The Comparison of the Relationship Between Sociocultural-Economic Features and Sexual Dysfunction Frequency in Sexually Active Premenopausal Female Patients on Renal Replacement Therapy

Abstract

Introduction Many studies determine different risk factors for sexual dysfunction (SD) in women, but little is known about the influence of socioeconomic and cultural factors, medical and psychological features on female SD frequency in patients under renal replacement therapy (RRT). Aim This study aimed to compare the relationship between medical, psychological, sociocultural-economic factors, and SD frequency in patients on RRT with the diagnosis of end-stage renal disease. Method The 115 RRT patients (hemodialysis [HD] 39, peritoneal dialysis [PD] 43, kidney transplant [KT] 33) and 103 healthy premenopausal female volunteers (control) without any known health problems were included in the study. Main Outcome Measures The questionnaire forms containing sociodemographic data, the hospital anxiety depression scale, and Arizona Sexual Experiences Scale were completely filled by subjects who were included in the study. Results There was no significant difference about mean age, dialysis duration, and body mass index between the groups. While there were significant differences among participants training period and employment conditions, socioeconomic status scores were similar. Significant differences were found in marriage type, marital duration, husband’s age, training period and working time per week, spending time with each other, weekly sexual intercourse frequency, the number of children, mothers’ and fathers’ education. RRT groups were more depressed than control, but no significant differences were observed among the RRT groups. PD and HD groups were more anxious than the KT and control groups. It was identified that SD rates were higher in KT and dialysis patients compared with the control. SD rates were significantly high in the HD group. Multivariate analysis showed that marital duration and being an HD patient are independent SD risk factors for RRT population. Conclusion Successful KT may improve SD. Differences in sociocultural, economic, medical, and psychological factors among individuals with SD should be taken into consideration in their treatment management.

Multifaceted Sexual Dysfunction in Dialyzing Men and Women: Pathophysiology, Diagnostics, and Therapeutics

“…There is a strong association between SD and diabetes mellitus (DM), but the studies investigating the effect of DM on female sexuality have yielded inconsistent results [66]. One study suggests that DM results in a decrease in genital sensation in women [67].…”

“…Yazici et al identified with the FSFI that 94.1% of their PD cohort and 100% of their HD cohort experienced SD compared to 45.8% of control. Several research teams showed that female patients receiving PD reported better sexual function compared with those receiving HD [66,74,75,78,85]. A small study by Duarsa et al [86] also showed that women undergoing CAPD experienced a significant improvement in FSFI scores.…”

“…This may be due to the fact that PD patients have lower incidence of anemia, better clearance of middle molecular-weight substances, and better residual renal function. The increased independence of a PD patient and fewer dietary restrictions may have a positive impact on psychological wellbeing [66]. In contrast, amenorrheic HD patients are more likely to have low estradiol levels secondarily leading to vaginal atrophy and dryness [11] and therefore exhibit higher prevalence of dyspareunia and problems with orgasm [2].…”

Structured review of the use of the Arizona sexual experiences scale in clinical settings

“…Another investigation in haemodialysis patients (n = 246) found higher ASEX scores among patients with comorbid restless legs syndrome (RLS) than those without RLS, and significant relationships between ASEX scores and demographic variables including educational achievements, occupation, and marital status (Dikici et al, 2014). An investigation in female patients who underwent renal replacement therapy found that ASEX-determined sexual dysfunction rates were significantly higher in a haemodialysis group (n = 39) compared to the peritoneal dialysis group (n = 43) and the kidney transplant group (n = 33), and sexual dysfunction rates were higher in kidney transplant and dialysis patients when compared with controls: multivariate analysis indicated that marital duration and haemodialysis were independent risk factors for sexual dysfunction in the renal replacement population (Koca et al, 2012). A further investigation found that total ASEX scores, ability to reach orgasm, and BDI scores were significantly higher among peritoneal-dialysis (n = 22) and haemodialysis (n = 25) patients than controls (n = 30): peritonealdialysis patients with depressive symptoms were 24 times more likely to experience sexual dysfunction than those without depression, and serum FSH and LH levels were positively correlated with arousal and erection/lubrication scores in the depressed peritoneal-dialysis patients (Kurdoglu et al, 2012).…”

“…The ASEX has been included in a series of investigations of patients with renal disease (Dikici et al, 2014;Hekmat et al, 2016;Koca et al, 2012;Kurdoglu et al, 2012;Ozdemir et al, 2007;Soykan et al, 2005). A point prevalence study in patients with end-stage renal disease (n = 98) determined that 69.4% had ASEX-defined sexual dysfunction (Ozdemir et al, 2007).…”