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Male Sexuality and Chronic Kidney Disease

Sexuality has physical and emotional components, both of which can be affected by chronic kidney disease (CKD). Kidney disease can cause chemical changes in the body affecting circulation, nerve function, hormones and energy level. Also, any underlying health conditions that contribute to CKD like high blood pressure or diabetes can affect male sexuality.

Too tired for sex?

Fatigue is one of the most common symptoms men with kidney disease experience. In the early stages of CKD, low levels of waste and fluid remain in the body. This can leave you feeling tired and sluggish. Your doctor can perform tests to determine how much kidney function you have left. If you are in the later stages of CKD or end stage renal disease (ESRD), your doctor may refer you to a renal dietitian. The dietitian will place you on a kidney-friendly diet designed to limit the amount of waste that can build up in your body. The less waste and fluid in your system, the better you will feel.

People with ESRD may feel tired after their hemodialysis session. If you are new to hemodialysis, it may take several treatments for your body to adjust. Ongoing fatigue should be discussed with your doctor and renal dietitian. Your doctor can recommend changes to your dialysis treatment or medicines. Your renal dietitian can help you go over your food and fluid intake and make any needed changes.

Low sex drive

Hormones are chemicals produced by the body’s endocrine system. They play a major role in a person’s ability to feel sexual desire. The kidneys are part of the endocrine system. The adrenal glands, located at the top of each kidney, produce certain hormones. If hormone levels become out of balance, you may experience a decrease in your sex drive.

Your doctor can perform blood work to determine if your lack of interest in sex is due to your changing hormone levels. He may prescribe medicine to bring your levels to a normal range.

Erectile dysfunction

Erectile dysfunction (ED), commonly called "impotence," affects many men—even those without kidney disease. An estimated 20 to 30 million men in the U.S. have problems with impotence. ED can happen when blood vessels and nerves to the penis become damaged. Without proper blood flow, the penis cannot maintain an erection.

Diabetes and high blood pressure affect blood flow and weaken blood vessels. If you have either of these conditions, follow your doctor’s treatment plan to prevent further damage.

Sometimes ED is a side effect of medicines, particularly those taken to control blood pressure. Talk to your doctor about the medicines you’re taking if you’re experiencing impotence. Your doctor may be able to make changes to your medications or suggest treatments for impotence.

Psychological effects of CKD on men's sexuality

Sexuality is not just about sexual intercourse. It’s also about how people feel and express themselves. Feeling sexual or attractive becomes more difficult when the body undergoes unexpected changes. This can affect how people interact with others and their ability to develop intimate relationships.

Body image

People with CKD may experience some undesirable changes to their bodies, making them feel less attractive Symptoms such as breath and body odor, complexion problems, weight gain or unusual facial or body hair can occur. A man on hemodialysis may feel self-conscious about how his vascular access site looks and feels. Men on peritoneal dialysis (PD) may worry about the size of their abdomens. Discuss any uncomfortable physical changes with your partner and your healthcare team. Some physical changes are temporary, while others may indicate a health complication.

Worry and stress

Men may feel worried, anxious and depressed when faced with CKD. This is normal, but these emotions may cause loss of energy and lower interest in activities, including sex.

If feelings of depression or sadness last for more than two weeks, tell your doctor and social worker immediately.


Some men are afraid sexual activity may be harmful to their condition or harmful to their partners. Speak with your doctor about your concerns. In very rare instances, sexual intercourse may not be possible. But activities such as touching, hugging and kissing provide feelings of warmth and closeness even if intercourse is not involved. Professional sex therapists can recommend alternative methods of sexual expression.

Get support

Your healthcare team is there to answer any questions you may have.Consider joining an in-person support group or an online group to talk with others who are in similar circumstances. Visit the DaVita Discussion Forum to see what others are talking about, ask questions and share experiences.