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Amenorrhea and Estrogen Disorders in Women with Kidney Disease

  • Kavitha VellankiEmail author
  • Holly Kramer
Chapter

Abstract

Endocrine abnormalities from altered synthesis and metabolism of sex hormones are a common feature in both men and women with chronic kidney disease (CKD). Despite the fact that kidney disease affects approximately one out of ten women in the United States and one out of five women over the age of 60 years, women’s health issues in the setting of CKD remain one of the most neglected and under-recognized issues in clinical practice. While the exact mechanisms are unclear, impairment in the hypothalamic-pituitary axis due to uremia, underlying comorbid conditions, and concomitant medication use are thought to play a predominant role. Abnormal menstrual cycles with amenorrhea, often associated with anovulation, are common in premenopausal women with kidney disease. Early menopause is also common in CKD with the potential negative effects of early menopause on cardiovascular and bone health poorly determined. Diagnosis and management of menopausal symptoms and postmenopausal osteoporosis in CKD remain challenging and controversial. Sexual dysfunction is highly prevalent in women on dialysis, but these symptoms improve markedly post-kidney transplant. While infertility is common, restoration of fertility in women with moderate to severe non-dialysis-dependent CKD should be discouraged due to risk of CKD progression.

Keywords

Women’s health Menstrual disorders Amenorrhea Kidney disease Kidney failure End-stage renal disease Contraception Menopause Hot flashes Estrogen 

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of MedicineLoyola University Medical CenterMaywoodUSA
  2. 2.Department of Public Health Sciences and MedicineLoyola University Medical CenterMaywoodUSA

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