Sexual health and intimacy with an ostomy
People with an ostomy may initially find intimacy challenging, but with patience and modifications, your sex life can continue as it did before.
Intimacy is a state of mind
After ostomy surgery, depression, shame, and fear are common emotions, especially in the bedroom. Regaining a sense of intimacy requires openness, honesty, and trust with your partner.
Intimacy tips for men and women with ostomies
Start slow
Start off gently and with ease. Take advantage of romance and tenderness. Intimacy also means kissing, touching, making sex pleasurable.
Dress comfortably
Women sometimes wear a cami or tank that covers the midsection and ostomy bag. Pouches are made in different sizes, with smaller ones often used during intimacy.
Empty your pouch
Take a few minutes before getting intimate to empty your pouch. It will give you a little more confidence and ease your mind.
Keep the bag at bay
Fabric pouches made for ostomy bags help conceal and stabilize them, while also reducing chafing. Accessories like ostomy belts and belly bands further aid concealment and stability.
Stick to what you know
People with stomas have sex the same way those without stomas do. Common positions are usually possible, so stay within your level of comfort and preferences.
The stoma is off limits
Never use your stoma as an entrance for intercourse under any circumstances. The stoma should never be penetrated.
Be open to conversation
Ostomates may fear pain, leakage, being naked, and rejection. The more you discuss your ostomy, feelings, and needs, the more intimate the bond between you will be.
Be kind to yourself
After surgery, take time to acknowledge your body's changes and your journey. Regularly assess your emotional state and share your feelings with your partner. Give yourself time to accept and adapt to your body's new state.
Avoid bleeding
Stomas don't have nerve endings, so they can't transmit pain, but they do have blood vessels that can bleed when rubbed or irritated. Try different positions to avoid issues.
Intimacy tips for women
Embrace open communication, self-love, and patience to navigate this new chapter. Explore comfort and confidence in your transformed body.
Considerations for women
Birth control
If you are using oral contraceptives, they may not fully absorb due to the shortened small intestine. Make sure to speak with your medical team about birth control.
Vaginal dryness
One side effect of colorectal surgery may be vaginal dryness. If you're experiencing this, try a good lubricant or ask your gynecologist what could help you best.
Decreased sensitivity
Some women experience decreased sensitivity in their clitoris due to surgery. If part of the large intestine was removed, the clitoral nerves may be affected.
Orgasms
Your initial tries at sex after surgery may not bring you to orgasm. This is normal. If problems persist, talk to your care team or gynecologist.
Intimacy tips for men
Regain intimacy with open dialogue, patience, and understanding. Focus on feeling confident with your body, ensuring a comfortable and fulfilling experience.
Considerations for men
Erectile dysfunction
After surgery, an inability to ejaculate or sustain an erection during initial intimacy is common. If problems persist, discuss it with your care team.
Chemo can affect libido
If you are still in active treatment, including chemotherapy or radiation, it can have an effect on sexual desires and intercourse ability.
Surgery may impact nerves
Nerves may be damaged in surgery, and the ability to have an erection can be wholly or partially lost. Ejaculation is also dependent on the nervous system.
Give your ostomy space and stability
In the “man on top” position, lean a little toward the pouch-free side of your stomach to take pressure off of your ostomy. Try a cummerbund for ostomy stability.
Buy some new boxers
Intimacy can be affected by your self-confidence. If you're worried about your pouch showing, try wearing attractive boxers to help with cover it. You can also wear a tight-fitting tank to provide support and coverage for your pouch.
Learn more about intimacy and colorectal cancer
Top resources
Kat Sisler: From ostomy-opposed to ostomy-grateful
My cancer and ostomy journey began with a rude awakening in January 2023. My father was diagnosed with colorectal cancer at 42, and given that history, I asked my doctor at my yearly physical when I should begin screening.
Empowering lives: celebrating World Ostomy Day
Every year on the first Saturday of October, people worldwide come together to celebrate World Ostomy Day, also known as Ostomy Awareness Day. This day serves as a reminder of the resilience, strength, and courage millions of individuals display each year living with an ostomy.
How to cut and fit an ostomy wafer for a stoma
In this video, ostomate and certified patient and family support navigator Stephanie Rouse demonstrates how to cut and fit an ostomy wafer, or skin barrier, for a stoma.