Sexual Health Q&A

Can inflammatory bowel disease (IBD) affect a person’s sex life?

Yes, it can. But people with inflammatory bowel disease can make some adjustments and still enjoy sex.

Inflammatory bowel disease (IBD) targets the digestive tract, leading to fatigue, pain, and diarrhea. The two main types of IBD are Crohn’s disease and ulcerative colitis.

IBD may be treated with medication and/or surgery. In some cases, having surgery requires patients to wear a bag outside of their bodies to collect stool as necessary.

IBD-related sexual issues can stem from emotional and physical aspects of IBD, as well as the treatment.

People with IBD may feel nervous about having sex. Given the nature of the illness, they often worry that their situation will make them unattractive to a sexual partner, especially if they need to use a collection bag. They may also be anxious about passing stool during sexual activity. Single people with IBD may avoid dating and sex because they feel embarrassed.

Fatigue is common, too. IBD can be exhausting, so it may be difficult to muster up the energy for sex.

Pain can be another problem. Some women may feel pain in the vagina, rectum, and in the area in between (called the perineal area). Fistulas – abnormal areas of tissue that connect the bowel to another organ – can cause pain, too. Surgery for IBD may cause pelvic organs to shift position, leading to pain, and nerve damage might reduce sensation in the clitoris.

Men with IBD may have trouble with erections and ejaculation. This may be the result of the disease itself, medications, or surgery.

What can people with IBD do to make sex easier? Here are some suggestions:

• Talk to your partner about your anxieties. Let him or her know that accidents happen – a collection bag can come loose or break. Be honest if a position is painful and be open to trying new ways to be intimate.

• If having a collection bag makes you feel self-conscious or unattractive, consider wearing a long T-shirt or specially-designed undergarments to cover it.

• Empty the collection bag before sex.

• Use enemas or suppositories after intercourse.

• Using a lubricant may help make sex more comfortable for women.

• Men who develop erectile dysfunction (ED) have several treatment options, including medications, vacuum devices, and penile suppositories.

• A sex therapist may help patients and their partners work through any sexual issues, including problems with communication.