Reproductive issues and kidney disease

Sexual dysfunction and infertility are common in men and women suffering from chronic kidney disease. These may result in anxiety, loss of self-esteem, marital discord, and depression, contributing to impaired life quality.

Sexual function in men and women is controlled by various neurologic, psychological and hormonal mechanisms, which are all affected in chronic kidney disease. Medications prescribed for various comorbidities may also contribute.

Men with kidney ailments have hormonal alterations in which the prolactin levels are elevated, and various gonadal hormones from the hypothalamus and the pituitary gland are produced at lower levels. About two-thirds of men on dialysis have low testosterone levels and have abnormal sperm production and motility. Poor erectile function and lack of sexual desire may cause further issues. In women, lack of pulsatile Luteinizing Hormone (LH) release often contributes to anovulation. Loss of lubrication in women contributes to sexual dysfunction. Diabetes itself can cause loss of sexual function, and diabetes is the leading cause of chronic kidney disease worldwide.

For those with chronic kidney disease and on hemodialysis, various medications for improving erectile function and sustaining erection can be tried. Women with poor lubrication can use artificial lubricants. Sometimes, hormonal medications may be employed for both women and men in conjunction with the gynaecologist and the urologists to improve sexual function. Regular dialysis up to three times per week will decrease the toxin load, and this is essential for maintaining hormonal balances and general sexual we l l being. Psychiatric counselling to relieve stress and counselling may help tremendously to achieve better sexual function.

Favourable effects have been reported in male fertility after renal transplantation. However, the increase in fertility also depends upon the care after transplantation and close follow up and monitoring of the various parameters by the treating nephrologist. The reduction of the toxin load and the normalisation of the kidney function after renal transplant itself will play a tremendous role in restoring sexual function. An increase in the sexual drive and overall better sexual performance is well known to be restored after transplantation. Further, the age of developing End-stage renal disease also plays a crucial role in determining the recovery of fertility post-transplantation.

The recovery of fertility also depends upon the preservation of vas deferens and testicular blood supply during the surgery, which is done on priority for the patient. Patients who had low levels of sperm before the transplant have an improvement in sperm motility and count in up to 12 months after the procedure.

Many men have fathered children successfully after transplantation. Many women, who lost reproductive function due to chronic kidney disease and are on dialysis will recover reproductive function, have normal menstrual cycles, and bear children after renal transplantation. However, sexual dysfunction due to severe and irreversible damage due to factors like advanced age, longstanding diabetes, various coexisting medical factors and prolonged dialysis may not be completely reversible. A renal transplant hence is an effective option for patients with chronic kidney disease regarding sexual function and childbearing. It has been established that after transplantation, the medications given to men will have minimal effect on procreation, the effects of medicines are more pronounced in women, but they do not usually come in the way of normal childbearing.

 

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High time to act upon sexual dysfunction due to antidepressant intake

Numerous problems like sexual dysfunction post taking antidepressants needs greater recognition, said a psychiatrist specialising in the field.

Prof. David Healy wrote that problems may begin after only a few doses and leave someone affected for life, or a relatively mild dysfunction can worsen dramatically when the person stops treatment.

Called Post-SSRI Sexual Dysfunction (PSSD), the core features of the condition are genital numbing, loss or muting of orgasm and loss of libido. According to Prof. Healy, many patients are just as concerned by additional features like emotional numbing or derealisation. Both sexes, all ages and every ethnic group can be affected.

Prof. Healy said, 10% of people of sexually active years in developed countries are on antidepressants chronically. Nearly 20 % of the population, therefore, may not be able to make love the way they want. In some deprived areas, the figure may be much higher. Some likely comfort themselves with the thought that once they stop treatment, they will get back to normal, when in fact they may be even less able to function.

In June 2019, in response to a petition lodged by Prof. Healy and colleagues in 2018, the European Medicine Agency asked pharmaceutical companies to warn that sexual dysfunction can endure after anti-depressant treatment stops.

Prof. Healy said: there is a great need tor recognize these treatment-related enduring sexual dysfunctions and pinpoint how they arise and might be treated.

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Several physiological factors cause lack of libido in older women

Libido or simply put as sexual desire takes a hit after women enter their menopause but why is it so? Researchers have the answer!

