title: Sexual function, activity, and satisfaction among women receiving maintenance hemodialysis.
abstract: OBJECTIVE
  Past studies that demonstrated that sexual dysfunction is common among women receiving chronic hemodialysis did not distinguish sexual dysfunction/difficulty from sexual inactivity. This study sought to differentiate these in order to elucidate the prevalence of true "sexual dysfunction" in this population.
  
  
  METHODS
  As part of a clinical trial of symptom management strategies in patients receiving chronic hemodialysis, female sexual function was prospectively assessed monthly for 6 months and quarterly thereafter using the Female Sexual Function Index, to which questions were added differentiating sexual dysfunction/difficulty from sexual inactivity. Beginning in month 7, patients were asked three questions about sexual activity, difficulty, and satisfaction monthly.
  
  
  RESULTS
  Of the women enrolled in the clinical trial,125 participants completed 1721 assessments between 2009 and 2011. Scores on 574 of 643 (89%) quarterly Female Sexual Function Index assessments were consistent with sexual dysfunction, due largely to sexual inactivity, which was reported on 525 (82%) quarterly assessments. When reported (n=1663), the most frequently described reasons for sexual inactivity were lack of interest in sex (n=715; 43%) and lack of a partner (n=647; 39%), but rarely sexual difficulty (n=36; 2%). When reported (n=1582), women were moderately to very satisfied with their sexual life on 1020 (64%) assessments and on 513 of 671 (76%) assessments in which lack of interest was cited as a reason for sexual inactivity. Women indicated an interest in learning about the causes of and treatment for sexual dysfunction on just 5% of all assessments.
  
  
  CONCLUSIONS
  Although many women receiving chronic hemodialysis are sexually inactive, few describe sexual difficulty. Most, including those with a lack of interest in sex, are satisfied with their sexual life and few wish to learn about treatment options. These findings suggest that true sexual dysfunction is uncommon in this population and that treatment opportunities are rare.
authors.affiliation: Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania;, †Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania;, ‡Department of Population Health, New York University School of Medicine, New York, New York;, §Nephrology Department, Geisinger Medical Center, Danville, Pennsylvania;, ‖Renal Section, Medicine Service Line, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania;, ¶Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, *Divisions of General Internal Medicine and, ††Palliative Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Maria K
authors.initials: MK
authors.lastname: Mor
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Sevick
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Shields
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Green
authors.forename: Paul M
authors.initials: PM
authors.lastname: Palevsky
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arnold
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fine
authors.forename: Steven D
authors.initials: SD
authors.lastname: Weisbord
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D010414:Pennsylvania; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome