Sex after transplantation

After transplantation, many people with kidney failure hope to finally regain a little more normalcy in their daily lives. For many people, this also includes a fulfilling sex life. Especially during dialysis, everyday life was characterized by many rules, appointments and a strict medication and therapy schedules. The various medications you have to take, your hormones (which can often be out of balance following a surgery), and of course the high emotional stress, often have a negative effect on your sex life over time.

Naturally - some things, such as your medication plan, do not change as they are equally important after your transplantation as they were before. Many people with a transplant can remain hopeful that their sexual desires will normalize one step at a time. Let's take a look at that together now.

How long should I wait to have sex after transplantation?

After the transplant, your body needs some time to recover from the operation. There is no general answer for how long this will take, as recovery is very individual. Factors that influence your ability to engage on sexual intercourse are the healing process of your wound and the removal of the ureteral stent. The ureteral stent supports your urinary tract after surgery and is removed a few weeks after the transplant in the clinic.

Your specific individual case is best discussed with your medical team. As a rule, however, you should wait 4-6 weeks after the operation before having sexual intercourse.

Independent of the physical healing process, you should also give yourself the necessary time to mentally process the demanding events of the past weeks, months, and years. Your body needs time to recharge its batteries after the strenuous surgery. Therefore, it is quite normal that it takes some time until sexual desire returns. Please do not put pressure on yourself! Take the time to let your new organ acclimatize in your body in peace. Talking openly with your partner about this topic is very important and helps facilitate an understanding supportive environment. 

Will my desire for sex increase again after kidney transplantation?

Unfortunately, as is so often the case, there is no general answer to this question either. Due to the discontinuation of regular dialysis, the normalization of your hormone balance and the change in some medications, it is quite possible that your desire for sex (=libido) will return all by itself after the transplantation.

If this is not the case for you, there is no reason to worry. If you would like for your libido to return, understanding what the underlying reasons my be is the first step to getting your libido back. Once you figure out what it is in your case, you can more easily find the appropriate solutions. 

Factors affecting desire for sex after transplant

Mental well-being

The last few weeks and months have been extremely taxing on your body. The long time on dialysis and the recovery after the transplant have taken a toll on you not only physically but also mentally. It is important to understand that your body now needs some time to process these events. How long that takes will vary from person to person.

Don't put pressure on yourself and take the time you need to process what you have experienced. Sometimes it can also be helpful to talk to friends and family about your thoughts and feelings. Talking openly with your medical team about your concerns can also have a positive effect on your mental well-being. This topic can be uncomfortable to talk about but you have absolutely nothing to be afraid of. Your closest people have been with you on your journey so far, and they will continue to do everything they can to support you. 

Physical well-being

After the transplant, there will also be some physical changes that you will have to get used to. As you probably already know, you will need to take medication after the transplant to ensure that your new kidney is properly accepted by your body (=immunosuppressants). These medications can make you feel tired and lethargic, especially in the beginning, which can cause many people lose their desire for sex.

Also, immunosuppressants can lead to infections in the genital area, which have a negative effect on sex life. Yeast infections are a common side effect, especially in women. Please do not be afraid to talk to your medical team if you experience any symptoms. By changing or adjusting your medication, these side effects can often be better managed. Although it may be uncomfortable to talk about, you should discuss the issue as openly as possible with your nephrology team.

In some cases, taking immunosuppressants can cause erectile dysfunction in men. There are treatment options for this as well – you just need to talk openly about it with your medical team. For example, for erectile dysfunction, the use of 5-phosphodiesterase (PDE-5) inhibitors can provide relief. These drugs inhibit the activity of the enzyme phosphodiesterase, making getting an erection easier. It is important that you always consult with your medical team before taking new medication. They will be able to discuss with you whether this medication is also suitable for you.

Injections & mechanical helpers

There are also other ways in which erectile dysfunction can be treated. For example, the "Corpus cavernosum auto-injection technique" can also help. With this technique, the man injects certain drugs into the erectile tissue of his penis, which can help facilitate an erection.

Penile vacuums or erectile tissue implants are also mechanical devices that can be used to treat erectile dysfunction. If you would like to know more about this, it is best to consult with your medical team. Together, you are sure to find a suitable treatment method.

Safe sex & contraception after transplant

After kidney transplantation, it is especially important that you follow various hygiene rules during sexual intercourse to prevent the transmission of infections. The immunosuppressants ensure that the reactions of your body's defense system (=immune system) are slowed down so that your new kidney can be accepted by your body.

At the same time, of course, the helpful functions of your immune system are severely restricted by these drugs. This means that your immune system has a harder time recognizing and fighting viruses, fungi, and bacteria - i.e., the triggers of infections. Therefore, it is all the more important that you support your body in this process. The following tips discuss how exactly you can protect yourself during sex:

• After an organ transplant, the use of condoms is especially recommended. Taking oral contraceptives (= pill) is possible, but due to the lack of protection against STIs, a condom should still be used for additional protection.
• By taking immunosuppressants, the effect of the pill is reduced. For this reason, additional contraception with a condom is recommended.
• Make sure that you and your partner have a thorough intimate hygiene. It is best to use disposable washcloths or wash any cloths regularly at over 60°C.
• Use condoms with a sperm repellent coating (=spermicides). This will also help you prevent infections.
• Get tested regularly for STDs and if possible, avoid regularly changing sexual partners.

The most important thing is to talk openly about all your worries and problems. Only then can you get the support you deserve on this important topic. And if you find it difficult to overcome your fears, hopefully this article will encourage you to do so. Remember that you are not alone - many other people are also affected by kidney disease. You'll see that solutions can be found for almost any issue, and you and your partner can find your way back to a fulfilling sex life.