Sex problems with renal failure
Sexual problems are 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 a number of medical conditions that can affect sexual function and ability to have children, in both men and women. 
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. The coil contraceptive and condoms are safe for people with kidney disease to use. The oral contraceptive pill can cause some complications more frequently in women with kidney disease than in the general population, so needs to be prescribed with care.
Irregular periods can occur in women with kidney failure and after transplantation. It is common for women with advanced kidney failure either to stop having periods, or to have irregular periods. However that does not mean these women are completely infertile (unable to have a baby), so contraception should still be used. After a successful kidney transplant, periods usually return to a more normal pattern.
Young women on dialysis who have no periods, and all women with kidney disease after the menopause, should consider hormone replacement treatment.
Sex is possible for women with kidney failure. Some people worry that the catheter (tube) for peritoneal dialysis, which hangs from the tummy just below the belly button, will stop them having sex. Others worry that a kidney transplant, which is placed low down in the tummy, might also be a problem. Neither of these should prevent anyone on peritoneal dialysis having sex.
Although loss of sex drive can be an emotional problem, women should not think that this is always the case. Problems such as anaemia and hormone deficiency can cause loss of sex drive in women, and these are treatable.
Although male fertility may remain normal with kidney disease, loss of sex drive and impotence (not being able to raise an erection) are very common. There are a number of causes for this, including anaemia and testosterone deficiency. These can be tested for, and in many cases treated.
There are a number of treatments available for impotence. The tablet Viagra is not suitable for everyone.
Yes, but men with kidney diseases may have a reduced sperm count and have difficulty fathering a child.
There is a reduced success rate for pregnancy if a woman has advanced kidney failure or is on dialysis.
Women can successfully have children if they have a functioning transplant, though there are some risks. Women are usually advised not to get pregnant in the first year after a kidney transplant. The drugs used to stop rejection of the kidney transplant need to continue to be taken during pregnancy.
There are two problems to consider:
Generally, even though parents may be taking several different types of medication, children born do not have excessive rates of abnormalities. However, the spontaneous miscarriage rate in early pregnancy may be higher than in normal people.
Some types of kidney disease run in families, and the chances of a child inheriting the condition can be calculated. Examples are polycystic kidney disease and Alport’s syndrome. Other types of kidney disease run in families, but it is harder to predict the exact chances of children being affected. An example is reflux nephropathy. Most kidney diseases do not generally run in families, but occasionally seem to be inherited, so it may be prudent for checks to be performed on family members.
Kidney disease can be diagnosed during pregnancy. The most common problem is urine infection, which can be treated with antibiotics. Minor kidney diseases which may have been present for years before pregnancy can be detected because careful medical checks are performed during pregnancy. Less commonly, kidney diseases can develop for the first time during pregnancy. Lastly, a condition called ‘eclampsia’ can develop which causes high blood pressure and kidney failure in previously healthy women.
information on sexually transmitted diseases
The Sexual Dysfunction Association, deals with impotence in men and women. Many useful articles.
British Association of Sexual and Relationship Therapists
the Family Planning Association
Also, in ‘The British Medical Association Family Doctor’ series, a booklet Understanding Sex is available from pharmacies.
NKF Controlled Document No. 201, Sex problems with renal failure, written 8 August 2004. Last reviewed 6 June 2011.
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.