Women's health

In the UK, the leading causes of chronic kidney disease (CKD) are diabetes and high blood pressure – diseases which affect both men and women. We explain how CKD affects women in particular, and how certain aspects of women’s health can affect CKD.

Why are kidney infections more of a problem for women?

Kidney infections affect women more than men. Frequent or untreated kidney infections can cause scarring on your kidneys and increase your risk of CKD. Early treatment can usually help prevent long term problems.

Kidney infections can be avoided by:

  • Drinking plenty of fluids, especially plain water. If you are receiving dialysis you may be advised to limit your fluid intake, so you should always follow the advice of your kidney team.
  • Going to the toilet as soon as you feel the need to; don’t hold it in.
  • Wiping from the front to the back after going to the toilet.
  • Going to the toilet after having sex.
  • Trying to avoid getting constipated as constipation can increase your chance of developing a kidney infection.

Can CKD affect my periods?

CKD can cause your periods to become irregular due to a drop in hormone levels. If you are on dialysis, your periods may stop completely, as the waste products that build up in your body can prevent ovulation. This can affect your fertility, as it is more difficult to get pregnant without a regular menstrual cycle.

Anaemia (low levels of iron in the blood) is common in CKD and you may be prescribed a medication called erythropoietin (EPO) to increase your iron levels. This also helps to improve your hormone levels, which can cause your periods to return and increase your fertility.

Can CKD affect my sexual health?

You may find that your sex drive reduces with CKD. There are several reasons for this, including emotional, physical and psychological factors.

Having a long-term illness like CKD can affect your job, income and family life. These added stresses and lifestyle changes can all impact on your body image and level of sexual desire.

CKD and its treatments can affect your weight, which may make you see your body in a different way. If you are on dialysis, you may worry that your catheter tube or fistula is unattractive or that you may damage your dialysis access during sex. Talking these concerns through with a supportive partner will help. It is rare that dialysis access is damaged during sex and your kidney team can advise you on protection.

Some medicines can also cause tiredness or reduced sex drive.

Lower hormonal levels can make it difficult for some women to become aroused or may cause them to experience vaginal dryness or painful intercourse. A water-soluble vaginal lubricant can be used to help reduce dryness, but you should discuss any concerns with your doctor. Changes to blood pressure medications, hormone supplements or anaemia treatment can also help with some of these symptoms.

Can I get pregnant if I have CKD?

Even if your periods are irregular, you should still use contraception if you are sexually active and do not want to become pregnant.

Talk to your kidney team if you are thinking of trying for a baby, as they can give you personalised advice that is right for your situation.

Pregnancy can cause a sudden loss of your kidney function, especially if you have a pre-existing kidney disease. If you are pregnant and have high blood pressure or are overweight, you are at greater risk of developing pre-eclampsia. This can cause temporary kidney failure known as acute kidney injury (AKI). If you have had pre-eclampsia or AKI during pregnancy, you are at higher risk of developing high blood pressure and CKD later on in life.

If you have CKD, or are on dialysis while pregnant, your baby may be born early or be smaller than expected, due to high blood pressure during pregnancy which can also affect your kidney function.

Early discussion with your doctor can help increase your chance of a successful pregnancy and allow appropriate treatment decisions to be made.

Some medications are not safe to take during pregnancy so you may need to change your treatment before you try to conceive. Talk to your doctor or pharmacist to see if your medicines are safe to take if you get pregnant.

Do not stop your medications without taking medical advice.

Do I need to go for more frequent smear tests/breast screening if I have CKD?

It is important that everyone attends their cancer screening examinations, regardless of whether they have CKD. Having CKD does not put you at increased risk of cervical or breast cancer, so you will not need to go for more frequent screening but just ensure that you attend your regular appointments when invited.

Will CKD cause me to go through the menopause early?

The average age for women to go through the menopause is 51. Some research has suggested that women with CKD may go through the menopause early compared to the general population, but there is a lack of robust data to confirm this. If your periods stop while on dialysis this does not necessarily mean you are going through menopause.

Your periods are likely to come back if you have a transplant.

How will going through the menopause affect my CKD?

The reduction in hormone levels that happens during the menopause may increase your risk of osteoporosis (thinning of the bones).

This risk increases if you are on dialysis, which can also lower your hormone levels, or if you have had a transplant, due to the anti- rejection drugs that you must take. You may be prescribed calcium supplements to help reduce the risk of osteoporosis.

Urinary tract infections (UTIs) affect women of all ages but are more common after the menopause due to a drop in oestrogen levels.

As CKD can also cause a drop in oestrogen levels, UTIs can become more frequent and severe. Vaginal oestrogen cream can help reduce many of the symptoms of UTIs, such as needing to pee more often or urgently, or pain when you pee. Talk to your GP or kidney team about your options.

Can I take HRT if I have CKD?

Hormone replacement therapy (HRT) can help relieve menopausal symptoms and can make a big difference to women’s lives. Every woman has the right to be considered for HRT, either through their GP or a menopause specialist.

HRT can be prescribed in many different forms, including tablets, patches, gels or creams. Talk to your doctor about the different forms to find the one that is right for you.

If you have high blood pressure, this will need to be controlled before you can start HRT. Your blood pressure will be monitored regularly while you are on HRT.

Some forms of HRT may not be suitable for you if you have a history of breast, ovarian or womb cancer, liver disease or blood clots. Talk to your doctor about your options.

Where can I find more information?

Women's health and chronic kidney disease: download or order Kidney Care UK's information leaflet

You can download our Women's health and chronic kidney disease leaflet for free.

You can also order a printed copy of Kidney Care UK’s Women's health and chronic kidney disease leaflet to be sent to you in the post.

Publication date: 11/2023

Review date: 11/2026

This resource was produced according to PIF TICK standards. PIF TICK is the UK’s only assessed quality mark for print and online health and care information. Kidney Care UK is PIF TICK accredited.