Introduction and Safe Sex If you would like to discuss your kidney diagnosis with our trained members of staff, ring our free-to-call number. The NKF Helpline is available Monday to Thursday 08:30 am - 5:00 pm Friday 8.30 am – 12.30 pm on 0800 169 09 36 or email [email protected] Are sexual problems common for people with kidney failure? Sexual problems are more common for men and women who have kidney disease. Not only are emotional problems likely to occur because of the stress of kidney disease, but also there are several medical conditions that can affect sexual function and ability to have children, in both men and women. Emotional problems that can cause sexual difficulty Many people in their lifetime suffer with some sort of emotional problems leading to sexual difficulties. The stability of a relationship prior to the onset of kidney failure can play a significant part in dealing with sexual difficulties of both men and women. Some common emotional problems are caused by people going through a grieving process due to loss of kidney function, independence, their job, and place in the family. There may be a change in body image, or not feeling a whole man or whole woman due to decreased sexual function. Dialysis can lead to lowered self-esteem with anger and depression, also affecting sexual function. Partners can feel powerless in a relationship because they do not know what to do to help the person with kidney failure, or if they receive a negative reaction when trying to help. The equal balance of the relationship may have changed, one seeing themselves as the carer and the other in a sick role. People need to talk about their fears and feelings. They also need to know that what they have said has been heard by the other person. Other hidden fears may also be present. For instance, some people may believe that kidney disease could be transferred during sex. This is not true. Many kidney patients and their partners could benefit from receiving counselling, either by a psychologist or sexual counsellor. This can be very effective. Investigating sexual problems In the past, many health professionals working with kidney patients have tended to avoid getting involved with their patients’ sexual problems. Even now, despite the more general interest and openness about sexual matters, people with kidney disease may still find that they have to raise the subject first. Another possible reason why some doctors and nurses have avoided the subject of sexual problems has been a mistaken belief that the available treatments were unlikely to work. This view needs to be updated. As with other aspects of kidney failure, there isn’t usually just one straightforward problem that can be easily corrected. Often there are several issues to look at and patience is required. Nevertheless, treatment is usually successful, provided both partners are keen to have a sex life and are willing to accept help. It may be possible to adjust medication, increase dialysis, improve haemoglobin or treat erectile problems. Contraception Contraception is important for people with kidney disease, just as it is for everyone else. Don’t assume that just because you have kidney failure that you cannot have a child. Progesterone only contraception in any form, the coil and condoms are safe for people with kidney disease to use. The combined oral contraceptive pill can be associated with an increased risk of complications in some women with kidney disease, so needs to be prescribed with care. In general, longer acting methods of contraception are preferred, for example the coil (either copper or mirena), depot injections or an implant. Barrier methods of contraception are less effective compared to other forms of contraception, for example hormonal methods, and so it’s important that they are used correctly. The advantage of male condom and female condoms is that they also act as a barrier to the spread of sexually transmitted diseases, for example herpes and HIV. A diaphragm or spermicidal jelly can also be used. Disadvantages of these methods are that men may not like to use a condom. Women may find it difficult to position the Femidom or a diaphragm correctly into the vagina; or find the process distasteful, especially since spermicidal jelly must be used as well, to increase the effectiveness of the contraceptive. Ideally, barrier methods could be used alongside other contraceptive methods for maximal effectiveness and reducing the spread of sexually transmitted diseases. Failure of a barrier method may occur when the device becomes dislodged during or after intercourse. Kidney patients can take the ‘morning after pill’, but this treatment can cause sickness and should not be used as a regular method of contraception. The combined oral contraceptive pill (often just called ‘The Pill’) contains both progesterone and oestrogen, and can be used in some women with kidney diseases, but a lower oestrogen preparation may be preferred. High blood pressure is very common in women with kidney diseases, and this is also a common side effect of combined oral contraceptives. Therefore, blood pressure should be monitored closely in women with kidney disease who are started on the pill, and avoided in women who already have high blood pressure and also those that are at an increased risk of developing blood clots for example due to a previous history or in those with heavy proteinuria. Women can use an intrauterine copper coil. This is a small plastic and metal device which is inserted into the neck of the womb. The copper coil is a very effective method of contraception, though it may cause some bleeding or heavier periods, and there is a very small risk of infection in the womb. There is an alternative type of coil available, which may better suit some women, and overcome some of the disadvantages of copper coils. It is marketed in the UK under the name ‘Mirena’ and combines some hormonal treatment with the coil effect. Unlike the copper coil, Mirena reduces menstrual bleeding and in many cases periods stop completely. In some women, this may be an advantage if the blood loss from periods has caused anaemia. Both forms of intrauterine devices are not associated with some of the side effects associated with combined pill, and have the advantage of working long-term, but like any type of medication can have side effects. Both need to be inserted by a trained doctor or nurse and changed roughly every five years. A man can have a vasectomy or a woman can be sterilised. These procedures can be carried out in people with kidney failure in the same way as anyone else. Before contemplating sterilisation, it is important to realise that the success of reversal by surgery is limited, so if someone changes his or her mind about children, it may not be possible to regain normal fertility. Lastly, sterilisation does not protect against sexually transmitted diseases, so safe sex with barrier methods should be practised if having sex with multiple partners. These various methods of contraception require consultation with a nurse or doctor in order to decide which would suit someone the best. Safe sex and sexually transmitted diseases People with kidney disease can get sexually transmitted diseases, so safe sex is important. Sexually transmitted diseases can occur in people with kidney failure just as they can in anyone else. There may be symptoms, such as genital itching or a discharge from the penis or vagina. However, many sexually transmitted diseases may cause no symptoms, so do not take chances, play it safe! Written by Dr. Nadia Sarween - Renal Medicine Consultant at University Hospitals Birmingham. Written August 2024 Next Review August 2027 Download this Information in PDF The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor. Manage Cookie Preferences