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. 2024 Jun 4;10(11):e31915.
doi: 10.1016/j.heliyon.2024.e31915. eCollection 2024 Jun 15.

Sexual health and testosterone concentration in male lymphoma survivors: A systematic review

Signe Micas Pedersen  1   2 , Ditte Stampe Hersby  1 , Mary Jarden  1   3 , Torsten Holm Nielsen  1   4 , Anne Ortved Gang  1   3 , Christian Bjørn Poulsen  5 , Peter de Nully Brown  1 , Niels Jørgensen  6 , Claus Larsen Feltoft  7 , Lars Møller Pedersen  3   5
Affiliations

Sexual health and testosterone concentration in male lymphoma survivors: A systematic review

Signe Micas Pedersen et al. Heliyon. .

Abstract

Advancements in lymphoma treatment have increased the number of long-term survivors who may experience late effects such as impaired sexual function and testosterone deficiency. The aim of this review was to determine the prevalence of testosterone deficiency and sexual dysfunction among male lymphoma survivors; and associations between the two. A systematic search identified 20 articles for inclusion. The prevalence of low total testosterone was 0%-50 %, with mean values within reference levels, and for luteinizing hormone above reference levels in 0%-80 %. Four studies included SHBG and free testosterone, with mixed results. Compromised sexual health was found in 23%-61 %. Overall, total testosterone and sexual health were associated. The risk of bias (ROBINS-E and RoB 2) was high/very high, leading to low/very low overall confidence in the bulk of evidence (GRADE). Longitudinal studies evaluating biologically active testosterone and sexual health are needed, to develop evidence based standard procedures for follow-up of sexual health.

Keywords: Androgen; Erectile dysfunction; Hypogonadism; Lymphoma; Sexual health; Survivor; Testosterone; Testosterone deficiency.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interestsSigne Micas Pedersen reports equipment, drugs, or supplies was provided by Besins Healthcare. Peter de Nully Brown reports a relationship with Roche that includes: consulting or advisory. Peter de Nully Brown reports a relationship with Gilead Sciences Inc that includes: consulting or advisory. Peter de Nully Brown reports a relationship with Swedish Orphan Biovitrum that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
– Flowchart of screening and inclusion of articles. HL=Hodgkin Lymphoma, NHL=Non-Hodgkin Lymphoma. Created with Biorender.com. HL=Hodgkin Lymphoma, NHL=Non-Hodgkin Lymphoma. Created with Biorender.com.
Fig. 2
Fig. 2
Mean total testosterone concentrations in nmol/L (nanomole/liter) and 95 % confidence intervals (CI) for included studies providing mean serum total testosterone concentrations. See footnotes of Table 2 for treatment abbreviations.
Fig. 3
Fig. 3
The relationship between mean luteinizing hormone and mean serum total testosterone concentration. Interpretation of testosterone in relationship to luteinizing hormone [42]. Dashed lines represent mean values for lower and upper reference interval limits based on reference intervals for included studies. Nmol/L = nanomole/liter. IU/L = International units/liter.
Fig. 4
Fig. 4
Prevalence of survivors with decreased sexual function by diagnosis See footnotes of Table 2, Table 3 for treatment abbreviations. HL: Hodgkin Lymphoma. NHL: Non-Hodgkin Lymphoma. IIEF: International Index of Erectile Function. BSFI: Brief Sexual Function Inventory. FLZMb-sex: Life Satisfaction Questionnaire-sexual domain. Prevalence is given in percentage of survivors with sexual dysfunction. NB: Should be provided in colors. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
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