After any ostomy, colostomy, ileostomy or urοstomy operation, it usually takes only a few weeks of patience to fully return to your daily routine. After recovery there is nothing abnormal that hinders your sexual activity as it is extremely rare for these surgeries to cause any permanent damage to the nerves of the genitals.
However, continuing to have sex after surgery can be an emotional and difficult time for both you and your partner. Problems arise when adapting to the new reality but most focus and worry about self-perception and how a change in the abdominal area can affect attractiveness.
As you will discover below, everything is usually just in your head and there are all the solutions so sexual life with a stoma to be as enjoyable for you and your partner as before. All you need is more information, a lot of communication and a little willingness and patience to adapt.
The fear & sexual problems caused by the stoma
I recently found this question published in the Canadian Intestinal Research Community, GI Society.
My wife recently had a temporary ileostomy. We are both afraid to have sex again. Are there things we can do to make it easier?
At first you are probably worried about everything like how to lie down or which side. These are frequently asked questions not only about sex but also about sleep.
Remember that you have had a major surgery, so it is normal to be worried about your partner’s reactions to your stoma. It will take time for both of you to adjust to the changes and for your body to recover.
Physically, you may not be able to relax and enjoy an intimate relationship for some time. This interval varies depending on:
Although decreased sexual desire is perfectly normal, it can lead to stress for both of you, so it is vital that you talk to each other to avoid misunderstandings.
If you are still in this phase, you need to work to regain self-confidence so that sex will no longer be synonymous with fear and anxiety, but a moment of intimacy and pleasure.
The change in body image
The main fear and essential obstacle to returning to previous sexual activity stems from the change of body image after ostomy surgery.
Although each person experiences it differently,
This bad attitude resulting from the totally wrong perceptions of individuals and of misinformation about sex and the stoma. Please don’t get ahead of yourself and don’t create a negative atmosphere.
Deal with physical change with determination and optimism. You are a fighter, thirsty for life and you should treat sex in exactly the same way.
Especially for women
Ostomy can affect women but not something that can not be overcome.
Quite often, dryness is observed but can be solved very easily with a lubricant, suppositories, lubricating condoms or even saliva.
Extremely rarely can surgery change the sensitivity of the clitoris or vagina due to changes in the nerve pathways. There is no need to worry, it will just take a little experimentation for you and your partner to rediscover these love zones.
Sometimes, the body develops scar tissue, which in turn can affect the elasticity of the vagina. Once more, there is absolutely no problem, you just have to spend a little more time to relax the vaginal area.
Finally, in the case of complete rectal removal, you may experience discomfort with some postures because the rectum supports the vagina during sex but again this is not a problem as there are countless postures that you just have to try. Usually those that don’t weigh down the stoma area are preferred.
Especially for men
There may be problems with erection after an ostomy surgery, but are temporary. The problem can be caused by changes in the blood supply and more rarely by nerve endings in the penis. Although some men will experience erection problems up to 2 years after surgery, there are many treatments that can help such as:
Most of the time, of course, the problem is purely psychological and it would be good to talk to your doctor or a specialist before turning to other solutions.
Although extremely rare as the nerves that control genital function are located near the intestine, there is a very small risk of impotence or infertility, especially in cases such as pelvic diversion in which the bladder is removed. Talk to your doctor if he or she thinks it would be good to store sperm before such an operation.
Especially for same-sex couples
Of course, the same is true here, but the ostomy is definitely an additional challenge for people who use their rectum for sex. It is a good idea to talk to your doctor as there is an increased risk of injury and bleeding so that you can continue to enjoy your sex life safely. Unfortunately,
If you had a relationship before
Everything is easier when we have someone to rely on. Having a partner before an ostomy surgery is valuable since you have already dealt with a disease that led to this.
You may be scared or sad at first and have dozens of questions about what is changing but you will learn everything and adjust together. It would be a big mistake to exclude your partner from this process. Communication is vital to restoring your sexuality.
The time you spend together, after illness, surgery and recovery is full of emotion. Discuss these feelings and the changes that have taken place.
