Chronic Kidney Disease and Sexual Health

Young Hispanic male doctor talking with male patient.

Don’t be shy to talk to your doctor about your sexual health.

If you have chronic kidney disease (CKD) you may have problems with your sexual health. Medicine, dialysis, and hormones can all affect sexual functioning. But know that you’re not alone. It’s time to talk about C-K-D and S-E-X.

Up to 80% of people with CKD—that’s about 8 in 10—report having sexual 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.

CKD 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 Problems

Although sexual problems can happen to anyone, you’re at 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. The more you know about it, the more you can do to manage your sexual health. Here are a few problems you may have.

Decreased libido (urge to have sex). CKD affects how your pituitary gland (a pea-sized gland at the base of your brain) releases a type of hormone called luteinizing hormone (LH). LH plays an important part in sexual development and functioning. Abnormal LH levels decrease the release of testosterone in the testicles and estrogen in the ovaries, leading to 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 because the ovaries slow or even stop making this hormone. This can lead to irregular periods, vaginal dryness, and painful sex.

Low energy and depression. It’s common to feel tired and depressed at some point in life, especially while you’re dealing with a serious health condition, such as CKD. Living with CKD can be challenging. Many people with CKD often report feelings of depression and fatigue, which may lead to less interest and enjoyment in sex.

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

Treatment Options

Sexual problems may be caused by several factors. Talking to your doctor about these problems 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 brands or dosage levels, or prescribe a new medicine. 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 so that they can work together to manage your health.

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