Allogeneic Stem Cell Transplantation and Sexual Disorders

Allogeneic hematopoietic stem cell transplantation (alloHSCT) is a well-established curative therapy for a variety of hematological disorders. Medical advances in last decades have significantly reduced the incidence and severity of complications after transplant, with a consequent decrease in mortality and an increase in the number of long-term surviving patients. AlloHSCT is associated with short- and long-term toxicities that can negatively affect sexuality. Five years after transplant, 80% of the female survivors and 46% of the male survivors report sexual dysfunction. Sexual disorders have a strong and negative impact on the quality of life of transplant patients. Chronic graft-versus host disease, gonadal dysfunction, and physiological disorders are the main causes related to sexual problems after alloHSCT. Main issues of sexual dysfunction reported by women are lack of sexual desire, difficulty to achieve orgasm, anxiety or pain during intercourse, or inadequate lubrication. Male sexual dysfunction includes decreased libido, erectile dysfunction, and ejaculatory disorders. Sexual health problems are often a difficult topic for patients and healthcare providers to discuss, and, in consequence, frequently underreported. Multidisciplinary assessment of sexual and emotional health should be an integral part of the early and long-term follow-up of alloHSCT survivors.