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Men's Health

Men with bleeding disorders face the same sexual health issues as men without bleeding disorders, but with the added challenges of acute or chronic pain from joint bleeds or associated arthritis, side effects from drugs they might be taking, and other diseases that may have been contracted during the course of treatment, such as human immunodeficiency virus (HIV), Acquired Immune Deficiency Syndrome (AIDS), and hepatitis C (HCV).

Maintaining sexual health when you have a bleeding disorder means being responsible and careful about engaging in sex, planning for a family, and taking care of your physical health.

This section of Men's Health covers issues of particular importance to men with bleeding disorders, including:

Musculoskeletal Issues

Men with bleeding disorders often live with chronic joint and/or muscle pain (called musculoskeletal pain). So, it's not unusual for them to fear engaging in sexual activity because of the pain it might cause or worsen. If you have or have had target joint bleeds in the hips, knees, or elbows, some positions during sexual activity may cause bleeding and exacerbate pain. Bleeding in the iliopsoas muscle, or inner hip muscles, can contribute to femoral nerve pain.

For more information on sexual activity and bleeding, go to Dating and Sex.

Sexual Dysfunction

Men with bleeding disorders and comorbidities such as HIV and HCV, have slightly higher rates of sexual dysfunction, such as erectile dysfunction (ED), than the general population. Erectile dysfunction may be a side effect of taking multiple medications to treat possible conditions related to a bleeding disorder, such as viral infection. Medications may lower testosterone levels and impede libido. Ask your primary care provider about the side effects of the medications that you are taking.

Many men experience anxiety or depression due to fears about their bleeding disorder or about passing on diseases to their partners while engaging in sex. These feelings can also lead to a lessening in sexual desire and to sexual dysfunction.

Fortunately, sexual dysfunction, whatever its cause, can be addressed.

Here are a few strategies to consider:

  • Find a comfortable position. Finding sexual positions that are easy on your body is important.
  • Communicate. Involving your partner in the decision-making process regarding sexual dysfunction may invite more creative intimacy into your relationship.
  • Talk to Your Doctor. Bringing up the issue of sexual dysfunction with your doctor may embarrass you initially but it may be a necessary step to attaining a healthy—and enjoyable—sex life. Sometimes a sexual dysfunction such as ED is a sign of other medical issues, including undiagnosed heart disease, and it may indicate that you should have your overall health checked.
  • Ask for Help. Sexual dysfunction doesn't always result from a physical problem, but may stem from a psychological issue. For example, one study found that 40% of men with depression also experienced erectile dysfunction. If you are experiencing sexual dysfunction, consult your doctor and a therapist or sex counselor to address this issue.

HIV and Hepatitis C

In the 1970s and 1980s, many men with bleeding disorders contracted HIV and/or HCV from tainted plasma during blood transfusions. As a result, they face major sexual health-related challenges:

  • Fear of passing on the virus to their partners
  • Lowered libido and increased risk of sexual dysfunction due to treatment side effects
  • Altered options for creating a family

Individuals with HIV can, however, still enjoy a healthy sex life and have a family. The Centers for Disease Control and Prevention (CDC) recommends that HIV-discordant couples, that is, couples in whom only one person has HIV, consistently practice safe sex. It is also recognized that when an infected partner receives antiretroviral therapy (HAART) and reduces HIV virus levels to undetectable, there is low, if not negligible, risk of transmitting HIV to an uninfected partner.

For more information, go to Safe Sex.

Men who are HIV-positive may safely have their own biological child using a form of reproductive technology called sperm washing. Through this laboratory method, sperm is separated from the seminal fluid that carries the HIV virus. Following this step, a variety of methods are available to use the sperm to fertilize an egg, and, it is hoped, lead to a pregnancy.

For more information, go to Family Planning.

Prostate Health

Men with bleeding disorders should be aware of the sexual health conditions that affect men in general. Some conditions, such as an enlarged prostate and prostate cancer, should prompt regular screening. An enlarged prostate, also known as benign prostate hyperplasia (BPH), does not lead to cancer. Prostate cancer is typically a fairly slow-growing cancer when it occurs in men under 60 years of age. It's advisable to talk to your doctor about your risk factors and to find out when you should be screened.