Sexual dysfunction is a common occurrence among chronic kidney patients.

Fatigue is a common issue among chronic kidney disease and dialysis patients, and feeling tired and having limited energy is one of the main reasons for sexual problems. In addition, depression in patients and/or spouses may lead to a decrease in sex due to a lack of interest and a lack of pleasure from having sex. Some medications may also affect a patient’s ability or desire to have sex. In addition, patients’ self-image may play a role in not wanting to have sex, due to feeling self-conscious or less attractive from having a fistula or a peritoneal dialysis catheter and worrying about what other people will think of it. Patients may also use dialysis as an excuse to not have sex, if they are worried about having sexual dysfunction and not being able to perform sexually. As well, men may have problems with their erections while women may have issues with having orgasms.

Patients who decide to do home dialysis, either peritoneal or hemodialysis, wonder if sexual intimacy is possible while undergoing dialysis therapy at home.

Some patients report on the added benefit of the help it provides in re-establishing a sense of normal life. Some patients are nervous to have sex while on dialysis because they are afraid of the dialysis needles and tubes accidentally becoming disconnected. In addition, some spouses of dialysis patients are nervous to have sex while the patient is on dialysis because they are fearful that the patient may get hurt or is too ill to have sex.

Sexual dysfunction can cause a change in the dynamics of an already stressed intimate relationship.

Sex is a normal part of life, so continuing to be sexually active and intimate can help patients to regain independence and control. It is important to have open communication, not only with romantic partners, but also with the health care team, so that patients become aware of what they are able to and not able to do. Nephrologists, nurses, and social workers can provide reassurance and answers to questions about sex. Although it may sometimes feel uncomfortable to talk about sex and sex-related issues, it is important to recognize that these issues are a normal part of the illness experience.