Do sexual dysfunctions get better during dialysis? Results of a six-month prospective follow-up study from Turkey

Abstract

Dialysis improves most symptoms of end-stage renal disease (ESRD), yet many patients continue to experience sexual dysfunction (SD) during the dialysis treatment. The aim of this preliminary study was to evaluate the frequency and the course of SD during a 6-month dialysis treatment. Additionally, relationships between the level of depression, cognitive impairment and biochemical parameters of SD were also assessed. The subjects were 43 ESRD (25 male and 18 female) on dialysis treatment for at least 12 months. SD was assessed using the Arizona Sexual Experiences Scale (ASEX); the level of depression and cognitive impairment were assessed using the Hamilton Depression Rating Scale (HDRS) and Mini Mental Status Exam (MMSE). Several biochemical parameters were also assessed. All assessments were carried out at baseline and repeated at 6-month follow-up. Of 43 patients, 20 (47%) and 18 (42%) complained of SD at baseline and at 6-month assessments, respectively. Of 25 males, nine (36%) and seven (28%) patients described SD at baseline and 6-month assessments, respectively; erectile dysfunction was the most frequent complaint. Of 18 females, 11 (61%) and 11 (61%) patients reported SD at baseline and 6-month assessments, respectively; difficulties with arousal and reaching orgasm were the most frequent complaints. Both total and item-by-item comparisons of baseline and 6 months ASEX scores did not reveal any significant changes during 6-month period, indicating that patient's sexual functions do not improve with dialysis treatment. For female patients, HDRS scores were significantly higher in patients with SD at baseline (t ¼ 2.15, P ¼ 0.05) and at 6-month follow-up (t ¼ 2.44, P ¼ 0.03) assessments; after excluding the effects of age and duration of dialysis for females using regression analysis, HDRS still significantly (t ¼ 4.02, P ¼ 0.003) associated with the SD. This preliminary prospective study suggests that SD is frequent in dialysis patients, does not remit with dialysis treatment, associated with depression in female patients, and much clinical attention is indicated.

Psychiatric Comorbidity, Sexual Dysfunction, and Quality of Life in Patients Undergoing Hemodialysis: A Case-Control Study

“…This finding is consistent with the results of other studies showing that SD is more frequent in patients with chronic renal disease (3,4,35,36,37,38). In a study conducted with patients undergoing dialysis treatment, 65% of participants expressed dissatisfaction with their sexual life, 40% expressed that sexual intercourse does not arouse any more interest, and 25% expressed symptoms of probable SD (39).…”

Female Sexual Dysfunction in Peritoneal Dialysis and Hemodialysis Patients

“…[1,6] Soykan et al used the Arizona Sexual Experience Scale (ASEX) and reported that sexual dysfunction was 61% in female with HD patients. [5] Basok et al using FSFI scores reported that the rates of FSD were 81, 66.7, and 50% in the PD and HD patients and control subjects, respectively. [17] We found that SD was 95.7% in female with ESRD patients (94.1% in PD; all of HD patients) and 45.8% in the control.…”

“…Until recently, little clinical research has been done on FSD; therefore, our knowledge and understanding of this disorder are limited. [2,5] We evaluated sexual function in female ESRD patients using the validated Female Sexual Function Index (FSFI) and relation with QOL, depression, and some laboratory parameters.…”

Women's sexual function and dysfunction: current uncertainties, future directions

“…23 Anxiety disorders can preclude women's ability to attend to sexual stimuli and to be lost in the moment. For women with diabetes, 34 renal failure 35 or multiple sclerosis, 36 it is the comorbid depression that is associated with higher prevalence of sexual dysfunction compared to control women.…”