EXPERIENCES IN GYNECOLOGICAL CARE OF PATIENTS WITH CHRONIC RENAL-INSUFFICIENCY

This study includes 37 women suffering from chronic renal diseases and 39 women undergoing chronic hemodialysis. Their menstruation, sexual activity, psychological situation as well as their fertility and ways of contraception were analysed over a period of three years time. The study shows, that irregularities of menstruation, reduction of fertility, sexual problems and psychological disorders are closely related to chronic renal diseases and that these impairments are significantly higher in dialysed patients. Infertility and menstruation irregularities are most probably due to hyperprolactinaemia and dysfunction of the feedback-mechanisms. Hyperprolactinaemia can be seen in about two thirds of the dialysed patients. Serum-concentration of estradiol, LH and FSH were found to be less than normal. Progesteron serum-concentration was too low during the second half of the menstrual cyclus. About two thirds of the dialysed patients showed psychological disturbances, depression, affectivity and neurotic tendencies. Pruritus and avidity of the vagina are the most important dermatological alterations of these women. Ovulation inhibitors with higher oestrogen doses represent an additional hypertensive risk. Treatment with low-dosage gestagens should produce the lowest rate of side effects.