An extinguished match in the shape of a heart. There are icons for fatigue, bloating, depression, sadness, cramps, and medication behind it.

IBD and sex

I don't think we talk about the impact that IBD has on sex often enough! So, what better time to start?

There have been many periods in which I didn't feel like having sex for one reason or another – due to IBD.

With IBD, who has energy for sex?

There are lots of factors that can influence sex drive in people with IBD. Here’s a summary of just some of them:

  • Chronic fatigue
  • Pain and cramps
  • Inflammation
  • Abdominal discomfort/bloating
  • Mental health, anxiety/depression
  • Loss of confidence
  • Medication side effects
  • Chronic fatigue

A flare often brings with it chronic fatigue, which can be debilitating enough on its own. Who wants to have sex when they are physically and mentally exhausted? Not me, that's for sure!

Most of the time, when suffering from fatigue, getting through work and making sure I eat take all of the energy I have for the day. When I get in bed, rest and sleep are all I am thinking about!

IBD symptoms that affect sex

Let's get into this list of symptoms commonly associated with Crohn's or ulcerative colitis.

Pain and cramps

Many of us aren’t just dealing with abdominal pain during a flare. It’s not uncommon to have inflammation in other areas such as our joints at the same time, which causes pain too.

Being in pain is often be very distracting, making it hard to focus on anything other than the pain itself.

Inflammation

For me, inflammation in my J-pouch caused more issues than anything else. I imagine it’s the same for any female who has active disease in their rectum.

I had tenesmus, a kind of cramping/throbbing pain there, which made me feel like I constantly needed to go to the toilet – even when there was nothing to empty! I was always aware of it, and it made sex almost impossible. It was usually pretty painful, and I’d often feel like I might “go” during. It was definitely enough to put me off trying most of the time. It’s simply the wrong place!

Abdominal discomfort/bloating

Even without a flare, I often feel really bloated and uncomfortable after eating. It feels like it takes forever for it to settle, and once the bloating is gone, it’s usually time to start going to the toilet!

Mental health, anxiety/depression

Depression and anxiety are also pretty common in people with IBD. People who have experienced mental health struggles are the only ones who really understand just how much your thoughts can impact your life.

Depression usually brings with it a lack of interest in the things you usually enjoy; from seeing people and hobbies, to sex! Fatigue is also a symptom of depression, so, back to the fatigue section above!

Depression and anxiety can make us doubt other people, and make us feel differently about ourselves. Lack of confidence will also be a factor in whether we feel like getting romantic.

Loss of confidence

There are lots of reasons that having IBD might knock our confidence. The possibilities seem endless!

People might have scars, ostomy bags, central lines, or NG tubes. All of which can make us feel self-conscious, and even a little uncomfortable with ourselves. That can make it difficult to believe that anyone else will find us attractive.

Medications such as steroids can also alter the way we look. For me, greasy hair, acne, weight gain, and a face the shape of a full moon were usually a result of steroids.

Our mental health can also make us feel less confident, and then there’s the more simple stuff. How attractive do you actually feel when all you've done is poop all day? Or when you feel like you look really bloated?!

Medication side effects

Sometimes, we find ourselves on A LOT of medication. This includes medicine to treat IBD and the symptoms of IBD such as pain relief, as well as medications to slow things down, speed things up, prevent bloating, or reduce acid. Then, we might need medication to treat the side effects caused by some of the other medications, too!

Some of these medications might also affect sex drive.

IBD and sex: my final thoughts

So, the back and forth to the toilet is exhausting, the psychological aspects are exhausting, and the pain is exhausting. Good luck having any energy left for anything saucy!

I can obviously only speak from a woman's perspective, but I assume that men have similar issues. There's always the possibility of changes in libido because of fatigue, medications, mental health, and body image, etc., regardless of whether you are male or female.

It can be hard to explain to a partner that your disinterest is nothing to do with them, and everything to do with you, but, it’s important that you do! If you communicate openly and you are talking to the right person, it should be OK. It might even help you differentiate between more meaningful relationships and the ones that are simply physical ones – whether you want it to or not!

How does Crohn's or colitis affect your sex life? Share in the comments below.

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