IBD and Intimacy

Talking to your partner

Even under the best of circumstances, relationships are complex. Adding IBD or pregnancy (or both) to the mix can make it even more so. But the key to a successful relationship in nearly any situation is effective and open communication.

Telling your partner about your IBD

When striving for open communication with your partner, it's important to tell him or her about your IBD diagnosis and how it impacts your life and may influence a pregnancy. Now, we aren't saying this is easy. Disclosing something so personal can be difficult and even scary, especially if you don't know how your partner will react. But if trying to conceive, it's only fair that your partner knows your situation fully in order to best support you and your unborn child. This is necessary to maintain the intimacy and trust formed between you.

Here are a few points to keep in mind regarding this conversation:

• Your attitude about your disease will help shape the attitude of those around you.
• To shape the perception of others, radiate self-confidence and self-awareness when discussing how the disease affects you.
• Sharing information about the disease can relieve a lot of the stress and anxiety related to dealing with it alone.
• A relationship can often flourish after disclosure.

Your partner's reaction

It's also important to remember that while you may be the one who is diagnosed, your partner is also affected. Sometimes partners can feel helpless, shut out or even selfish. You and your partner may have similar feelings about the disease but could approach these emotions differently, which can cause conflict.

It can be helpful to visit the physician with your partner to allow him or her the opportunity to ask questions and gain a better understanding of the disease and how it can impact your relationship. Lack of communication can promote secrecy and mistrust, but sharing information will enhance and strengthen the intimacy you share. With open communication, IBD and intimacy can go hand in hand.

IBD's impact on sexuality

IBD has both direct (e.g., fatigue, diarrhea, abdominal pain) and indirect (e.g., medication side effects, consequences of surgery) effects on an individual's body image, sexual function and interpersonal relationships. Anxiety and depression can be common for patients with IBD as well. The fear of pelvic floor function or incontinence can understandably affect one's self-esteem or sexual confidence as well. Given the nature and anatomic location of IBD, it can have a large impact on sexuality.

Male vs. female concerns

IBD sexuality concerns tend to be gender specific. Women are primarily concerned with body image, feeling alone, having children and physical attractiveness. Women also report decreased sexual desire and satisfaction compared to men after diagnosis.

Men, on the other hand, tend to be more nervous about sexual performance. Both women and men worry about IBD's impact on intimacy. But these are common concerns for all people in relationships—not just those with IBD.

What can I do?

Treatment can often help alleviate some of these concerns. Medication can make patients feel better—helping improve well-being, body image and energy levels. These positive impacts can in turn enhance sexual desire and functioning. However, on occasion, some medications, like corticosteroids, can impact sexuality negatively. Steroid-associated mood swings can strain relationships and aesthetic side effects like acne, weight gain, stretch marks or excess hair growth can profoundly impact body image and confidence. Therefore, you should talk to your doctor about any negative effects treatment may have on your love life. He or she may be able to help resolve them.

IBD surgery's impact on sexuality

Though many worry about how surgery will impact their sex life, it usually helps. It's been shown that sexual desire in both men and women remains the same after IBD surgery as it did before, and most patients resumed sexual activity soon after surgery.

Surgery can help alleviate the fear of incontinence as well. Women in particular report higher levels of desire and satisfaction after certain surgeries, such as ileal pouch anal anastomosis (IPAA). As a result, most patients are generally satisfied with their sexual life after IBD surgery.