Sexuality and Chronic Kidney Disease

Over half of all people with chronic kidney disease experience some problem with sexual function. This can vary from just a lack of interest to a complete inability to reach orgasm. For many people, this can have a devastating effect on their self-esteem and put further stress on an already stressed intimate relationship.

Talking with one’s partner or the healthcare team about sexuality, orgasm, or sexual problems may cause feelings of embarrassment. Because these topics sometimes make us feel uncomfortable, many people choose to ignore the problem. Whatever the cause or difficulty, sexual problems can often be corrected.

Causes of sexual problems


Fatigue

Fatigue is a major factor. Any chronic illness is tiring, and chronic kidney disease, which is often accompanied by anemia and a demanding treatment, practically guarantees fatigue.

Depression
Depression is another common issue. Almost everyone experiences periods of depression, and one of the symptoms of depression is loss of interest in sexual intimacy.

Medications

Medications can also affect one’s ability or desire to have intercourse. Since there may be other medications which are just as effective without the side effect of loss of sexual function or desire, talk to your doctor about your pills.

Feelings about body image
Having a peritoneal catheter, or a fistula or graft, may cause some people to avoid physical contact for fear of feeling less attractive or worrying about what people think when they look at them.

Diseases
Some diseases, such as vascular disease and diabetes, can lead to decreased blood flow in the genital area, decreased sexual desire, vaginal dryness and impotence.

How to get help

The most important thing is to feel comfortable discussing your problems. Talk to the member of your healthcare team with whom you feel most at ease – your doctor, social worker, nurse or pharmacist.

  • The first step is a medical review to determine if the problem is physical
  • You may also be referred to a social worker, psychologist, psychiatrist, nurse specialist or sexologist to look at non-medical factors
  • Assessment is often followed by counselling and education
  • Learning how to speak more openly with your partner is essential. By clearly expressing your personal needs, you can often reduce anxiety and improve your feelings about your sexuality.

For men
Common concerns may be erectile dysfunction (problems achieving or keeping an erection), reduced sexual desire (low libido), and ejaculation issues. Treatment options may include counselling, penile implant, male hormones, oral medications or those which are injected. Ask your doctor for a referral to an erectile dysfunction specialist for a complete evaluation including a review of your medications.

For women
Women may also experience decreased libido. For those who have problems with vaginal dryness, a number of options are available: creams or devices that contain estrogen can be put into the vagina; lubricants can also be used. In addition, regular sexual stimulation in any form helps improve vaginal moisture. Talk to your partner about your needs.

What you can do

Here are some things that may help change how you feel about yourself.

  • Take extra care with personal grooming. When you look good, you feel good.
  • Try not to think of sexual intercourse as the only sex act as this may cause you unnecessary distress if you have limited desire or energy. Sexuality doesn’t have to include intercourse. There are many forms of sexual expression that don’t require as much energy and are enjoyable such as hugging, kissing and caressing. Work with your partner to find enjoyable ways to give and receive pleasure.
  • If you are shy, books can be a good source of self-help. Go to your local library or a book store and find a book that deals with your concerns. On the internet you can search for useful Web sites and dialysis patients discussion boards about sexual functioning. It can be helpful to see that sexual concerns are common, and that help is available.
  • Most importantly, don’t ignore the problem and keep in mind that a positive attitude is an important part of good physical health.



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