Sexuality and End Stage Renal Disease
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1 Sexuality and End Stage Renal Disease Information for patients and families Read this information to learn: How Sexuality and End Stage Renal Disease (ESRD) can cause changes in sexuality What changes can happen in men and women What treatments are available Who to talk to if you have any questions Please visit the UHN Patient Education website for more health information: University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. Author: The Hemodialysis Team Reviewed: 01/2018 Form: D-5343
2 How can ESRD affect my sex life? End Stage Renal Disease (ESRD) is complete or almost complete failure of the kidneys. ESRD causes many changes to your body. This affects many areas of your life, including how you experience sex. ESRD can cause changes to: your ability to perform and enjoy sex (also called sexual dysfunction) your sexuality Sexuality means more than performing sex. It also includes how you: feel about yourself share your feelings with others build relationships What kinds of changes to sexuality can ESRD cause? Changes that may happen to men with ESRD include: less desire for sex difficulty ejaculating difficulty getting or keeping an erection low self-esteem Changes that may happen to women with ESRD include: less desire for sex painful intercourse changes in menstrual cycles low self-esteem Women with ESRD can get pregnant. It is important to use some type of birth control. Talk to your healthcare team, if you are thinking of getting pregnant. 2
3 How does ESRD cause sexual dysfunction? ESRD can cause sexual dysfunction in different ways. 1. Physical causes Hormone imbalances ESRD can cause men s hormone levels to change. The hormones testosterone, estrogen and prolactin can be out of balance. This can reduce libido (desire for sex) and cause difficulty with erections. Changes in hormones for women can cause painful intercourse. It can also cause changes to how they ovulate or menstruate. Blood vessel damage High blood pressure and diabetes can cause damage to blood vessels. A build-up of waste products (called Uremia) also damages blood vessels. Blood vessel damage may cause men to have trouble getting an erection (also called erectile dysfunction). Decreased sensation Uremia and diabetes can cause nerve damage (nerve numbness). This can lead to erectile dysfunction. It can also cause men to take longer to ejaculate (also called delayed ejaculation). 2. Medication side-effects Some prescription medications can cause loss of libido, erectile dysfunction and delayed ejaculation. Recreational drugs (for example: marijuana, cocaine and crack) can also cause sexual dysfunction. 3
4 3. Life changes People with ESRD experience many changes in their lives. These may include: financial problems because you are unable to work less travel and social activities decreased ability to enjoy your hobbies low self-esteem because of your medical condition Please remember: Sexual problems are common for people with ESRD. Some treatments are available. Talk to your nurse, social worker or nephrologist about any concerns you may have. Please feel free to let your health care worker know if you need somewhere quiet or private to talk. What treatments are available? There are treatments for some causes of sexual dysfunction. Your nurse or nephrologist can help you decide on treatment. Here is a list of some options: Hormone therapy A medication with hormones is prescribed to increase or replace hormones lost because of ESRD. 4
5 Medications Medications like Sildenafil (Viagra) are prescribed to help men with erectile dysfunction. Don t take Viagra if you take nitrates (often prescribed for chest pain) because this may cause a sudden, unsafe drop in blood pressure. Penile implant surgery Men who are suitable for this surgery have a material put into their penis to help keep it erect (hard) during sex. Penile injection A medication is injected into the penis to produce an erection. External suction A suction pump is placed over the penis to help produce an erection. Sexual counselling Both men and women can benefit from talking to a sex therapist. A sex therapist can help men and women manage their difficulties with sex. Who can I talk to if I have questions? Talk to your nurse, social worker or nephrologist if you have any questions. They can listen if you would like to talk more about your sexuality. Original document prepared by: Denise Williams, RN, MN, CNeph(c) Soh Tee Goh, RN, BScN Deloris Bennett, RN, BScN, CNeph(c) Edited by: Vanessa Godfrey, RN, MScN, CNeph(c), February 2014 Reviewed by: Hemoquality Committee, Patient Education Sub-Committee 5
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