Male sexual function after autologous blood or marrow transplantation

Although endocrine dysfunction has been reported in survivors of allogeneic bone marrow transplantation (alloBMT), data for autologous BMT (autoBMT) r ecipients are lacking. Because information on male potency in particular is scanty, we prospectively assessed male sexual function after autoBMT We id entified 16 men who were less than or equal to 50 years of age at the time of evaluation and disease free for at least 6 months after autoBMT. Nine ha d Hodgkin's disease, 4 had acute myelogenous leukemia, and 3 had non-Hodgki n's lymphoma. Blood samples were assayed for luteinizing hormone (LH), foll icle-stimulating hormone (FSH), and testosterone. Patients were surveyed wi th a modified version of the Pyschosocial Adjustment to Illness Scale regar ding erectile dysfunction and loss of interest in sexual activities. Sevent y five percent of the men reported normal interest in sexual activities and 87.5% reported normal erectile function; however, 4 of 16 reported a moder ate loss of interest in sexual activities, and another 2 of 16 reported fre quent loss of erectile function. Ah 4 men with decreased libido and both me n with impaired erectile function had Hodgkin's disease. Fourteen (88%) of 16 patients had an elevated FSH level, 7 (47%) of 15 had elevated LH, and 6 (38%) of 16 had decreased testosterone levels. Decreased testosterone leve ls correlated with a moderate or total loss of libido (P = .008) and a diag nosis of Hodgkin's disease (P = .01). Thus, after transplantation, most men have abnormal levels of gonadotrophins. Decreased levels of testosterone a nd symptoms of sexual dysfunction correlated with a diagnosis of Hodgkin's disease and may be related to the induction and salvage therapy received pr ior to autoBMT.