Intimacy and sexuality when you have a colostomy, ileostomy and/or urostomy

Many might avoid physical contact due to a fear that it might lead to expectations or demands that cannot be fulfilled.     

There is generally nothing standing in the way of having a good sexual life, when you have had an ostomy operation. To loose the desire for sexual intercourse in the period of sickness and after operation is thus very natural. It is however, by talking about your emotions regarding the ostomy, the disease and the operation that might help you get through this difficult time.

Talk to your stoma nurse about your intimate life

Talk to your nurse about all your concerns – also concerns 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 alle muligheder for og risici ved at bevare endetarmen vurderes.

Talk to your partner about your ostomy

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

Although you might not have any energy or find it difficult to start your sexual life due to tiredness, fear of pain or due to more 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 disquieting to an ostomate without partner. When would it be appropriate to inform about your ostomy? Early in the relationship, to make sure the partner does not feel defrauded? Or later on, with the risk of the intimate atmosphere being ruined? It can be difficult to open up about the topic.

To be prepared for the situation it can be a good idea to prepare what to say, to make you feel ready for the situation when it occurs, as it can be difficult to be the one to take the initiative to such a conversation.  

But 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. A radical change of the body, the fear of a serious decease, hospitalization and the operation itself are all together a very 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 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 but by your needs, which can still be fulfilled.

Focus on your partner’s needs

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

Intimacy is more than sex - also when you have an ostomy

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.

How to feel comfortable when telling a new partner about your ostomy?

Most ostomates find it least complicated to have sexual intercourse in their own home. 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?

When thinking about the ostomy and the bag it might be difficult to relax and give yourself sexually. But such problems can be defeated. Both ostomy 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. 

Read more about products and stoma underwear relevant for the intimate situation here.

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. For instance, 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. Do your own experiences – carefully step by step.  

How about the stoma?

The ostomy is perfectly capable of coping you resuming your sexual 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 sexual life. 

Remember that the ostomy will often be most active 1-1½  hours after a meal, so it might be a good idea to prepare your partner to the air outlet, to keep it from confusing and disturbing you. 

What can you do to make your sexual experiences even better?

It can help to try different sexual positions that shift weight away from your ostomy, supporting yourself with a pillow, and the use of lubricants.

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

Changes in the anatomy after your ostomy operation

The physical consequences of an ostomy operation and its impact on sexual life depends on different factors. This means that some of the functions regarding the sexual life can be temporarily or persistently damaged, and thereby not function as they previously did. 

It is important to get sufficient information about your surgery from the hospital. A drawing 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 ostomy. You can also transform a pair of beautiful lace panties yourself by cutting a small opening in the bottom. Also, 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 vest during intercourse covering the ostomy. 

In order to be able to feel free, relaxed and capable of enjoying sexual life, you can make some precautions and considerations such as:

• Making sure the bag is clean and empty  
• Using mini pouches, minicaps or ostomy plugs for intimate situations. Go to our ostomy product catalogue here.
• Colostomists can irrigate. Be aware that this is not a one off. Read about colostomy irrigation here.
• Roll up the bag and fasten the underside with a piece of tape. Go to our product catalogue here and see all our accessories.
• Cover the bag with a special stoma cover, colostomy wafer or similar. 
• Use stylish underwear that hides the bag and minimises sound.

One should continue to use contraception as before the surgery, if pregnancy is not a long-term goal. 

Birth control for women with an ostomy

Ostomates can use any type of contraception. However, for some ileostomists the barium swallow is so prompt, that the assimilation of contraceptive pills becomes adverse. Contraceptive pills are therefore not a safe method for you having an ileostomy.

Fertility after surgery

Special for women:

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

Special for men

• At any operation with a risk of nerve damage, you should prior to the operation discuss the possibilities of having your semen deposited in a sperm bank, with your doctor. This is done in the case that you might later want children.
• Stress in in relation to operation and treatment can reduce the content of the male sex hormone testosterone in a short period of time.
• As long as the testicles remain untouched during surgery, there is no ground for hormonal treatment. 

You can get help getting pregnant if you have an ostomy

Both ostomates and everyone else involuntarily childless today have many different options. Contact your doctor regarding help.

Ostomates 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. 

In the beginning of the pregnancy

To have contact with an ostomy nurse in the beginning of the pregnancy will be relevant as special considerations regarding the products you use might be necessary. 

In the later stages of the 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 the birth?

You can, without any risk for yourself or your baby, give birth. The ostomy is no hindrance. 

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

It’s unsafe to use the stoma for analsex 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 possible need of new surgery.