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Sexual dysfunction (SD) is common in end stage renal disease (ESRD) patients, affecting their quality of life. Sexuality is not a subject that patient's, particularly Muslim women, discuss when they require assistance. They need to develop strategies to cope with SD. The qualitative study explored how Muslim women with ESRD cope with SD. A phenomenological approach was adopted and data were collected using semistructured individual interviews. Purposive sampling was used to recruit 20 participants from two southern regional hospitals in Thailand between September and December, 2018. Recruitment continued until data saturation was reached. Data were analysed using Colaizzi's phenomenological approach. Participants were aged between 30 and 63 years (mean = 45.25, SD = 8.50). Ten were receiving haemodialysis (HD) and 10 were receiving continuous ambulatory peritoneal dialysis (CAPD). Five themes were identified: (1) receiving compassion and understanding from their partner, (2) being afraid of sin if not taking responsibility as a wife's role, (3) denying and ignoring sexuality, (4) being patient to keep their family together and (5) accepting SD associated with God's will. The findings suggest that understanding Islamic views on SD and how the religion's beliefs and practices influence SD and the way Muslim women cope with it. Hence, it is critical in opening lines of communication with patients and their partners to help them cope with SD. [ABSTRACT FROM AUTHOR]