Sex Advice

Crohn’s disease can come with many frustrations and challenges. Maintaining a satisfying sex life can be a particularly difficult challenge for someone with Crohn’s disease.  Abdominal pain, gas, bloating, diarrhea, and the need to find a bathroom in a hurry are all aspects of Crohn’s disease that do not sound the least bit sexy.

Love & Crohn’s

Too often it is the embarrassment that often accompanies Crohn’s disease that makes patients avoid intimacy, fear relationships, and think sex can no longer be a part of their life.

Body image issues that result from scaring after surgery, ostomy bags, fistula around the anal and genital area that make sex painful can take an emotional toll on a person’s sexual self-esteem. Each new relationship brings with it the task of disclosure of illness and need for explanations for symptoms and coping methods. Fear of bowel accidents or of the sudden need to rush to the bathroom in the middle of what is supposed to be an erotic encounter sometimes pushes people in the direction of abandoning their need for sex, intimacy, and affection. 

Romantic partners are also often left frustrated when patients pull away from them, avoid intimacy, and refuse to discuss feelings and methods that allow sex to still be possible. Fear of hurting someone physically during the act of intercourse by harming their ostomy area or causing them pain during sex due to fistulas can make a partner afraid to learn how to touch and make love to someone with Crohn’s disease.

Not to Burst Your Bubble, But…

Here is the secret that no one wants to talk about in life: everyone poops. That is in no way minimizing the suffering of people who have Crohn’s disease because the last thing it is, is a joke. However, there seems to be a lack of honest conversation about bodily functions. If there is going to be an honest conversation about sexuality, it has to include bodily functions. That way, when they don’t always function they way we want them to, we can be more comfortable dealing with them.

The tricks are to find ways to be sexual when experiencing windows of wellness, cope with symptoms as they occur, including during intimacy, and have courage to claim sexuality as a right. Do not give up on that sacred part of yourselves because it is easier to take the path of least resistance than to not go gentle into that good night.

Making Accommodations

If an ostomy bag is in place, talk to your healthcare provider about how to secure it so it doesn’t come loose during sex. Many people with ostomy bags lead completely normal and satisfying sex lives. Change the bag just prior to sex. Talk to your health care provider about fistulas that may be in the anal or genital area making sex uncomfortable or painful. Fistulas can often be treated and there is no reason to suffer needlessly. 

Pad the bed before having sex if you are worried about a bowel accident. This will make clean up easier should it occur. If it does occur, try not to let it define your romantic encounter. Clean it up and try again. Many people, healthy and unhealthy have to stop in the middle of sex to urinate, especially as they age. Stopping for an accident or to go to the bathroom is okay.

Be informed about sexual side effects of medication. Some may lower sex drive. In women, some may contribute to a vaginal yeast infection.

Learn about your body in as much detail as possible. Learn what triggers a Crohn’s flare for you. Learn to recognize the signs of an impending bout of diarrhea. If you feel it coming, you can adapt your sexual schedule accordingly.

Express Your Intimacy & Speak Up

Find other ways to express intimacy and love besides intercourse. Relationships are more than sex. While people value their sexual selves for the pleasure it brings, sex is not always the end-all be-all. Having a partner you can talk to about these issues is a form of intimacy in itself. Find other avenues for pleasure.

Communicate with each other. That goes for the partner who does not have Crohn’s as well for they have a right to discuss their feelings and how the disease affects them.  Be honest about feelings, fears, comfort with coping methods and how a wonderful and fulfilling sex life can still be possible. A partner of someone with Crohn’s knows that bowel incontinence and related issues are not something a person with Crohn’s does on purpose. If they can’t understand that, maybe it is time to get a new partner.

Don’t be afraid to go outside your comfort zone and seek outside professional help. Many couples who are dealing with a chronic illness benefit from talking to a counselor or sex therapist and it can go a long way in helping couples reclaim their sex lives.

The worst thing is to do nothing and suffer in silence.