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Reproductive and sexual dysfunction in uremic women

Biff F Palmer, MD
William L Henrich, MD, MACP
Peter J Snyder, MD
Section Editor
Jeffrey S Berns, MD
Deputy Editor
Alice M Sheridan, MD


Disturbances in menstruation, fertility, and sexual dysfunction are common among women with advanced chronic kidney disease (CKD). Hypogonadism may result in anovulation, infertility, or oligomenorrhea [1].

The menstrual cycle typically remains irregular, with scanty flow, after the initiation of maintenance dialysis, although normal menses are restored in some women [2-6]. In others, menorrhagia develops, sometimes leading to significant blood loss and increased transfusion requirements.

Sexual dysfunction is also common [7-11].

Although rare, pregnancy can occur in women with advanced renal failure, but fetal wastage is markedly increased [8]. Some residual renal function is usually present in the infrequent pregnancy that can be carried to term. (See "Pregnancy in women with underlying renal disease".)


The normal menstrual cycle is divided into a follicular or proliferative phase and a luteal or secretory phase. During the follicular phase, gradually increasing secretion of follicle-stimulating hormone (FSH) causes recruitment and maturation of a single ovum and increasing secretion of estradiol. When the estradiol concentration reaches a sufficiently high level, it stimulates a sudden increase in luteinizing hormone (LH) secretion, thereby causing the release of a mature ovum, called ovulation. LH then stimulates the remainder of the follicle, called the corpus luteum, to secrete both estradiol and progesterone. (See "Physiology of the normal menstrual cycle".)

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Literature review current through: Nov 2017. | This topic last updated: Sep 18, 2017.
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