Kidney School™—a program of Medical Education Institute, Inc.

Module 11—Sexuality and Fertility

Couple hugging


The words you use to talk to yourself are very powerful. The thoughts you have in your own mind that you may never say out loud are "self-talk." These thoughts and beliefs play a big part in how you feel about yourself. Examples of negative self- talk might be, "nobody will want me now," "I'm worthless," or "I have nothing to look forward to."

With practice, you can learn to turn your negative thoughts into positive self-talk. This will speed up your coping and make your relationships better. How can you do this?

If you talk with people who've had kidney disease for a while and coped well, you'll find that they look on the bright side, feel good about themselves, and take pride in what they've achieved. Here are some positive thoughts, or "affirmations" that have helped others who have lived 15 years or more with kidney failure:

  • "I want to live."
  • "I am still me."
  • "I am still valuable."
  • "I am in control."

Try saying these to yourself a few times each day, and whenever you catch yourself thinking something that makes you feel bad about yourself. If your own efforts are not enough, ask your doctor or social worker to refer you to someone who can work with you. "Cognitive behavior therapy" can help you change negative self-talk.

Because of some of the after-effects of kidney disease—like skin problems and body image problems when I was on PD, for example—I felt less attractive, less desirable, and so I took myself 'offline' that way. I found myself thinking that since I had kidney disease and was on dialysis, no one would want me anymore. I had to work through a mourning process—the loss of my health, feeling betrayed by my body, accepting my frailty, which all of us share—and move to self acceptance. I have gotten to a place where I feel that I deserve love and acceptance from the opposite sex, and now I comport myself as if that is true.

The reality is, nobody is perfect! With or without kidney disease, very few of us look in the mirror and are fully happy with what we see. We all need to make peace with ourselves, and our faces and bodies.

Feeling good about yourself—and being willing to be intimate with a partner—is not just a matter of how you look. It has to do with accepting who you are and your value in the world. You need to believe that you are a good, worthwhile, interesting person who deserves to be happy.

My PD catheter is just another proudly-worn battle scar that makes me uniquely individual. When I meet someone new, I always lay all my cards on the table. It is much easier to proceed from there. It's true that many run when they learn of my impairments, but that only saves me from any greater trauma later on and they just weren't my type anyway. Maybe it takes a little courage to overcome fear of rejection.

Staying Connected

If you worry that you might lose your partner's love, you may think it's better to end the relationship than wait for your partner to end it. But, like other challenges, if you work together as a couple, you can adjust to kidney disease and have a loving relationship. Like many other couples, some people with kidney disease do get divorced. Others say that kidney disease brought them closer as they faced it together.

A counselor can often teach you better ways to talk with each other. If you and your partner are having trouble talking about your relationship, talk with your social worker about finding someone to help you.

Protecting Against Abuse

Although no one likes to think about it, someday you could become a victim of physical, emotional, or sexual abuse. Don't let yourself become a victim just because you have kidney disease. To protect and empower yourself, learn as much as you can about how to avoid places where you might be abused, how to know signs of abuse, how to defend yourself if you are abused, and, finally, know your legal rights and how to stand up for them.

Report abuse to the police, seek physical and/or psychological exams, and help the police prosecute anyone who abuses you. You could be protecting yourself and others who might be victims. For more information, see the resources at the end of this module.

Page 3 of 69 | Further reading