Hemophilia is a genetic, life-threatening blood disorder that affects the body’s ability to make blood clots to prevent excessive bleeding. However, hemophiliacs have lived longer due to improvements in therapies, nearly as long as someone who is not affected by the disorder.
For this reason, many aging-related disorders are starting to emerge among patients with hemophilia. One of these health conditions that is rarely discussed among the medical and scientific community, despite its impact on patients’ quality of life, is erectile dysfunction (ED), which is the inability to achieve and/or maintain an erection.
In the study, a group of Canadian researchers set out to analyze the incidence and risk factors for ED in a group of men with hemophilia.
Study participants in the British Columbia adult hemophilia program in Vancouver were asked to complete the International Index of Erectile Function (IIEF) questionnaire containing 15 questions that assessed sexual function. Lower scores were associated with sexual dysfunction.
Researchers also gathered clinical information to evaluate potential risk factors for ED, including previous surgeries, viral infections, certain types of medications, and risk of heart disease. Lab tests included a full panel of blood work, and blood pressure and body measurements.
Endothelial (blood vessel) function was assessed by brachial artery (the largest blood vessel of the upper arm) flow‐mediated dilation (FMD), which measures the blood vessels’ ability to widen, and hyperaemic velocity time integral (VTI) — the speed at which the blood circulates.
The cross-sectional, prospective study invited a total of 56 men with hemophilia at different degrees of severity to participate. From these, 12 were unable to complete the questionnaire for reasons such as not feeling comfortable disclosing such personal information or having no sexual partner in at least four weeks.
Results showed that 39% of the men had symptoms of ED (IIEF scores lower than 26), including 4.5% with mild to moderate ED (IIEF scores between 17–25), 18.2% with moderate ED (IIEF scores between 11–16), and 15.9% with severe ED (IIEF scores lower than 10).
Further analysis also showed that men with symptoms of ED tended to be older, with a median age of 65, than those without ED, whose median age was 43. As for risk factors, analysis revealed that long-time smokers with high blood pressure, larger waist-to-hip ratio, and high levels of homocysteine (an amino acid linked to blood vessel inflammation) in the serum are more likely to develop ED.
No significant differences were found on endothelial function (measured by FMD and VTI) between men with or without signs of ED.
“In conclusion, ED symptoms appear prevalent in (patients with hemophilia), particularly in the older group. This disorder along with the underlying causes needs to be explored further in a future larger observational study,” the researchers concluded.