter. I was just really getting back to normal when I wrecked my bike and that put an end to that recovery. But time has passed and my drive began rearing its ugly head again & today is a new day and I got that SuperBowl feeling. Mike
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Avatar universal
In response to your question on men, my husband completed 52 weeks of tx 2004-2005 and before starting,,,no problem,,,during tx and after completing,,,,did not effect him at all.
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Avatar universal
Tator,

You make me wished I still smoked just so I could quit with you ! I didn't mean to make ya feel guilty. (well, actually I guess I was hoping some would). More like I was tossing out a "food for thought" like thing. lol My wife smokes but she goes outside so I got a big break there when it came time to quit my habit of one and a half packs a day of Winston's for 35 yrs.. I used 4 pieces of nicorette gum in my attempt. I really got lucky with withdrawal and didn't have any probs.

I hadn't thought of the financial gain at first. It sure is getting pricey to smoke. They are taxing the death out of smokers ! I don't think taxing addicts to pay for health and other budget items is really the answer. That's another thread.  ;)

I wish you and all others who may join you in any attempt at quitting the best of luck !!!

Best regards,
PK
Helpful - 0
107513 tn?1232286464
In a thread down below, Cuteus asked you to provide the board with articles in which substantiate your claims of severe long term effects from combo tx. I have researched this myself, and have yet to see any creditable, or large scale studies or findings on this subject. If you can provide any, I'm sure many would be interested in them. Speculation and word of mouth does not take the place of "creditable", long term studies.
I know the risks, I I have read the insert in depth, and dicussed possible long term manifestations with my Doc's.. But again, I am yet to see clinical proof.
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Avatar universal
Snook said: In a thread down below, Cuteus asked you to provide the board with articles in which substantiate your claims of severe long term effects from combo tx. I have researched this myself, and have yet to see any creditable, or large scale studies or findings on this subject.
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The fact there appear to be no large scale studies or fundings on this subject raises a very big question itself. You would think the drug companies (who fund just about all the large-scale studies we talk about here) would be interested in how we folks do let's say fine years down the road? Hmmm.

We've had this discussion before, and I believe one consensus is that this particular area has been underfunded and understudied.

So that brings us to the world of anecdotal information. While many here, for example, may not have experienced long-term effects from combo tx -- anyone who has read this board or other boards-- for any length  of time -- will find story after story that points in the other direction.

Personally, I don't see how long-term anemia (and most of us are anemic for most of tx, procrit or not) can benefit our cognitive functions in the long term. Especially us older folks who have less cyclinders firing to begin with.

If I really believed there was no potential for permanent long-term side effects, I'd have no hesitency to treat for 72-weeks(instead of 58) or even longer, regardless of the temporary sides.

But, like many, I do fear the potential for permanent sides and therefore have to weigh the risk of treatment duration (or for some treatment itself) against the benefits of the drugs.

Snook, not to put you on the spot, but I vaguely remember some time ago, your well-respected hepatologist told  you at your first consulation when you asked about extending treatment. I forgot his exact response, but didn't it infer that the risks of a more extended treatment outweighed the benefits? I believe Goofy's well-repsected hepatologist has warned him of tx risks (Goof, like many others, is treating with low hgb, ANC and platelets at time). Two of my consults have also cautioned me about about the effects of these drugs. So, studies or not,  isn't this in part what we're talking about?

Hope this finds you well.

-- Jim
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Avatar universal
I wanted to comment on your assertion that people at Stage 0-1 can't have extrahepatic manifestations.  I'm between Stage 0 and 1 (based on biospy and Fibrosure results) and I have plenty of them.  I've tested postive for cryoglobulenemia and anti-phospholipid syndrome -- both are auto-immune disordered triggered by HCV. By the way, I've always had one of the lowest VL's on this board.  It's even slipped into the "undetectable" range at times.

Don't get me wrong...my QOL is very high and I have absolutely no plans to treat with the current drugs prior to reaching Stage 2.  But you won't convince me that people with little or no fibrosis don't have extrahepatic symptoms.  I have them and I'm not unique.

Susan
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Avatar universal
Hey guys!  Tx definitely brought on erectile dysfunction in my case. Things have improved since stopping tx. Does the hcv have its own effect? Maybe. Also, I have'nt smoked for many many years and I relapsed anyway for what that is worth. Just a quick hello to youse that still hang about.
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Avatar universal
I am on week 36/48 and my libibo went dead for about two months early on during tx. Absolutely dead! nothing!, I was frightened, never experienced anything close. But finally, after that period, I saw some signs of life again. Since then, I have been able with the help of some tried and true visualizations, to get the old periscope out of the water, if only on occasion.

