ACCORDING to a new study, females suffering with chronic kidney disease (CKD) often experience heavy menstruation and infertility. Due to limited data and discussion around the topic, researchers were keen to establish what could be done to improve patient experiences in discussing their reproductive health with their physicians.
Ninety-eight patients with CKD were surveyed regarding their menstruation, fertility issues, and use of contraceptives. Six patients also undertook telephone interviews, where they discussed reproductive health issues, and their experiences in discussing said issues with their nephrologists. The survey covered patients with a mean age of 33 years across three different continents, 58% of whom were white, and 88% cisgendered. With regard to treatment, 60% of patients were not undergoing dialysis, 20% were, and 20% had undergone a working kidney transplant.
Of those surveyed, 77 reported that they had a current menstrual cycle which was mostly predictable. The majority of the cohort did report having heavier periods. Patients that had undergone kidney transplants were particularly affected, with all that had taken part in the survey stating that they had heavy menstruation. Nineteen percent of patients also stated they had experienced secondary amenorrhoea; 9% had a history of infertility; and 38% of patients reported that they had had a blood transfusion, which could be linked to heavier menstrual bleeding. This is of particular concern in patients with CKD, as blood transfusions can increase the risk of rejecting a kidney transplant.
Low use of contraception was also noted, at less than 50%, mostly due to wanting to conceive, or ‘fear’ of using contraceptives. Lastly, most patients alluded to wanting to have a greater discussion regarding their reproductive health with nephrologists, and were “passionate about voicing their menstrual and kidney health concerns” says study author Danica Chang, University of Calgary, Alberta, Canada, as well as wanting greater multidisciplinary care.
Overall, the study demonstrated a need for nephrologists to be better educated in recognising an association between CKD and menstrual abnormalities, as well as to communicate across disciplines to ensure patients are getting adequate care. The authors noted: “Even asking questions relating to menstrual health could create a space where patients could feel safe talking about this.”
