Breaking the Silence on IBD and Intimacy
Discussing how IBD affects your personal life can be difficult, and as a result issues surrounding intimacy and relationships tend to be an overlooked and ignored area. This leaflet provides some tips that you might find useful as you navigate your way around coping with IBD.
Riviere P, et al. Quality of sex life in patients with inflammatory bowel disease: the gastroenterologists’ perspective. Inflamm Bowel Dis. 2017;23:E51–E52
GENERAL WELL-BEING
GENERAL HEALTH
Make sure you are well rested, have a healthy diet, and exercise regularly.
A healthy and active lifestyle contributes to a positive frame of mind, as well as a healthier body.
ARTHROPATHY, ARTHRITIS & JOINT PAIN
Can affect sexual satisfaction and limit physical activity. Exercise and/or fusion therapy can help.
Always consult your gastroenterologist or rheumatologist if symptoms persist.
DEPRESSION & ANXIETY
If you are experiencing emotional distress or psychological difficulties such as depression or anxiety,
it is important to ensure these are adequately treated.
Discuss any problems you are having with your healthcare provider who may refer you to a psychologist or psychiatrist for extra support.
TOBACCO & ALCOHOL
Tobacco and excessive alcohol can affect sexual performance and, in some cases, aggravate IBD symptoms.
NEW RELATIONSHIPS
DATING WITH IBD
Plan dates so that they suit you; arrange shorter dates where toilets are available nearby, avoid dinner dates if food is a trigger.
This will help you feel more confident when dating someone new
Opening up to potential partners about your illness can be stressful and knowing when to do this is tricky. Whenever you decide to share your condition with someone, be straightforward.
Discuss the facts surrounding your diagnosis and your current health status.
Answer any questions simply and honestly.
NEGATIVE REACTION
In case of a negative reaction to your condition, accept that it is better to find out earlier rather than later in the relationship. Don’t let this impact your self-esteem; you simply met someone with whom you were incompatible.
SELF-IMAGE
BE KIND TO YOUR BODY
When you see your body in a positive way, you will create more opportunity for intimacy .
COUNSELING
individual or couple counselling may help you to come to terms with any changes in
how you feel about self-image.
LET’S TALK ABOUT SEX
IBD can change your sex life… but it doesn’t have to end it!
TALK TO EACH OTHER:
Talk about each other’s needs and concerns openly and honestly, and share
thoughts and desires. You will find that you are less stressed about sex if you’re open about your concerns.
PLANNING
Although it may not be spontaneous, try to plan your intimate moments for a time of day when you know you are feeling your best; for example, in the evening when you’re most energetic and symptom-free.
You may find going to the toilet and emptying your bowel before sex makes you feel more confident about avoiding an accident during intimate moments. Also bathing before sex can help with any concerns about odours.
SEXUAL POSITIONS
Different sexual positions may help if pain during sex is an issue; for example, it may be easier to control the level of movement and penetration if you are the one on top. Try a lubricant to enhance sexual experience.
ANAL SEX
Take extra care if practising anal sex.
Use a condom to avoid sexually transmitted diseases and avoid anal sex completely if you are experiencing a flare-up.
OTHER FORMS OF INTIMACY
- Intimacy doesn’t always have to be sexual
- Try engaging in other types of physical intimacy to express love
- Cuddling, caressing, kissing, and massaging can all increase desire without having intercourse
SPECIALIST ADVICE
- Speak openly and honestly with your healthcare provider;
if they know what the problem is they can help you - If necessary, a sexologist can help implement appropriate treatment or
rehabilitation
SURGERY, STOMAS AND FISTULAS
SURGERY & SEX
You may need to avoid sex before stoma or j-pouch surgery. After surgery, it is recommended to abstain from sex,
usually for a period of about 8 weeks, until the surgeon finds that the wound is healing properly.
STOMA BAGS & SEX
HAVING A STOMA BAG SHOULD NOT BE A BARRIER TO HAVING AN ACTIVE SEX LIFE!
- Empty the stoma bag before intercourse; this minimises the possibility of leakage, giving you peace of mind
- Make sure the stoma bag is attached securely, then it should not be affected by the sexual position you choose
- There are different types and sizes of stoma bag available, some designed to be as discreet as possible
- Specialised lingerie for women can help support and cover the bag, which can help boost your confidence
FISTULAS & SEX
Fistulas do not have to interfere with your sex life. If sex is uncomfortable or painful, applying lubricant before penetrative sex, or trying different sexual positions, can help. If there is a seton in the fistula, you should consult your healthcare provider about sex and any associated risks.
COMMUNICATION IS KEY –
BREAK THAT SILENCE!
SHARING IS CARING
Don’t be shy to talk, talk, talk… and then talk some more – with your partner, your doctor , your healthcare team, your friends, your family, and your support network.
BE HONEST
Talk honestly about what is on your mind, don’t be tempted to hide aspects of your IBD; being open and honest with your partner about your condition, the symptoms you experience, and the sexual challenges that can occur is important and can help to bring you closer together as a couple.
HELP TO UNDERSTAND
Help your partner understand how you are feeling, so they can relate to what you are going through.
NEED SUPPORT?
Talk about what you need support with; your partner and family members cannot read your mind!
COMMUNICATION IS A TWO-WAY THING
Don’t forget to listen to your partner and ask them how they are feeling; they will have their own worries too!
DON’T FORGET TO LAUGH!
Having a sense of humour and seeing the funny side of things can be a real help in getting through tricky intimate moments.
SOURCE
- Fact sheet – Emotional factors. Crohn’s and Colitis Foundation. www.crohnscolitisfoundation.org
- Fact sheet – Sex, intimacy and IBD. Crohn’s and Colitis Foundation. www.crohnscolitisfoundation.org
- Sexual relationships and IBD. Crohn’s and Colitis UK. www.crohnsandcolitis.org.uk
- Tips for a healthy sex life with Crohn’s disease. Everyday Health. www.everydayhealth.com
- IBD, sex and intimacy. The Grumbling Gut. www.thegrumblinggut.com