Dialysis and Sexual Desire
You are not alone.
Desire is challenging for many people, and it changes throughout our lifetime. Some people notice desire changes once they are in a long-term relationship, after inviting a child into the world, as their body ages, during times of stress, after losing a loved one, in conjunction with health diagnosis, or after starting certain medications. So, if you are noticing a change in your desire-scape, you are not alone! Here are some ideas to start:
Ask your doctor for a review of medications to see if any have side effects that might impact sexual desire. It is important to explore medical or physical reasons for changes first, before trying behavioral changes. If a medications is suppressing your desire response, addressing that will make any other changes you implement much more effective!
Talking openly and honestly with your partner(s) about everyones level of satisfaction with current sexual engagement levels. Frequently, we worry about having "enough" sex, but there is no magic amount of sex that means a relationship is healthy. Whether “enough” sex is happening is for the people in the relationship to decide. If you and your partner(s) are feeling low desire, and are feeling good about it, then great! And know that may change, so having open conversations with the intention of supporting one another is key. However, if you or your partner(s) are interested in inviting more desire into your life moving forward, it helps to better understand desire. I recommend reading Come as You Are by Emily Nagoski. She does a great job of describing desire, and how it works. But here are some cliffnotes:
Our desire system is like a car. It has gas pedals and brakes. Our gas pedals are the things that make us go "yum!" and our brakes are the things that make us go "not right now." Some people have more sensitive gas pedals, so they are revving up to go pretty frequently, and don't need a lot of maintenance. Some people have more sensitive brakes, so even if they are interested, they have a lot of reasons why NOT to engage sexually (the dishes need to be done, you have to wake up early tomorrow, etc). You can have gas pedals that are less sensitive (so not a lot of spontaneous desire) and brakes that are also less sensitive (so when you ARE interested, it is onnnn), or you can have less sensitive gas pedals and more sensitive brakes (you aren't often interested, and when you are, there are a lot of reasons you say "no"). It's hard to say how your desire will respond to being on dialysis. Everyone is different, and our bodies change over time. For example, some people respond to stress by wanting to get busy! It can be a way to self-soothe. Other people respond to stress by totally shutting down their desire system. And starting dialysis can be stressful, for you and your partner(s). So, getting to know your gas pedals (what does get you in the mood?) and your brakes (what are the stories that come up behind your "no's"?) is helpful, because then you can work with your partner(s) to invite the "yums" for everyone, and move through the "not right now's."
Explore what sex means to you and to your partner(s). Is it connection? Is it an expression of love? Is it a road to orgasm? Is it about enjoying touch? There are a lot of ways to meet those needs that don't involve penetrative sex. Massages, dates, cuddles, mutual masturbation, enjoying erotic film or art together, and so much more.
Stay curious about your body and your desire. Different is not bad, it's just different. And you have the opportunity to learn about what kinds of sexual engagement work for you and your partner(s) now that something has shifted in your body. Who knows what that could look like? But sometimes, when we are forced to shift from the script we grew up on regarding "good sex" (two people with traditionally functioning bodies having penetrative sex and gloriously orgasming every time), we find different things that our bodies and minds like even better than what we are used to doing.
Respect you and your partners’ desire levels, and do not force sexual activity. Everyone has a right to say no, and forcing ourselves out of obligation can result in shutting down more in the future. Focus on inviting desire, rather than having obligational sex. It will be more fulfilling for everyone.
Another tip: It can be helpful if you are not up for it, and your partner(s) are interested, to think about what is a yes for you in that moment. Maybe they want penetrative sex, which is a "no" for you in that moment, but you are open to caressing them and moaning while they takes care of themself. And who knows, maybe that will awaken some interest from you to go further. Or maybe not, and they will have a hot moment with you involved that can deepen your connection and their feelings of sexual satisfaction.