Sexuality and Kidney Disease
Can people with kidney disease or kidney failure still enjoy sex?
It's important to remember that people with kidney failure can have healthy marriages and meaningful relationships. They can fall in love, care for families, and be sexual. Staying intimate with those you love is important. It's something everyone needs.
Many people think that sexuality refers only to sexual intercourse. But sexuality includes many things, like touching, hugging, or kissing. It includes how you feel about yourself, how well you communicate, and how willing you are to be close to someone else.
There are many things that can affect your sexuality if you have kidney disease or kidney failure — hormones, nerves, energy levels, even medicine. But there are also things you and your healthcare team can do to deal with these changes. Don't be afraid to ask questions or get help from a healthcare professional.
What if I lose interest in sex?
Your interest in sex may change when you have kidney disease or kidney failure. At first, you may have less interest in sex. This can happen because you need a lot of energy to cope with the physical and emotional changes brought on by your illness. In time, your interest may return to normal.
Some patients may find it more difficult to have or keep an erection. This is very common with kidney failure. It can result from the side effects of medicine, having a buildup of toxic wastes in the blood that may not be fully removed by dialysis, or other things. Many of these problems can be treated. Don't be afraid to ask questions or get help from a healthcare professional.
Emotions can also affect sexual functioning. This includes stress, depression, nerves, fear of disability or death, marriage problems, and much more. For some people, having kidney disease may cause physical changes that can make them feel less attractive. This can also affect sexual interest. Couples who find that their sex lives are changing should talk to their doctor or social worker. Many of these problems can be treated.
Is sexual intercourse safe for kidney patients?
Some patients and their partners may worry that sexual activity could cause the patient's death or harm the dialysis access or transplanted kidney. No limitations need to be placed on kidney patients sexually. If sexual activity does not place pressure or tension on the access site, it will not cause damage. Fear can cause people to avoid sexual activity needlessly.
After receiving a transplant, it is important to wait until the scar has begun to heal. Once your doctor says it is all right to resume sexual activity, there is no reason to worry about damaging the transplanted kidney.
For some couples, sexual intercourse is not possible. Some may feel that sex is not as important as it once was. Activities such as touching, hugging, and kissing provide feelings of warmth and closeness even if intercourse is not involved. Professional sex therapists can recommend alternative methods.
How will I know whether sexual problems are due to physical or emotional causes?
This requires a complete medical, psychological, and sexual history of you and your partner. Medicines should be reviewed for sexual side effects and changed if possible. Blood tests should include hormone levels and blood sugar levels to check for diabetes. Patients can be checked to see if nerve and blood supply to the penis are good and if they can have an erection. If no physical problem is found, an emotional cause must be considered.
What can be done if the problem is physical?
Several options are available for those whose penis will not get or stay hard (erection). Penile implant surgery places inflatable or semi-rigid rods into the penis. In some cases, surgery can improve blood flow to the penis. If they do not want surgery, hormones may be given. Oral and injectable medications can cause an erection. External suction devices can make the penis hard enough for intercourse, but they require time and hand strength. Doctors with special training in impotence can give information on all options as well as their advantages, disadvantages, and side effects.
Vaginas usually have less vaginal wetness and may have pain during sexual activity. Lower hormone levels can cause vaginal dryness. Use of a water-soluble vaginal lubricant can lower or stop pain associated with intercourse. Do not use petroleum jelly because it can increase the risk of infection. Some patients may be unable to have a climax or may need more time to get "turned on" because of loss of energy, hormone changes, or medications for high blood pressure. A change in blood pressure medicine or extra hormones may be needed. Your doctor can provide information on options.
What can be done if the problem is psychological?
Feeling worried, anxious, or depressed is normal when faced with a serious loss such as kidney disease and kidney failure. These emotions can cause loss of energy and lower interest in many activities, including sex. If a sexual problem does occur, embarrassment and guilt often follow. Fear that the problem will happen again may cause the person to shy away from sexual situations. Relaxation exercises can help to control these fears. Regular physical exercise and activity help keep the mind busy and can improve physical condition and body image. If sexual problems continue, sex therapy can help. Even if the problem is psychological, some of the treatment options mentioned for physical problems may be helpful.
Can sex therapy help?
Sex therapy deals with the sexual problems of couples and individuals. The first step in sex therapy may be sexual education for the individual or couple. The therapist may assign activities to be done at home. These include communication exercises, stress reduction activities, and practicing ways of improving skills in giving and receiving enjoyable touches. Sex therapy can help with problems such as low sexual interest, trouble in reaching climax or reaching climax too soon, pain during sexual activity, and erection difficulties. Therapy also can help a person work through the effects of chronic illness on sexual functioning.
A sex therapist can be a psychiatrist, psychologist, physician, or social worker. Look for someone who is licensed and who has advanced training and experience in sexuality and sexual problems. Charges vary and may be covered partly by insurance.
What can kidney patients do to help themselves?
Take an active role in learning about kidney disease and treatment. Follow the prescribed diet and fluid limits. Take all medications properly and tell the doctor of any side effects. Ask for an exercise program to help muscle tone, strength, and endurance. Your doctor and dietitian can suggest a weight gain or loss program, if needed. Lead a healthy lifestyle. Be aware of other things that could affect your sexual functioning, such as drinking too much alcohol and smoking.
What about having children?
While sperm production will not be affected by kidney disease, complications in utero may occur. A new baby is a joy for any family. But pregnancy can put a lot of stress on your body. If you have kidney disease or kidney failure, it can put you and the health of your unborn child at risk. It can also make your kidney disease worse. If you are thinking of becoming pregnant, you should discuss it carefully with your doctor.