Q: My fiancé is 49 and has liver cirrhosis and is positive for the hepatitis C virus. His erection is short-lived and very weak, and it is not easy for me to get orgasm with him. He was a heavy alcoholic, but he stopped drinking completely six months ago. Do you think there is a possibility of improvement in his case? What medication or advice can you suggest? I am shy about telling him my problem with this, as he thinks he is perfect.
A: From what you are describing, your fiancé has a serious and multifaceted health issue. First, hepatitis C is a chronic viral infection that affects the liver and can lead to long-term complications such as cirrhosis and liver cancer. According to the Centers for Disease Control and Prevention (CDC), untreated hepatitis C can cause progressive liver damage and systemic symptoms that may impact hormone balance and sexual health.
Cirrhosis itself severely compromises liver function. The liver plays a major role in hormone metabolism—particularly in converting testosterone (the primary male hormone) into estrogen. When the liver is damaged, this process is disrupted, resulting in excess estrogen levels, lower testosterone, reduced libido, and weaker erections. Additionally, the accumulation of toxins in the bloodstream due to poor liver function can impair cellular metabolism throughout the body, including in penile tissue, making erectile dysfunction more likely.
In situations like this, lifestyle management and medical supervision are key. It’s excellent that he has quit alcohol; continued abstinence is critical. He should also maintain a balanced diet, avoid hepatotoxic medications, and follow up regularly with his hepatologist. Some men in similar circumstances explore mechanical aids such as a vacuum erection device, which helps draw blood into the penis and maintain firmness with the use of a constriction band. This can be effective for physical stimulation and also help rebuild intimacy through shared exploration.
Other potential treatments—such as medications for erectile dysfunction—must be prescribed with caution. Drugs like sildenafil (Viagra) are metabolized by the liver and may not be safe in advanced cirrhosis. A doctor specializing in sexual medicine or endocrinology could evaluate hormone levels and discuss suitable options. You can also read more about correcting health-related erection problems and how hormone or vascular issues contribute to erectile dysfunction.
Because this issue affects both partners, open communication is important. Consider framing the conversation around shared well-being rather than performance. For additional background on hormonal imbalances and their sexual impact, the article “Estrogen-Containing Foods & Male Function” offers insights into how even subtle shifts in hormone levels can influence men’s sexual response.
Ultimately, the best path forward involves medical management of liver disease, hormone evaluation, and supportive strategies to maintain intimacy. Emotional patience and health-focused teamwork will give your fiancé the best chance of regaining vitality and confidence.