Undoubtedly there will be fears about whether you remain sexy but you lose nothing by asking what your other half thinks of you. You will probably hear that it hasn’t changed his feelings for you and he/she craves you the same as before. That alone is enough to regain your confidence.
But even if the stoma makes him / her feel uncomfortable, explore it together. What you will achieve as a couple will be a way to get even closer than before.
Of course some relationships may end after an ostomy operation. Sex is only one part, yes very important, of a healthy relationship. If your ex-partner claims that this is a reason for breaking up with you then you are definitely better off without him or her.
Start dating again
So, if you have not been in a relationship or broke up, then the time will inevitably come when you will start dating. The big question is when will you inform a prospective partner about your stoma and it is definitely not a good idea to leave it just before the clothes come out.
Of course it all depends on what you are looking for. If you only want sex, ie a one night stand, then it would be better to inform immediately. But if you are looking for something serious then you will definitely find the right time.
After all, going out on a few dates with the same person will give him/her time to see that
What changes in sex when you have an ostomy
Waiting a full penetrative sexual intercourse immediately after ostomy surgery may not be realistic. Generally, surgeons recommend about 3 weeks of waiting but this varies from person to person. Initially spontaneity may be lost as
A gradual approach to sexual activity that you have had before can help you and your partner feel more comfortable and confident.
First of all, penetrative sex is not the only way to get close and it applies to everyone regardless of sexual orientation. If that idea scares you, remember that satisfaction also comes from a caress, a hug, a kiss or just holding someone by the hand.
Get closer to each other, touch each other, give yourself the time it takes to regain your confidence and rejuvenate your relationship after a difficult surgery. Find room for humor, as the stoma makes unexpected noises. Try to avoid schedules and specific expectations regarding repeated sexual activity.
Above all, you need to be honest with yourself and take the time to discuss your feelings with your partner. Find out if the problems really stem from the illness you are experiencing and the stoma or previous relationships.
In any case, our primary sexual organ is the brain. Sexual problems usually come from anxiety and insecurity and not from some physical pathology. If you can’t find all the solutions with your partner you should be ready to discuss with your doctor as his/her advice may concern various issues.
It may involve a practical solution, such as a change of posture during sex, or the use of lubricant if the problem is dryness or discomfort. There are also many other medical specialties to refer you to if you feel that you will benefit from their advice such as a sexologist or psychosexual counselor.
The sex secret lies in the stoma bag
We all get ready for sex, from a simple shower, shaving or wearing sexy lingerie to soft lights, champagne or music for the more romantic. Of course, nothing changes for people with ostomy, but the right bag and the right preparation will help you feel more comfortable in the bedroom.
Smaller, more discreet stoma bags are the best choice whether they are disposable self-adhesive bags or two-piece systems. While they have limited capacity this is a minor problem for you as you will be using them for a very specific reason. Just remember to go back to your normal stoma pouch after sex.
The ostomy bag is the most important tool and essentially is part of your body. Modern bags are made of such materials so that you have a constant feeling of purity. As for those who are afraid of possible odors that may appear during sexual intercourse, there is absolutely no risk since, thanks to the development of technology, there are now the appropriate filters that repel all unpleasant odors.
Of course, there are similar solutions for the case of irrigation.
If your current stoma pouch is a problem for you, talk to your doctor or Traumacare staff. We can suggest you various options that will help you while you have the opportunity to
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What should I know about contraception, pregnancy and childbirth?
With regard to contraception, you may need to change the type of measures you used before the surgery, as in the case of birth control pills, where your body may no longer be able to absorb the full dose of the medicine. You should ask your doctor about contraception after surgery.
Colostomy, ileostomy and urostomy don’t prevent a woman from becoming pregnant or giving birth. Many women have had successful and uncomplicated pregnancies after surgery. In fact, in many cases they had many children after undergoing stoma surgery.
However, it is usually recommended to wait about a year after surgery to start a family, as this gives you healing time and allows you to recover psychologically. If you have any concerns, please contact your doctor or the Traumacare nursing staff.