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How does kidney failure affect male physiology?

Although still having children as normal, the physiological life of men with kidney failure often has problems due to decreased sex drive and erectile dysfunction.

Men with kidney failure often feel tired, lethargic, have less sex, lose interest in sex, and cannot ejaculate. However, the most common sexual problem, and often the most worrisome for men with kidney failure, is the difficulty or inability to maintain a penile erection for long. This condition is called erectile dysfunction (ED), impotence or impotence. Many men with kidney failure have difficulty getting an erection that lasts as long as usual, even though they are still able to ejaculate. Eventually, many patients lose the ability to get an erection. This can easily lead to psychological burden, especially if the patient’s sexual desire does not change.

In addition, headaches, dizziness, low back pain, physical weakness also make the patient’s spirit decline. Overall, this condition reduces sperm quality, reduces sexual function, lowers the ability to have children, and even causes infertility in men.

Men with kidney failure often experience decreased sex drive and erectile dysfunction.  Photo: iStock

Men with kidney failure often experience decreased sex drive and erectile dysfunction. Image: iStock

There are several causes of physiological problems in men with kidney disease, including anemia, and the male hormone androgen produced by the adrenal glands has been drastically reduced due to kidney damage. In most men with kidney failure, sexual problems are not caused by one cause, but are often caused by a combination of the following:

Poor blood supply: The penis needs an adequate blood supply to get an erection. However, kidney patients experience narrowing of blood vessels throughout their body, including those that supply blood to the penis, reducing blood flow to the penis, resulting in difficulty getting an erection. It’s not just kidney patients who have this problem. It also occurs as part of the natural aging process and is common in older men, as well as in men with diabetes.

Leaky blood vessels: To keep the penis erect, extra blood to the penis must stay inside it. In men with kidney failure, sometimes extra blood leaks back out of the penis, and, as a result, loses the ability to get an erection.

Hormonal disorders: Hormones are chemical messengers that control many body functions. They follow the blood throughout the body. Some hormones are specifically designed to control sexual desires. Levels of these sex hormones may be higher or lower than normal in people with kidney failure. In particular, in men with kidney failure, the testicles can produce less of the male sex hormone testosterone, leading to a decrease in sex drive.

Nerve damage: Nerves are also involved in penile erection. With kidney failure, damage can cause nerves to not work properly, leading to difficulty getting an erection.

Medications: Certain medications can contribute to sexual problems. The biggest culprits are high blood pressure medications called beta-blockers, such as atenolol, propanolol, metoprolol, and bisoprolol.

Fatigue: Fatigue can affect sexual performance. Fatigue in kidney patients can be caused by anemia, inadequate dialysis, or other medical problems, such as heart disease.

Psychological: When a kidney patient starts dialysis, it is difficult for them to avoid anxiety and stress. This obviously leads to a loss of desire for sex.

Diagnosis and treatment

Men with kidney failure who have physiological difficulties should seek medical attention from specialists in Nephrology, Urology, and Orcology for examination and appropriate treatment advice. Your doctor will check your general health and check your pulse at different points on your leg. If the pulse is weak, this means that the blood vessels in the legs have narrowed, reducing the blood supply, reducing the blood supply to the penis.

In addition, the patient may have a blood test. In addition to the usual blood tests, there will be tests that measure different hormone levels in the blood, including testosterone and also luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin. LH and FSH are the hormones that regulate the testes. The usual role of prolactin is milk production in women, but it is often present in larger-than-normal amounts in male patients with erectile dysfunction on dialysis.

The doctor will also review the medications the patient is taking. Certain medications can contribute to a patient’s difficulty with sexual activity. Finally, check to see if psychological problems or relationship problems can lead to impotence.

Depending on the cause, the doctor may suggest a treatment plan for anemia, increase the amount of dialysis or change the patient’s medications. If the above measures do not work, the doctor may prescribe more specific treatments for impotence such as hormone injections, injections or inserts of drugs into the penis, or using a vacuum-assisted suction device. blood into the penis, creating a lasting erection.

In addition, men with kidney disease are also encouraged to make lifestyle changes to improve their general health and well-being, to avoid alcohol, to stop smoking, to lose weight, and to exercise regularly.

Mr. Ngoc (Follow NKF)

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