Sexual Problems Common Among Women on Dialysis

[RightSide]

 03/30/2009

NASHVILLE—The majority of women receiving maintenance dialysis who are sexually active suffer from sexual dysfunction, according to research presented at the National Kidney Foundation’s Spring Clinical Meetings.

“We know that many men with kidney disease have erectile dysfunction, but in our series of studies on quality of life issues among dialysis patients, we found that there has been less research about sexual function in women,” said senior investigator Dr. Steven D. Weisbord, a nephrologist at the University of Pittsburgh and at VA Pittsburgh Healthcare System.

As part of their pilot study,  Weisbord and colleagues surveyed 44 sexually active female dialysis patients (mean age 59 years) using the Female Sexual Function Index.

Total FSFI scores showed that 75 percent of respondents had a high degree of sexual dysfunction. Answers to individual questions indicated impairment in each of the 6 domains of sexual function (desire, arousal, lubrication, orgasm, pain, and satisfaction).

“There are probably multiple causes for sexual dysfunction among women on dialysis, including effects of renal disease itself,” Weisbord said. “Also, many are on multiple medications, some of which interfere with sexual function. Plus the prevalence of depression is high in this patient population, which may play a role.”

Only 21 percent of those with sexual dysfunction had discussed the issue with a gynecologist, and none had brought up the topic with their kidney specialist or a primary care provider. Not one of the patients had received any treatment for the problem.

There are likely two main reasons for women’s disinclination to discuss their sexual problems with their doctors, the researcher said. “They may think—perhaps correctly—that there are no viable treatment options. This is a sensitive issue that many are not comfortable discussing with their doctor.”

“One of our goals is to raise awareness among kidney care providers, get them to interact more with their female patients and at the very least facilitate a formal workup for their symptoms. There are some potential treatment options, though none as established as the use of phosphodiesterase inhibitors for erectile dysfunction.”

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[monrein]

A huge additional issue for women is the decrease in estrogen in menopause, which results in vaginal dryness and painful intercourse.  There has been a lot of controversy surrounding hormonal replacement therapy and I decided not to go that route.  I did speak to my gynecologist and he prescribed a localized estrogen tablet, inserted vaginally three times a week ,  doesn't enter the blood stream, and that has helped a bit although it definitely doesn't reverse the clock.  As women age they also require more direct clitoral stimulation, think vibrators, and better lubricants.  There is also a topical ointment called Hurricane, comes in flavours like pina colada, LOL, and that can help with pain on insertion.  Be careful where it's applied though since deadening feeling everywhere would be quite counter-productive.

There's a huge difference in the sexual issues of a young person on D and those experienced by a person over 50.

[okarol]

I have heard more than once that sex drive can be an issue for patients, even before they actually get on dialysis. I have tried to find more info over the years because lack of libido in a young adult with CKD just really hasn't been studied. I have heard it could be related to the adrenal gland, which sits on top of the kidney, and it helps control hormones. Maybe I will write to Dr. Steven D. Weisbord at the University of Pittsburgh and ask him if he knows of any other studies.

[MandaMe1986]

I can tell you there is an effect on young adults before D.  I have no desire or energy. But truthfully if I had to lose something, my sex drive really isn't that big of a deal. 

[joyfulmother]

Well, I could care less about sex BUT my hubby does so I keep trying to figure it out! 

[Rerun]

When you feel like crap all the time who wants sex? 

[G-Ma]

joyfulmother.....exactly...those of us in relationships want something to work...it would help to know how to get it to work.

[MandaMe1986]

Well yeah I understand. And I understand my boyfriend hates that I never want sex.  But when I have spent all day cleaning, taking care of the kids (and that in cludes fighting with them all day), and cooking, and everything else that needs to be done. I just don't care. 

[twirl]

this is a difficult situation in my marriage
my husband does not understand and he gets his feelings hurt
I just usually feel like crap

[MandaMe1986]

Matthew is the same way Twirl. He thinks I don't want him and a bunch of crap like that. Its hard when they don't understand.  But I try not to let it get to me.  I mean there really isn't anything I can do.

[peleroja]

lol, you don't even have to be on dialysis to not be interested in sex.  I've never been interested in sex, but it was something I learned to do because men like it.  Sadly, it took me a long time to realize I can live quite happily without a man in my life.  Living sex free almost 12 years now!

[MandaMe1986]

wow 12 years!    

[twirl]

yeah and I can not drink anymore to --- well you know

interest is still here if my husband would get done faster

 

oh no, Sluff is going to ban me 

[MandaMe1986]

hey lasting to long is better then not long enough

[twirl]

 

[okarol]

 

[peleroja]

There goes the neighborhood 

[Wenchie58]

Staying abnormally mute on this topic....wouldn't wanna shock the heck out of all of ya!   LOL!! 

[Hilrose]

Its a very sensitve issue, but Wenchie,  I wish you tell us... don't keep the secret to yourself.

H

[G-Ma]

       Peleroga my HERO.

[twirl]

wenchie58

this is not Gossip Girl  ======= we will not tell
could not be more graphic than what monrein wrote 
( she is a riot )   

[paris]

Come on Wenchie---you have us all curious! 

[RichardMEL]

Wenchie is my hero!!!

Yes I know I shouldn't be posting in here but what the hey.. I was curious I guess. I know one woman on Dialysis who has no problems with her sex life (well from what she tells me anyway! lol) so I suppose it's not going to be the same for everyone. Same with me I want it just as much as before... of course not getting any for [ CENSORED LENGTH OF TIME ] has something to do with it    

I can certainly understand the feeling like crap/bloody tired from everything else reasons for not having an interest in sex. It would be very difficult for those of you with partners because that IS a normal part of a relationship and it would be very difficult for the partners to understand that it is just another aspect of living with someone with kidney failure. sigh.

[Beth35]

I never had problems.  Now I have two kids so I'm sure that would add to the tiredness.

[Tinah1968]

Wow this made me feel "Normal" thought I was the only one not really caring for sex..

And Wenchie.. Do tell..