Intimacy and sexuality with an ostomy

Losing the desire for sexual intercourse while you are unwell and after an operation is natural. Many might avoid physical contact due to a fear that it might lead to expectations or demands that cannot be fulfilled. However there is generally nothing standing in the way of having a good sex life when you have had an ostomy operation. Talking through your emotions towards your ostomy, disease and operation might help you get through this difficult time.

Talk to your stoma nurse about your intimate life

Talk to your nurse about all of your concerns – including those related to your intimate life. This will help you get a good start. Your stoma care nurse is used to discussing all issues you’re experiencing and will be able to help in many ways, both with advice and with accessory products.

If you practice anal sex, make sure you talk to your nurse about this before surgery so that your options and the risks involved can be assessed.

Talk to your partner about your ostomy

Talk openly and honestly with your partner. Even if doing so makes you feel embarrassed at first, you can be sure that it will only deepen the bond of respect and trust between you.

Although you might be lacking energy and are finding it difficult to re-start your sex life due to tiredness, fear of pain or other mental barriers, it is still important to maintain closeness and physical contact with your partner - without it necessarily leading to sexual intercourse.

How to tell a new partner about your ostomy?

The thought of a prospective intimate relationship might seem daunting to an ostomate without a partner. When would it be appropriate to speak about your ostomy? Early in the relationship, to make sure the partner doesn't feel deceived? Or later on, with the risk of ruining the moment? It can be difficult to open up about the topic.

To make sure you are ready for the situation it can be a good idea to prepare what to say beforehand.

Always remember that you are so much more than an ostomate. By showing this to your partner, you keep the ostomy from ever becoming a problem to the extent that it will affect your relationship.

Colostomy and ileostomy support groups

Ultimately, nothing is more helpful than talking to someone who really understands what you are going through. Your local support group is one way of meeting peers to get handy tips, inspiration and personal support. Talk to your stoma nurse about relevant groups to join. 

Following ostomy surgery, it’s natural to have concerns about your body’s appearance. Radical changes to your body, the fear of a serious disease, hospitalisation and the operation itself can all come together with an immense emotional load. It can take time to get used to the physical changes and you may feel less attractive as a result. Although it can be a challenge, you will feel better when you accept it as a part of who you are - the same goes for your partner. You life is not dictated by your ostomy, your needs can still be fulfilled.

Focus on your partner’s needs

It's ok if it takes a little while before your intimate life is what it was before. Avoid putting pressure on yourself and your partner, it is going to take time to adjust, but most people are able to get back to a healthy sex life eventually. Focus also on your partner's needs, not only your own, then many of your concerns will  decrease naturally.

Intimacy is more than sex

Remember that intimacy is much more than intercourse, and can be fulfilling and fun on its own. Take time to enjoy simply touching each other, holding, cuddling and kissing – allow feeling ready for intercourse to come naturally over time.

New relationships

The fear of being rejected is something almost everybody deals with. Remember that non-ostomates also get rejected. The possibility of meeting a person, who, without knowing about your ostomy, will reject you, also exists. This might be a person who is intimidated by something new and different.  Keep in mind how likely it would be that the relationship would not work, even if you were not an ostomate.

What happens with the ostomy bag when you have sex?

If you are thinking about your stoma and bag it might be difficult to relax and give yourself sexually. Keep in mind that both the stoma and the bag can endure sexual intercourse. It is important to remember the sex you had before the operation, to make sure you don’t forget previous problems, and blame the ostomy. 

Intimacy and a normal loving relationship following ostomy surgery can be resumed. How and when depends on the nature of the operation you've had. You could feel discomfort if the rectum or bladder were removed, and the uterus may change position. Changes in feeling can occur, and you might feel some level of pain. Each individual experience will be slightly different.

How will the stoma cope?

The stoma is perfectly capable of coping with you resuming your sex life and the operation scar will not break. The disease you have been operated for is not infectious and the risk of it returning is not dependent on your sex life. 

