Sexuality in female patients on hemodialysis: a scoping review

BACKGROUND: Kidney failure significantly affects sexuality, particularly female sexual function. AIM: This study aims to map current knowledge regarding the sexuality of women undergoing hemodialysis (HD). METHODS: A scoping review was conducted following Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Databases searched included MEDLINE, Web of Science, and gray literature sources up to August 2023. The guiding question was: "What is the available evidence on sexuality in women on hemodialysis?" Studies containing the terms "sexuality," "women," and "hemodialysis" were included, without language or publication date restrictions. RESULTS: From 1048 initially identified articles, 23 met inclusion criteria. An additional 15 gray literature studies were included, totaling 38 studies involving 2165 women on HD. Sexual dysfunction was highly prevalent, with a pooled estimate of 87%. Most studies (61.5%) used the Female Sexual Function Index to assess dysfunction. Women on HD presented higher rates of dysfunction compared to other stages of chronic kidney disease. Sexual dysfunction was often associated with poor quality of life, depression, and anxiety. Only four studies used qualitative methods, addressing topics such as gender roles, social constructs of sexuality, the impact of treatment on sexual health, and access to professional support. CONCLUSION: Women on HD face high rates of sexual dysfunction, closely linked to mental health and quality of life. Qualitative research on their lived experiences remains scarce and deserves further attention.