Many men with chronic kidney damage experience sexual problems. Like less sense of sex and erection problems.

Sex hormones play a role in sexual excitement. The hormone testosterone affects men and women in having (and getting) a sense of sex. In the case of kidney damage, testosterone decreases. The sense of sex can therefore decrease.

In addition, erection problems can arise.

Erection problems

With sexual excitement, more blood goes to the penis. This makes the penis stiff. Approximately 7 out of 10 men with chronic kidney damage or kidney failure get erection problems. This means that it is more difficult to stiffen the penis or keep it stiff.

• Sometimes an erection is no longer possible at all.
• Sometimes the sensitivity of the penis is reduced by neuropathy (nerve pain). To get excited then you need stronger sexual stimuli than you might have been used to.
• If you do not have an erection, sexual intercourse is not possible, but enjoying sex and getting an orgasm is often possible. Due to the reduced feeling, the perception of orgasm can be different.

Sometimes there is orgasm but no ejaculation anymore. The sperm then ends up in the bladder. This is also called dry cumshot. It does not hurt: you just piss out the semen.

Causes of erection problems

There are several causes of erection problems:

• high blood pressure
• medicines
• testosterone deficiency
• overweight or an unhealthy lifestyle
• fear of failure or other worrisome thoughts

Kidney damage often involves high blood pressure. That affects the blood vessels. As a result, there is insufficient blood in the penis during sexual excitement. The penis then only gets half stiff, or not at all. It is also possible that there is enough blood to go to the penis, but that it is drained too quickly. Then the penis will swell, but it will not stay stiff for long.

Medications can also prevent erection. Blood pressure-lowering drugs sometimes ensure that there is insufficient blood to the penis during excitement. This also applies to certain sedatives if you use them for a long time.

Sometimes medication for the treatment of kidney disease leads to a shortage of testosterone. Then your penis and your brain are less sensitive to sexual stimuli. Being overweight can worsen testosterone deficiency.

Fear of failure or other worrisome thoughts

In the case of erectile problems caused by kidney damage, emotional problems often arise from fear of failure or other worrisome thoughts. If one fails to get an erection, the man can be afraid in advance that it will not work again next time. If all the attention goes to the erection, there is no attention to the love game. The man is more of a spectator who looks critically at whether the penis stays stiff. As a result, he does not notice sexual stimuli and loses his erection.

In case of fear of failure, there is also a good chance that the man (unwittingly) tightens the muscles of the pelvic floor too much. These are the muscles with which you stop your pee. If the muscle tension in the pelvic floor is too high, the blood circulation of the penis does not start with sexual excitement. Then there is no erection.

If the erection problems persist, there may be guilt that your partner suffers from your problems.

Discuss your problems

Are you less easily sexually stimulated? Or do you have other erection problems? Talk about it with your nephrologist in Delhi. Or discuss it with your best sexologist in Delhi. It can also help you to discuss sexual problems if you find it difficult.

Your best nephrologist in Delhi will talk to you about your problems, or refer you to a urologist or sexologist. Check whether the amount of testosterone in your blood can be measured. In a conversation, you will discuss together what causes your sexual problems. In addition to physical obstacles, emotional matters usually also play a role. Think of anxiety, fatigue, shame or guilt.

Treatment options

There are different treatment options for men with sexual problems.

• more and stronger stimulation of the penis. For example, with lubricant, hand or mouth
• a penis ring
• erection pills
• injections with a substance into the erectile tissues of the penis
• good nutrition and enough exercise
• the lovemaking plan at times when you are not too tired

Erection pills ensure that the erection lasts longer with sexual stimulation. Such medicines are only available on prescription. Erection agents are also offered on the internet, but that is not recommended: these resources are not reliable.

Always consult your kidney specialist in Delhi if you want to use resources to solve your erection problems. Your doctor knows which are safe for you and how to use them.

Solutions for fear of failure and worrisome thoughts

You can prevent fear of failure by (seeing) learning sex as something you enjoy. And not as something for which you have to perform.

• Relax your body and your pelvic floor muscles.
• Focus on what feels pleasant in your body.
• Do not put yourself under pressure, for example with the idea that you should be able to have a community.
• You and your partner may have just as much pleasure with stimulation by mouth or hand.

Because of worrying thoughts about sex, it is often difficult to pay attention to what you find exciting. It is then more difficult for you and your partner to enjoy sex.

Do you already suffer from fear of failure or other worrying thoughts? And keep it on? Talk about it with your partner. Feel free to ask for help from a healthcare provider if the problems persist. For example your top nephrologist in Delhi, or a sexologist in Delhi.