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The Prevalence of Sexual Dysfunction among the Patients with End Stage Renal Disease in Jamaica.

BACKGROUND
Sexual performance and gratification impact quality of life. Although recognized in the literature as a problem, sexual dysfunction among patients with end stage renal disease (ESRD) has never been studied in Jamaica.


SUBJECTS AND METHOD
The prevalence of sexual dysfunction was determined among 268 adult Jamaican patients (166 males, 102 females) with ESRD who had been on haemodialysis for at least three months. Erectile dysfunction (ED) was assessed using the International Index of Erectile Function (IIEF). Female sexual dysfunction (FSD) was determined using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases (ICD)-10 classifications of sexual disorders. Prevalence, severity of sexual dysfunctions and relationships with the primary aetiology of ESRD and anaemia were assessed.


RESULTS
Erectile dysfunction, desire and orgasmic disorderS were found in 91.4%, 88.3%, and 81.6% of male subjects, respectively. The majority of male patients were dissatisfied with their performance at intercourse after progressing to ESRD. Hypoactive sexual disorder, sexual arousal and orgasmic disorders, and aversion sexual disorder were prevalent, found in 96%, 88.1% and 87.1% of female patients. All diabetic patients with ESRD reported hypoactive sexual disorder and orgasmic dysfunction; arousal disorder was found in 94.7%. Aversion sexual disorder was found more among patients with underlying chronic glomerulonephritis. All patients with severe anaemia were found to have hypoactive sexual disorder and among these, 87.5% and 97.8% had severe arousal and orgasmic disorders, respectively.


CONCLUSION
Sexual dysfunction among patients with ESRD in Jamaica was prevalent in males and females. Associations exist between sexual dysfunction and diabetes mellitus, chronic glomerulonephritis and anaemia.