Managing Sexual Health with Chronic Kidney Disease

Key Points

  • If you have chronic kidney disease (CKD) you may have problems with your sexual health.
  • This is because medicine, dialysis, and hormones can all affect sexual function.
  • Find out what you can do to manage these problems.
Young male doctor talking with patient.

CKD and sexual health

Up to 80% of people with CKD (about 8 in 10) report having sexual health problems. Like other health conditions, if left untreated, sexual problems can have a negative effect on your life. The good news is that many things can be done to help.

Factors that affect sexual health

At first, you may notice subtle changes, such as loss of interest in sex. But as CKD progresses and kidney function gets worse, sexual problems can get worse. Some causes of sexual problems include:

  • Side effects from medicine.
  • Hormonal changes.
  • Nerve and blood vessel damage.
  • Side effects from dialysis.
  • Depression and anxiety.

Common sexual health problems

Sexual problems can happen to anyone. But you have a higher risk if you have CKD, especially if you also receive dialysis treatment. Know that it's not a "you" problem, it's a CKD problem. Here are a few problems you may have:

Decreased libido (urge to have sex). CKD affects your levels of luteinizing hormone (LH), which plays an important part in sexual development and functioning. Abnormally low LH levels decrease the release of testosterone in the testicles and estrogen in the ovaries. This can cause problems with sexual arousal.

Erectile dysfunction (in men). Diabetes is one of the main causes of CKD. Over time, high blood sugar may damage nerves and blood vessels throughout your body. This damage can reduce blood flow to the penis, causing problems getting or keeping an erection.

Premature menopause (in women). Premature menopause is common in women with CKD. Although not clearly understood, it's known that CKD affects how your body makes and releases hormones. Women with CKD tend to have lower estrogen levels. This can lead to irregular periods, vaginal dryness, and painful sex.

Low energy and depression. Dealing with a serious health condition, such as CKD, can lead to depression and fatigue. This could lead to less interest and enjoyment in sex.

Medicine side effects. You might take medicines to manage CKD and other related health problems, like diabetes, high blood pressure, high cholesterol, or heart disease. These medicines may cause erectile dysfunction, decreased arousal, and orgasm dysfunction.

Talking to your doctor

Don't be shy to talk to your doctor about your sexual health. Your doctor can help identify a treatment plan that's best for you. Some treatment options include:

Hormonal therapy: Your doctor may prescribe medicine that helps increase hormone levels. Increasing estrogen in women and testosterone in men may increase sexual arousal.

Changing or prescribing medicines: Blood pressure medicines, such as diuretics (water pills), and antidepressants may affect sexual health. Your doctor may suggest different medicines or dosage levels. Make sure to let your doctor know if you have any side effects when your medicines are changed.

Talk therapy: Sexual problems can be both physically and mentally challenging. Talking with a mental health professional about sexual problems can help you deal with depression and anxiety. Make sure that both your nephrologist (kidney doctor) and your mental health professional know your treatment plan.

It may not be easy to talk about your sexual health, but it's an important part of your overall health. Work with your health care team to manage and treat your CKD. This can help slow its progression to reduce complications, including sexual health problems.