Intimacy After Stoma Surgery

Yes, it is possible to continue to have a healthy sex life – or even improve upon it – after ostomy surgery. 

But sex is rarely discussed with patients before ostomy surgeries, even though it’s a significant issue and can have a profound effect on a patient’s life.

If you feel comfortable enough, you can bring this up with your surgeon or stoma care nurse as it is one aspect that is usually only brought up by patients. Both your surgeon and stoma care nurse can provide advice and information about this – they have access to it throughout their training – but it can cause some initial embarrassment for both parties.

Possible obstacles prior to surgery

A physical relationship might have been difficult prior to ostomy surgery, due to:

• Pain – both from their health and from sexual intercourse
• Low mood / depression / anxiety
• Lack of energy
• Side effects of any treatments being undertaken

It is important to appreciate this going into surgery but aware that things might not change immediately after the operation is successful.

Possible obstacles after surgery

As Schuler explains in her research “Four key psychosexual issues faced by patients with ostomies have been identified:

1. alteration in body image;
2. inability or loss of desire to have intercourse due to physical and/or psychological aspects of surgery;
3. psychological and emotional responses in adjusting to surgery including communication difficulties between patient and partner;
4. and infertility due to the nature of surgery, disease, or treatment.”

In addition to this, patients are getting used to alot of new changes themselves. Alot happens in a short span of time and this can be really overwhelming. And for some, having an intimate relationship isn’t in their mind while their health is still unsteady. It takes a while for healing to complete – especially if you are left with open wounds or have complications – so treading lightly and being sensitive is important.

Recovery from a major operation takes time. Many people who have stoma surgery had a debilitating condition first, which slows the recovery process. Do not expect to resume your sex life as soon as you get home.  Talk to your doctor about when you can resume sexual activity. There is no set timetable and each couple will have a different comfort level.

Hints and tips for intimacy

Hollister offer this great set of advice for reintroducing intimacy back after stoma surgery:

• Trust is key to true intimacy. The more you share about your stoma, how you feel, and what you need, the stronger the bond between you and your partner.
• You’ll need to take it easy and gently to start. Keep in mind that tenderness and romance make sex pleasurable as well. Remember that loving, kissing and touching are an important part of sexuality.
• The old adage is true: The way you see yourself influences the way others see you. Take time after surgery to acknowledge the changes your body has been through, check in with your emotions about how you feel post-surgery, and share your feelings with your partner. You’ll find that acceptance of your body after surgery comes with time.
• A stoma does not have nerve endings; therefore, it does not transmit pain or other sensations, but it can bleed slightly if irritated or rubbed. Trying different positions can help you avoid any issues.
   –  The side-by-side position often works well for people living with a stoma because the pouch will fall to your side and not come between you and your partner.
• Take a few minutes before you get intimate to empty your pouch. It will give you a little more confidence and ease your mind. 
• Try to not let the pouch get in the way. If your pouch doesn’t have a comfort panel, consider using a fabric pouch cover made from cotton during sex. This will prevent the pouch from rubbing on you and your partner’s skin. It will also hide contents if you use a transparent pouch.
• If your stoma makes you uneasy during intimate moments, cover your pouch with specially designed underwear, lingerie or pouch covers.

For Women

• If you use the pill, you may need to change your birth control—particularly if you’ve had an ileostomy. Oral contraceptives are often not absorbed with a shorter small intestine. Talk to your doctor or stoma care nurse about the best form of birth control for you.
• After surgery, many women experience vaginal dryness. Try a lubricant, or ask your doctor about other options to treat vaginal dryness.

For Men

• Some men may experience erectile dysfunction symptoms (i.e., achieving/sustaining an erection or inability to ejaculate) the first time they are intimate following surgery. Don’t worry or panic! This can often occur—it may be related to the surgery itself or to worries/concerns over being intimate post-surgery. If you experience continued problems maintaining an erection, call your surgeon. Most likely, there is a solution.

Important:

DON’T change anything (unless you want to). How do people with stomas have sex? The same way as people without stomas. Conventional sexual positions are almost always possible. Of course, sex is about your comfort level and individual preferences.

DON’T use the stoma for intercourse under any circumstances. You or your partner should never use the stoma for sexual activity (penetration).

Until next time,

Do you have any questions or queries? Or just want to share your own experiences? You can leave me a reply here or leave comments via my social media accounts – on Twitter, find my blog page on Facebook and over on Instagram

If you enjoyed this post check out IBD, an Ostomy & Living with a Partner and ‘What is a Stoma?’ Part V: Managing – Mental & Physical Recovery

References:

Love, Sex and Relationships – Colostomy UK

“No one said this would be an issue…” Intimacy after ostomy surgery – Monika Schuler, Nursing 2021, September 2013

Intimacy after ostomy surgery guide. Turnbull G, United Ostomy Association of America [UOAA] 2009