Kidney disease and reproductive concerns

BENGALURU: In men and women with chronic renal disease, sexual dysfunction and infertility are prevalent. These can lead to worry, low self-esteem, marital strife, and depression, all of which contribute to a lower quality of life.

Men and women’s sexual function is governed by a variety of neurologic, psychological, and hormonal systems, all of which are impacted by chronic kidney disease. Medications for a variety of conditions may also have a role.

Men with renal disease suffer hormonal changes, such as higher prolactin levels and reduced levels of different gonadal hormones generated by the brain and pituitary gland. Low testosterone levels, as well as poor sperm production and motility, affect around two-thirds of men on dialysis. Impaired erection function and a lack of sexual desire might lead to more serious problems. Anovulation is frequently caused by a lack of pulsatile Luteinizing Hormone (LH) secretion in women. Sexual dysfunction in women is caused by a lack of lubrication. Diabetes can impair sexual function, and it is the main cause of chronic renal disease in the world.

Various drugs for increasing erectile function and sustaining erection can be attempted by patients with chronic renal disease and hemodialysis.

Artificial lubricants can be used by women who have insufficient lubrication. Hormonal medicines for both women and men may be used in collaboration with a gynaecologist and urologist to enhance sexual function. Regular dialysis, up to three times per week, helps to reduce toxin load, which is important for hormonal balance and overall sexual well-being. Psychiatric counselling to decrease stress and counselling to improve sexual function can be quite beneficial.

Male fertility has been observed to improve following kidney transplantation. However, the rise in fertility is also dependent on post-transplant care and the treating nephrologist’s vigilant monitoring of numerous indicators.

The lowering of toxic load and normalisation of kidney function following a renal transplant will be critical in recovering sexual function. It is generally known that following transplanting, an increase in sexual desire and overall improved sexual performance can be recovered. Furthermore, the age at which an individual develops end-stage renal illness is a significant factor in deciding whether or not they would be able to conceive after a transplant.

The preservation of the vas deferens and testicular blood flow during the surgery, which is done on a priority basis for the patient, is also important for fertility recovery. Patients with poor sperm counts and motility before the transplant saw an improvement in sperm motility and count in as little as 12 months.

After transplanting, several men have successfully fathered children. After renal transplantation, many women who have lost reproductive function owing to chronic kidney disease and are on dialysis may regain reproductive function, have regular menstrual periods, and have children. Sexual dysfunction caused by severe and irreparable damage caused by senior age, long-term diabetes, different comorbid medical problems, and extended dialysis, on the other hand, may not be totally curable. In terms of sexual function and childbearing, a renal transplant is a good choice for people with chronic kidney disease. It has been demonstrated that pharmaceuticals given to males after transplantation have no influence on reproduction; however, the effects of medications are more obvious in women, but they do not generally interfere with normal childbearing.