Intimacy may take some time to rekindle after significant IBD flares and ostomy or IPAA/J-Pouch surgery. When IBD patients are very sick, libido may wane but often returns once the patient is feeling well again. While there are no set guidelines as for when to resume intercourse, many colorectal surgeons advise their patients to wait anywhere from 4-8 weeks after surgery depending on how they are feeling.
Sexual Concerns
For some men, colorectal surgeries sometimes may lead to unwanted effects of retrograde ejaculation, urinary retention and erectile dysfunction.1 This may be temporary and can be resolved with the appropriate interventions. Please work with your gastroenterologist and urologist to discuss medicinal options and/or pelvic floor physical therapy to strengthen the pelvic floor muscles after surgery.
For some women, vaginal pain or a lack of lubrication may make sexual intercourse painful following bowel surgery. Coupled with bladder dysfunction and urinary retention, surgery may result in pelvic floor issues for women.1 This is usually short-term and can be resolved with lubricants, estrogen creams and even pelvic floor physical therapy, which strengthens the pelvic floor after colorectal surgery. Please coordinate care with your gastroenterologist and OB/GYN. To find a pelvic floor physical therapist, please visit the International Pelvic Pain Society’s website and/or the Herman & Wallace website.
If struggling emotionally after IBD flares and colorectal surgery, it may be time to consider a consultation with a couples’ therapist and/or a sex therapist. Please refer to the section on How to Find a Mental Health Practitioner. Psychology Today is also a good resource to help locate various kinds of therapists.
For those looking for a certified sex therapist (CST), visit the online directory at www.aasect.org to find a professional.
For additional information on intimacy with an ostomy, please refer to the UOAA resource: Intimacy After Ostomy Surgery Guide.
Tips for Intimacy
When an individual feels ready for intimacy again after an IBD flare-up and/or ostomy surgery, the following tips may be helpful:
Empty the ostomy pouch before sexual activity.
A smaller ostomy pouch or stoma cap can be used if the individual prefers something more discrete.
A sitz bath may be helpful after intercourse to relieve any fistula-related or rectal pressure.
Contraception
The traditional birth control pill, in some cases, may not be optimal for women with ileostomies, as some pills are excreted wholly or partially if gut absorption is an issue. For IBD patients specifically, there may be concerns around using estrogen and the risk of blood clots. There are progesterone-only or low-estrogen contraceptive options, including intrauterine devices (IUDs), patches, and injectables, etc., for females to consider.2 There are also various contraceptive options for males to consider. Be sure to explore avenues in conjunction with your gastroenterologist and OB/GYN.
Written by Tina Aswani Omprakash. Medically reviewed and validated by Jordan Axelrad, MD, MPH. These webpages are funded by a grant from The Leona M. and Harry B. Helmsley Charitable Trust.
- Giglia, M. D., & Stein, S. L. (2019). Overlooked Long-Term Complications of Colorectal Surgery. Clinics in colon and rectal surgery, 32(3), 204–211. https://doi.org/10.1055/s-0038-1677027
- Cotton, C. C., Baird, D., Sandler, R. S., & Long, M. D. (2016). Hormonal Contraception Use is Common Among Patients with Inflammatory Bowel Diseases and an Elevated Risk of Deep Vein Thrombosis. Inflammatory bowel diseases, 22(7), 1631–1638. https://doi.org/10.1097/MIB.0000000000000800
Contact Us
United Ostomy Associations of America
P.O. Box 2293
Biddeford, ME 04005-2293
Call us toll-free at: 1-800-826-0826.
Our Information Line hours are Monday-Friday, 9am to 3pm EST. If you have an emergency, please dial 911 or contact your local medical professional.
Please understand that UOAA is a private, nonprofit, advocacy and informational organization. We are not a medical facility and we do not have medical or legal professionals on staff. Therefore, UOAA does not provide Medical, Mental Health, Insurance or Legal Advice. Visit UOAA Virtual Ostomy Clinic provided by The Wound Company for non-emergency, virtual ostomy support.
