The association of leprosy with male fertility and sexual function: a single center study

Introduction and objective: Mycobacterium leprae has been identified in the testicular tissue of men with leprosy. We investigated the relationship between leprosy and male infertility and sexual function.

Methods: Male patients at the Los Angeles County + University of Southern California Medical Center Hansen’s Disease Clinic were surveyed regarding sexual and reproductive history and sexual function via Sexual Health Inventory for Men (SHIM) scores. Survey topics included erectile dysfunction (ED), sexual function, libido, reproductive history before and after leprosy diagnosis, and SHIM scores. SHIM scores were compared with age matched controls without leprosy.

Results: Forty men with leprosy were interviewed, with a mean age of 53 years. The average age at leprosy diagnosis was 39 years. Thirteen (32.5%) men reported ED, 12 (30%) ejaculatory dysfunction, 6 (15%) impaired libido, and seven (17.5%) primary infertility post-leprosy diagnosis. SHIM scores consistent with mild to severe ED were found in 22/40 (55%) patients and were significantly lower in leprosy patients compared to age matched controls (20/25 versus 23/25, p < 0.001). Lower SHIM scores were also associated with the presence of other neurologic deficits (p = 0.029). Participants with SHIM scores suggestive of ED were no more likely to have had hormone analysis testing done than those with unimpaired SHIM scores.

Conclusions: Men with leprosy had a range of sexual and reproductive issues. Nearly half reported de novo sexual symptoms, and males with leprosy had lower SHIM scores compared to controls. Men with leprosy should be screened routinely for sexual dysfunction and asked about their reproductive goals.