Risk factors for sexual dysfunction in a male with leprosy:
(1) absence of a partner (avoidance, rejection, etc)
(2) depression and anxiety
(3) autonomic neuropathy (which can result in erectile dysfunction)
(4) testicular atrophy with hypogonadism and loss of libido
(5) side effects of medications (antidepressants, etc)
(6) presence of diabetes, benign prostatic hypertrophy or other comorbid condition
where:
• Testicular atrophy is seen in borderline and lepromatous leprosy. It can result in feminizing features (gynecomastia, change in hair distribution, etc) and infertility.
Some of these factors can be treated, but sexual dysfunction can be a significant problem in advanced disease.
