Has your sex life been different since you started dialysis? For example, do you have irregular menstrual periods or have you stopped menstruating altogether? You're not alone, as about half of all people on dialysis report sexual changes. This article will answer your questions about dialysis and sex for women.
Libido loss - why and what is happening in my body?
With kidney failure, both men and women may experience a reduction in sex drive. In women, this is reflected in irregularity in menstruation or complete cessation of menstruation. In addition, women often experience vaginal dryness. These and other sexual changes can be caused by four main overriding factors: hormonal imbalances, developing secondary diseases, emotional stress and the use of medication.
Loss of libido, for example, is often a result of hormonal imbalances. In fact, increased secretion of the hormone prolactin reduces the production of sex hormones. Prolactin is often found in increased amounts in the blood of people on dialysis. Other conditions, such as diabetes, can also affect your sex drive. The intense emotional stress during dialysis can also affect sexuality in some people.
You should also be aware that medications prescribed in conjunction with dialysis can also cause sexual changes. Blood pressure or heart medications, or medications for depression, anxiety or nerve pain taken during dialysis could also be a cause of disruption to your sexual desire.
Is there a difference between HD and PD patients when it comes to sex?
Perhaps rather unexpectedly, the impact on sex life is additionally dependent on your form of dialysis. Peritoneal dialysis (PD) often seems to lead to fewer problems than hemodialysis (HD). It often depends on you and your partner as to which form of dialysis would actually interfere more with togetherness. Before you start PD or HD, you should clarify for yourself and your partner whether changes to your body would cause problems with one form of dialysis or the other. If you wish, you can also discuss a plan for overcoming these challenges together with your medical and care team.
How will dialysis medications affect my sex life?
As briefly discussed earlier, medications you take while on dialysis can cause changes in your sex life. Blood pressure medications, antidepressants or medications for nerve pain or itching can reduce your libido in various ways. The reduced physical capacity also means that, as a person on dialysis, you are often too weak to engage in sexual intercourse.
What treatment options are available? Can sexual enhancers be used?
The treatment of these changes depends on their cause(s). Due to different triggers, the treatment is very individual. It is best to talk to your doctor about this. This is a known issue for your medical team and there is no reason for you to be ashamed of it. If the cause is related to your hormonal balance, you may be treated with medication, for example. In case of additional emotional stress caused by dialysis, a counseling session with you and possibly your partner can help.
Preventive for sexual problems as well as contributing to the recovery of your desire and performance is a healthy lifestyle. Sufficient physical exercise and effective, high-quality dialysis have a positive effect on physical performance and sexual functions, especially in women. On the other hand, smoking is counterproductive. But you should refrain from that anyway, if possible. Maybe a better sex life is the reason for quitting in the end!
Can I get pregnant during dialysis?
Although with a reduced likelihood, women can get pregnant during dialysis. However, a dialysis pregnancy carries significantly higher risks than usual. Unfortunately, premature births and even miscarriages are more common than in the general population. In addition, the amount of time pregnant women spend on dialysis increases significantly. If you're pregnant, you'll also have to dialyze for at least four hours every day. By the way, this intensified dialysis can also increase the chance that you will become pregnant. So talk to your dialysis team early on.
You can find more information on this topic in the article "Dialysis & Pregnancy" on our blog.
How does a kidney transplant affect women's sexual function?
Many people on dialysis are able to enjoy their sexuality in a new way after a successful transplant. In women, not only does fertility improve after a kidney transplant, but so does sexual desire. So kidney transplantation can lead to normalization of sexual life. If you have a strong desire to have children, it is also a good idea to push for a transplant. Due to the significantly increased fertility, the possibility of becoming pregnant is significantly increased.
However, you should make sure that you allow the surgical wound to heal properly after a transplant before you start planning your baby. On average, this takes about 4-6 weeks. During subsequent sexual intercourse, it is also best to choose positions that exert little pressure on the new kidney. So don't get too much inspiration from sexual practices that involve a lot of twisting around ;-)
You should take care to use contraception for at least one year after the kidney transplant. Pregnancy before stable graft function has been established is risky for both mother and child. It usually takes about a year for equilibrium to be established and you can plan a pregnancy with less worry. You should choose the type of contraception in consultation with your treating physician. For example, some types of pills can increase blood pressure in women.
You may also miss your period because of all the medicines you are taking. You will still be able to conceive. Before you become pregnant, your medications often need to be changed to protect your baby. Therefore, talk to your treatment team early on.
What should I do if my sex life is bothering me?
As an affected woman, you should always talk to your treating medical team. This can help you with your questions. Moreover, this is the prerequisite for any therapeutic treatment. It must be chosen individually, taking into account the cause of your sexual situation. Your doctor can often achieve a positive development by a slight change in your therapy or medication. You can also consult your gynecologist if you have any questions.
Should I talk to my partner about my low sexual desire?
The clear answer to this question is yes. Ideally, you should be open about the issue. Your partner should know about the changes in your body. Only then can they understand your individual situation. However, do not let yourself be put under pressure. With the understanding of your partner, there will be more space and moments for tenderness, which you should enjoy. The exchange about topics in the intimate and sexual life is indispensable for overcoming such difficult phases.
