Most new cases of IBD are diagnosed during the teens and early 20s. As a result, issues such as intimacy, sex, fertility and pregnancy are frequently of concern, especially given the chronic nature of Crohn’s disease and ulcerative colitis
Does IBD affect puberty?
Both growth and sexual maturity can be delayed by having IBD. Children with Crohn’s disease are usually affected more than those with ulcerative colitis. The causes include inadequate nutrition, active disease, and corticosteroids. Although puberty may start later in some children, eventually they will catch up.
Does IBD affect the sex drive?
People with any chronic illness, including IBD, may find that they have less interest in sex when their disease is active. IBD does not extend directly into the sexual organs or genitals. However, Crohn’s disease may have an indirect effect in women due to the possible formation of a fistula (opening) between the bowel and another organ, including the vagina.
Active disease may inhibit sexual activity directly because of symptoms such as abdominal cramps and diarrhoea. However, less obvious inhibitors are malnutrition and lack of energy. Sexual desire and performance are not affected by the medications most commonly used to treat IBD.
Surgery is relatively common in IBD. As with any other surgery, strenuous activity (including sex) should be avoided immediately after surgery to allow healing. The amount of “downtime” depends on the type and extent of surgery performed. Some women may find intercourse painful after a removal of the large bowel (total colectomy), or surgery in the pelvis, but this is usually temporary. Some women may develop a heavier vaginal discharge.
Sometimes surgery involves the formation of a stoma (opening from the bowel to the skin) when a bag collects waste. This has no physical effect on sexual function, but may initially be embarrassing. Often the person with the stoma is more bothered about the stoma than the partner! In a caring relationship normal sexual intimacy can be expected when a stoma is present. However, some care will need to be taken as the stoma bag may leak or dislodge.
For men who have had their rectum removed and a pelvic pouch formed, there is a slight risk of impotency and problems with ejaculation.
Women with Crohn’s disease may have an increase in intestinal symptoms during menstruation.