Chronic Kidney Disease and Sexuality

By Linda G., Guest Blogger

Steve and Linda prepare for a weekly date

Steve and Linda prepare for a weekly date

Hi again! My name is Dr. Linda Gromko and I am a Seattle family practice physician who assisted my husband Steve Williams with both hemodialysis and peritoneal dialysis for three-and-a-half years before his death in April 2011. In coordination with interior designer Jane C. McClure, I wrote Arranging Your Life When Dialysis Comes Home: “The Underwear Factor’ and two other books about my family’s experience with ESRD.

I recently spoke before the NW Chapter of Nephrology Social Workers on “Sexuality and the Dialysis Patient.” This was a group of very invested helping professionals, committed to their clients’ total well being.
Here were the main take-home messages from our session:

1. Kidney disease can impact virtually every aspect of a person’s health. Sexual function is sort of the “canary in the coal mine.” When the body as a whole isn’t working well, sexual function can suffer.

2. The majority of End Stage Renal Disease is associated with diabetes and/or high blood pressure. Both of these conditions can impact a person’s overall health and sexual function.

3. Many medications – including some blood pressure meds and antidepressants – can cause erectile dysfunction (E.D.) or lack of orgasm. Rather than stopping medications, know that alternative meds may be available! Ask your health care provider.

4. Kidney transplant is the Renal Replacement Therapy associated with the best sexual function.

Steve gets a kiss from kidney donor Teresa D.

Steve gets a kiss from kidney donor Teresa D.

5. The frequency and quality of dialysis can impact sexual function. You can’t have enough dialysis, when you consider that kidneys are at work 24 hours a day! Peritoneal dialysis and frequent home hemodialysis are both associated with better sexual function, when compared with traditional in-Center dialysis!

6. Body image is important – and so is protecting a precious fistula or peritoneal dialysis catheter. Tricks include peritoneal dialysis belts – or even lingerie. And a cotton t-shirt can protect an arm fistula.

7. Medications to treat erectile dysfunction (E.D.) can often be used in kidney patients – with two important cautions: a) The combination of E.D. meds and nitrate blood pressure medications can cause a dangerous drop in blood pressure, and b) all drugs must be double checked for dosing adjustments needed in kidney patients.

The social workers seemed to agree that sex isn’t a frill. In addition, they agreed that intimacy in a relationship isn’t just sex! One of the best things a social worker did for Steve and me was to help us with Access Bus transportation so we could have regular dates; a weekly afternoon of a movie and a meal became a cornerstone of our relationship.

I would encourage kidney “couples” to talk with their doctors and social workers if they have sexual concerns. If you are uncomfortable, try this: “This is a little uncomfortable to talk about, but I have some concerns about our relationship as a couple.” Or use “our physical relationship.”

And if your helping professional is uncomfortable discussing sex, don’t let that stop you from getting the help you need. Ask for a referral to a sex therapist (may not be covered by insurance). Another excellent resource which covers all aspects of life with CKD is the book, “Help! I Need Dialysis” by Dori Schatell and Dr. John Agar. Kidney disease can take a lot away! Protect your intimate relationship and make it a priority.

As always, please comment below to let me know what you think.

Comments

  1. Clarkee says:

    THANK YOU!! This is a very difficult subject that deserves discussion. Thank you!!

    • You are most welcome. One of the most important points I want to make is that even if it is uncomfortable to discuss, we CAN talk about sexual matters. Think about all the other difficult topics we discuss routinely! Linda

  2. Jenny Rol says:

    This is very true and very interesting but how do you do when your partner is in denial of the situation and doesn’t want to admit he has erectil problems at all .. even when it is a long while you cannot get intimate?

    • This is difficult. Your partner may be embarrassed. Or he may simply not know that E.D. is common and can be treated. Take your nephrologist or social worker aside, and ask for some help. Hopefully, they’ll “normalize” the situation by saying something like, “It’s common for couples impacted by kidney disease to have some challenges with their physical relationship. How has kidney disease impacted you two as a couple?” That way, the “blame” is on the disease – not your partner! At the very least, it’ll break the ice – and the two of you may be able to talk about it later. If you aren’t sure your helping professionals will talk about sex, send them this blog post! Good luck. Linda

  3. excellent post. i want to thank you for this informative read, i really appreciate sharing this great post. keep up your work. bbom bbom bbom bbom bbom

  4. i really liked the topics you post here. thanks for sharing this information that is so helpful for us. good day. bbom bbom bbom bbom bbom

  5. Health problems do not only take a toll on the people who are experiencing but also on their families. Thanks for sharing your story. It really helps people who are dealing with chronic and serious health problems.

    • Thank you for your comments. There isn’t that much written on families’ experiences with kidney failure; everybody is trying so hard just to hang in there! But it’s important to talk to others who have been there, or are sharing common experiences now. Best wishes to you and your family. Linda

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