Remember that the stoma will often be most active 1-1½  hours after a meal, so it might be a good idea to cover the air outlet during this time, to keep it from disturbing you. 

What can you do to make your sexual experiences better?

It can help to try different sexual positions that shift weight away from your stoma, supporting yourself with a pillow, or using lubricants.

Some men experience difficulties keeping their erection after their ostomy surgery due to damages to the nerves. If you experience this issue it can be helpful to be in a position where you are less physically active as this can prolong the erection. 

Changes in anatomy after your ostomy operation

The physical changes from an ostomy operation and their impact on your sex life will depend on a few different factors. Some functions may be temporarily or permanently damaged, and not work as they previously did. 

It is important to get sufficient information about your surgery from the hospital. A diagram of the operation might be helpful. If you experience sexual difficulties following the ostomy operation, it is important to determine the cause and correct the problem. 

Tips for women

Crotch-less underwear might be an option to provide more support for the stoma. You can also transform a pair of beautiful lace panties yourself by cutting a small opening in the bottom or adapting lace underwear so that it’s worn as a tube around your body covering the pouch. 

Tips for men

Some prefer to wear a t-shirt or a singlet during intercourse to cover the stoma. 

Vanilla Blush – specialising in ostomy underwear

Our friends at Vanilla Blush specialise in making underwear and lingerie for men and women who have had Ostomy surgery. Visit the Vanilla Blush website.

In order to feel more free, relaxed and capable of enjoying sex, you can follow some of these useful tips:

• Make sure the bag is clean and empty  
• Use mini pouches, minicaps or ostomy plugs for intimate situations. View our ostomy product catalogue here.
• Colostomates can irrigate, please be aware that if you choose to do this, it is something you should continue to do regularly Find out more about colostomy irrigation here.
• Roll up the bag and fasten the underside with a piece of elastic tape. View our range of ostomy accessories.
• Cover the bag with a special stoma cover, colostomy wafer or similar. 
• Use stylish underwear that hides the bag and minimises sound.

Birth control for women with an ostomy

Most ostomates can continue to use contraception as before the surgery, if pregnancy is not a long-term goal.

For some ileostomates the barium swallow is so prompt, that the assimilation of contraceptive pills becomes adverse. Contraceptive pills are therefore not a safe method for some who have an ileostomy.

Please consult your doctor or Stoma Therapy Nurse for further information.

Fertility after surgery

Women:

• A comprehensive bladder or intestine operation can result in reduced fertility due to adhesions or if the uterus has reclined.

Men

• Before any operation with a potential risk of nerve damage, you should consider discussing with your doctor the possibility of having your semen deposited in a sperm bank. This is done in case something was to go wrong that may limit your ability to have children in the future.
• Stress from the operation and treatment can reduce the amount testosterone produced in the short term.
• As long as the testicles remain untouched during surgery, there should be no need for hormonal treatment. 

Assistance with getting pregnant

There are many different options for both Ostomates and others having trouble getting pregnant. Contact your doctor regarding your options.

Ostomates can have a normal pregnancy

Having an ostomy does not prevent you from carrying a baby to term and having a normal delivery. As the belly grows, the stoma will typically just follow the changing shape of the abdomen. 

Early stages of pregnancy

It is worth getting in touch with your stomal therapy nurse in the early stages of pregnancy as they will be able to help you with special products that may be necessary. 

Later stages of pregnancy 

In the later stages of pregnancy, you might need to use a mirror when changing your pouch. Delivery usually takes place as normal. 

Will the ostomy affect birth?

You can give birth without any risk to yourself or the baby, the ostomy shouldn't be a hindrance. 

Before the operation, it is important to consult the surgeon about the need to preserve the rectum and the associated risks. 

It’s unsafe to use the stoma for anal sex as a replacement of the rectum

To substitute the ostomy for the rectum is highly advised against as it can lead to bleeding and cicatrisation that might cause problems and a possibility that you might need further surgery.