I am still not near what I was like before tx, but at least now I know I am still alive.

I know depression can cause this as well, I wonder if it is somehow related. I have had some mood swings with tx, though it has been manageable without meds.

My wife has been great during tx, I really don't deserve her.

Hoping this and all the other sx go away for us all.

Take Care
Bob
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Avatar universal
So you want a quit partner?? when do you wanna start? i could sure use reinforcement...
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Avatar universal
i wasn't gonna come in b/c it was "for the boys", but as usual, i couldn't help myself.....surprise, i wansn't the first to sneak in!
ya boys - both ways.....i've blamed the zoloft, maybe tx too?

* this sun nite, i'm shot #44/48 - counting down...

could probably start a whole new thread, but how long is de-tox? how long before you feel back to "normal", or do you?

chelley
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Avatar universal
Just got back from day(8hrs!!) in the mountains;My ex took me to dinner ,we drove around chattin& laughing-great day,but i'm whupped..Well its day 3 or 4? no cigs...lungs got bettr immediately,but i'm soo antsy w/out my crutch&personal assasins......re:weed.did a little hit 'bout an hour ago& it's gone rite to my head...Now i wanna cig!!-diff in the 2 is one takes such a minute amt. to do the job;the other is chronis,constant,stinking companion...much worse for lungs,anemia & probably SVR...French study on pot use/Svr used heavy drug-abusing population(former heroinaddicts/methadone/compliance issues/advanced liver damage-it was kind of a hodge-podge of factors therefore less than credible alltold,so jury is stillout)......
Sex and the hep-man.....Ad's take some adjusting to,i have found that wellbutrin may counteract and or replace 2nd of the day-when yu know the moment mite be rite...otherwise i stick w reg dosin,lexapro & zoloft don't cause erectile dysfunction but rather anti-climax;you can go on for hours getting completely desensitized and demoralized....good exercise tho;and thoroughly appreciated by sum partners..
My sex drive while trx is down 80%--i feel like **** ;but,when it happens such a powerful systems booster!!! endomorphins,blood flow,you are alive!!! & most importantly touchin,holding,lovin another -takes ya outa the treatmnt head for awhile:Priceless.......
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Avatar universal
Doctors may advise against he stress of quitting smoking during tx. This is not unusual. Revenire hit upon the real danger.

I have no idea why smoker's put so much importance on their health when it comes to HCV ? Makes no sense. I was a smoker. During tx the first time while I was suffering one day I thought: "Wouldn't I feel like the biggest idiot if I go through this hell, clear, and then die from smoking?"

Here are the cold, hard, facts:

3% (that's THREE) of those with HCV will die from it.

40% (that's FOURTY) of those who smoke will die from a smoking-related illness.

Seems very clear to me where priorities should lie on this subject.

Please no stories about hard it is to quit. ;)

Best regards,
PK
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Avatar universal
I'm sorry to hear about your wife's condition.  It sounds quite painful and certainly adds to an already full plate at your house.  

For the record...I am NOT treating.  I think you mis-read one of my posts awhile back and came to the wrong conclusion.  I'm still in my ususal "holding pattern" and feeling good -- knock on wood.

I'm glad you're beginning to think about some next steps: biopsy, trial drug, etc.  I guess we can never take too long of a hiatus from thinking about this disease.  But I'm very optimistic about some of the drugs in the pipeline and I just know you'll be one of the beneficiaries of the kinder and gentler treatments.

I understand about your need to take a break from the board.  I haven't been logging onto MedHelp as often, either.  But it's always good to know that we're just one mouse-click away from people who share and understand our strange journey.

Don't be too much of a stranger.  You always add some spice to the board.

Take care, my friend.

Susan
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Avatar universal
Yeah there are some of us who also smoke in here - knowing ... everything but still not overcoming that.  

In a perfect world I'd be living healthy like Rocker but...doing whats we cans in this world is all we can.

Debby
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86075 tn?1238115091
I agree with you it must be the anti-d's, my short stint with them yielded the same results, well, no results...and when I go on them again...it'll be okay with me, cause when you don't have something, it's not missed no? at least for me...

yeah, you guys can't keep us womens outta anywhere! you know that!!!
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