Chronic kidney disease and women's sexuality and gynecologic health

Chronic kidney disease (CKD) exacts a significant toll on a woman's sexuality and gynecologic health. The various effects of kidney failure and its treatments on women's sexual health from adolescence through menopause will be the topic of an in-depth series of presentations at the American Society of Nephrology's 41st Annual Meeting and Scientific Exposition in Philadelphia, Pennsylvania.

Women whose kidneys are failing experience hormonal changes that can have numerous adverse effects on the body. In a program moderated by Margaret J. Bia, MD, of the Yale University School of Medicine in New Haven, Connecticut, and Denyse Thornley-Brown, MD, of the University of Alabama at Birmingham, experts will explore the sexual life cycle of women with CKD and discuss the medical impacts that kidney disease has on their sexuality from childhood through advanced age.

Lynne P. Yao, MD, of the Inova Fairfax Hospital for Children in Fairfax, Virginia, will highlight the latest information on issues of adolescence, revealing the abnormalities that can develop in girls with CKD. These children are particularly vulnerable and can experience impaired growth and abnormal menstrual cycles due to altered metabolism and hormone deficits. Physicians face a number of challenges that are unique to treating these patients.

Next, Tracy Breen, MD, of the Mount Sinai School of Medicine in New York City will discuss how CKD can contribute to ovarian failure and premature menopause. Because kidney disease disrupts the balance of hormones produced by the body, women with the condition can experience symptoms of menopause at a young age.

Susan H. Hou, MD, of the Loyola University Health System in River Forest, Illinois, will then provide an overview of issues related to pregnancy and fertility in female kidney disease patients. Fertility is decreased in these women, and when they do conceive, the likelihood of a healthy and successful pregnancy is less than that seen in women without kidney disease. Females with kidney disease who become pregnant also risk developing hypertension and kidney function loss. Dr. Hou will highlight the many strides that have been made in improving the health of pregnant women with kidney disease as well as the serious issues that must still be addressed to make it safe for these women to become pregnant and give birth.

Finally, Manjula Kurella-Tamura, MD, of Stanford University in Palo Alto, California, will present information on menopause and hormone replacement therapy in women with CKD. Because estrogen may have a protective effect against developing kidney disease, many women are not diagnosed with kidney disease until they reach menopause. Between 40 and 70% of women with CKD are menopausal and therefore are likely to consider taking hormone replacement therapy to relieve their symptoms. Dr. Kurella-Tamura will discuss the controversies regarding the use of hormone replacement therapy in these women and whether recommendations should be any different than those for women with normally functioning kidneys.