A qualitative study completed by interviewing dozens of women about their lack of desire for sex into several major themes -- including sexual dysfunction in their partners.

The findings of the study were published in the journal Menopause which shed light on various reasons women in their 60s reported behind why they lack libido.

"If a woman is having sexual problems, what's going on with her partner may be contributing. Sex doesn't occur in a vacuum," said lead author.

Up to 40 per cent of women over age 60 have low libido, and about 10 per cent of them report feeling bothered by it.

Researchers conducted three 12-woman focus groups and interviewed 15 other women privately, depending on which setting the participant preferred.

Through these conversations, five major themes emerged -- Postmenopausal vaginal symptoms; erectile dysfunction in partner; fatigue or bodily pain; life stressors; and body image.

The most surprising thread here, Thomas said, was that so many women identified sexual dysfunction in their male partners as a major contributor to their own lack of desire for sex.

"Some women find workarounds, but others get stonewalled by their partner because he feels defensive. As women we're encouraged to be accommodating, so we learn to tamp down our own needs and desires, and prioritize those of others," the researcher explained.

Another revelation was that for some women, despite having retired from their jobs and successfully ejected their adult children from their houses, they were still too stressed to view sex as a priority.

Still, since most of the research on low libido in older women has focused on hormones, Thomas said, hearing detailed accounts from the women themselves produces novel ideas that may not come out of a large survey.

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Moringa (Drumsticks)- every part of the plant is full of nutrition

The drumsticks, scientific name Moringa oleifera often finds its way into the kitchen, used in the preparation of a variety of cuisines and delicacies, especially in India. From leaves to flowers, to seeds to the drumsticks itself, almost every part of Moringa or drumstick tree are edible and come laden with health benefits. In this article, we will discuss some of the benefits of drumsticks including their leaves, roots, flowers, and seeds.
Benefits of drumstick seeds

• The drumstick seeds are a rich source of Vitamins (A, B-complex and C) and antioxidants and play a pivotal role shielding the body from the harmful oxidative effects of the free radicals.
• The seeds are also known for their anti-carcinogenic properties. The drumstick seeds contain Oleic Acid which is a Good Cholesterol that keeps the heart hale and hearty.
• People dealing with acne, acne scars, fine lines, can achieve fruitful results using oil extracted from the drumstick seeds, keeping the skin young and healthy.
• The drumstick seeds are an excellent source of zinc (known to promote healthy sperm production) and iron (an ideal option for people with low hemoglobin or anaemia).

Benefits of drumstick tree roots

• The Moringa roots come as a blessing for people dealing with medical conditions such as thyroid disorders, digestive problems, asthma, Inflammatory disorders, skin problems, to name a few.
• Research suggests the use of drumstick tree roots can be highly beneficial in the case of ovarian cancer.

Benefits of Moringa/ Drumstick leaves

• If you want a healthy, glowing and youthful skin, the Moringa leaves are what the doctor has just advised. Packed with almost all the vital nutrients and vitamins (B, Beta-carotene, folic acid, C, K, and provitamin A), the Moringa leaves comes is an excellent blood purifier and keeps a host of skin problems including acne and pimples at bay.
• The Moringa leaves contain pyridoxine, folic acid, and riboflavin, and come across as a natural remedy for people with digestive problems.

Benefits of Moringa Flowers

• The Moringa Flowers act as aphrodisiacs, enhancing the sexual desire or libido in a person. Thus, the flower is beneficial for people dealing with low libido or sexual dysfunction.
• The Moringa leaves have diuretic properties and are the best options for people trying to lose weight. This property makes the Moringa leaves an excellent remedy to deal with edema.

Other common benefits 

• Moringa is a rich source of the amino acid Tryptophan and provides excellent relief from stress, anxiety, depression and related problems and complications by enhancing the production of the hormone Serotonin.
• The antiurolithiatic property of Moringa roots goes a long way to prevent the formation of gallbladder stones or kidney stones.
• Drumsticks keep the eyes healthy reducing the incidences of retinal dysfunction and dilation of the retinal vessels significantly.
• Drumsticks are also known to give the immune system a much-needed boost, strengthening them to a great extent.   
  

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