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People with hemophilia are almost four times more likely to have sexual problems than people without bleeding disorders, according to the results of a new international survey.

The investigation found that problems with sexual intimacy in patients with hemophilia were associated with old age, severe or chronic pain in the previous year, bleeding in the previous two weeks, and amplitude limited joint.

According to the researchers, these findings “highlight associations between hemophilia-related issues and sexual health” and underscore the need to include sexual health issues in health care, research and policy. hemophilia.

“It will be imperative that initiative programs or policies assess and improve the sexual health of [people with hemophilia] in comprehensive hemophilia care, ”the researchers wrote, noting that“ sexuality is a critical component of human beings ”.

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The study, “Assessing the sexual health of people living with hemophilia, ”Was published in the journal Haemophilia.

The team of researchers, led by researchers at McMaster University in Canada, noted that having a healthy sex life is important for relationships, self-esteem and overall well-being. However, people with poor health and chronic illnesses have been found to experience issues with intimacy, including a lack of interest in sex and difficulty with sexual functioning.

However, very little is known about the sexual health of people with hemophilia. Information on this issue is crucial in guiding physicians on how to provide better care and improve the quality of life for patients, according to the researchers.

To assess the prevalence of sexual difficulties in hemophilia patients and determine contributing factors, the team analyzed data from the Patient-Reported Outcomes Burdens and Experiences (PROBE) study (NCT02439710).

The PROBE initiative is a data collection network that includes a 29-item questionnaire designed to provide hemophilia patient organizations with information on the health status and quality of life of patients.

A total of 3,979 adults were recruited from 48 countries between January 2016 and February 2017. Of these, 2,007 were people with hemophilia and 1,972 were participants who did not have a bleeding disorder.

Almost all of the hemophiliacs (95.3%) were men. A male predominance was also observed in the group of people who had no bleeding disorder, of which 67.9% were men.

Participants in both groups had a similar average age, in their early 40s. In the group of patients with hemophilia, the majority had severe disease (69.6%), followed by those with moderate (16.3%) and mild (14.2%) hemophilia.

Most of the patients had hemophilia A (81.8%), while less than a fifth (18.2%) had hemophilia B.

A total of 302 patients with hemophilia (15.1%) and 79 people without bleeding disorders (4.0%) reported experiencing sexual difficulties. In general, this indicated that people with hemophilia were 3.82 times more likely to have sexual difficulties than people without bleeding disorders.

Among hemophilia patients who had had health problems in the previous year, sexual problems were 4.25 times more common, according to the results. The analyzes also indicated that the two patients who, in the previous year, had used mobility aids or assistive devices, or had used pain relievers, were more than twice as likely to have sexual problems. .

In addition, patients with hemophilia who experienced acute or chronic pain were three to six times more likely to have sexual difficulties.

“Pain has direct and indirect effects on sexual functioning,” the researchers wrote, noting that concomitant psychological difficulties can make the problem worse.

“Psychological problems, for example depression, anxiety or a decreased interest in sex, can contribute to sexual difficulties in people who are suffering at the same time,” they wrote.

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Next, the team evaluated the impact of having other diseases on sexual function. They found that sexual difficulties were about twice as likely to occur in patients with hemophilia who also had hepatitis B, hepatitis C, HIV, a history of stroke, high blood pressure, diabetes, arthritis and gingivitis.

In addition, the risks of sexual problems were almost twice as high in hemophilia patients with severe disease.

Independent factors that were associated with more frequent sexual problems in patients with hemophilia included advanced age, severe and / or chronic pain in the previous year, and reduced range of motion in any joint.

Bleeding was also a problem. Results showed that people with hemophilia were more likely to have more frequent sexual problems if they had had any bleeding in the previous two weeks, or if they had had life-threatening or limb bleeding. during the previous year.

Overall, the results indicated that “sexual difficulties are much more common among [hemophilia patients] than [people without a bleeding disorder]The researchers wrote.

“To the best of our knowledge, no other study has been conducted to examine sexual health in a large sample of [hemophilia patients] in various countries, ”they wrote.

The team noted that one of the limitations of the study was not to investigate the specific types of sexual problems that patients experienced, for example, if their difficulties involved a lack of sexual interest, anxiety. sexual or difficulty during intercourse.

“Longitudinal studies with a more comprehensive assessment are needed to determine the underlying problems related to sexual difficulties in [people with hemophilia],” they wrote.

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Julio V. Miller

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