Haemophilia, aging and sexuality.

The older generation of patients with haemophilia still has musculoskeletal problems which limit activities and participation. One important aspect of male aging is the changes in sexuality. Sexual desire can be disturbed by fatigue, low testosterone or pain. Sexual excitement (erection) may be influenced by diabetes mellitus, arteriosclerosis, hypertension and side effects of antihypertensive and antiviral medication. Sexual response problems can be caused by antidepressant medication. In aging haemophiliacs arthropathy, iliopsoas muscle bleeding, chronic hepatitis C and HIV medications influence sexuality. The haemophilia care professionals should communicate proactively, give information on various practical aspects of sexuality (suggest suitable positions, recommend painkillers, reflect on prescribing erection-enhancing medication, refer to a sexology expert).