Sexual Problems In People With IBD

If You Are Unhappy With Your Sex Life, Your Best Bet Is To Your Doctor

Feet In Bed
Every adult deserves to have a healthy sex life. If yours isn't what it could be, seek help from your doctors. Image © Peter Cade / The Image Bank / Getty Images

People with inflammatory bowel disease (IBD) face an uphill battle when it comes to dating, relationships, and sex. There's often a lot of talk swirling around dating and relationships, but most of it falls short when it comes to sex. Obviously, it's an uncomfortable topic for many people to discuss, and that includes health care professionals.

Has your gastroenterologist ever asked you about whether or not you are satisfied with your sex life?

How about your colorectal surgeon? Your obstetrician/gynecologist or urologist? People with IBD might discuss intimacy with any of these physicians, but the reality is they are probably not. Yet, sexual dysfunction (which is a very cold and clinical medical term that certainly doesn't help the situation) is a staggeringly huge problem in the IBD patient population.

Why Sex Is Important To Patients

Crohn's disease and ulcerative colitis tend to be diagnosed more frequently in young people, making discussions around intimacy crucial. This is not to say that a healthy intimate life is not important at all ages, but younger people may be in the middle of their reproductive years, or even have those years still ahead of them. Young people with IBD who are dating or thinking about marriage have this extra layer of difficulty as they navigate their social lives.

What Is The Scope Of The Problem?

A study of 47 participants yielded some upsetting results on the depth of sexual problems in patients with IBD.

The patients took questionnaires — the female sexual function index (FSFI), international index of erectile function (IIEF) for males, patient health questionnaire (PHQ-9), and fatigue severity scale (FSS) — to uncover any problems they have with intimacy and satisfaction with sex. Of the 21 male patients included in the study, some of the problems reported included impaired erectile function (52%), orgasmic function (23%), and sexual desire (81%).

The women in the study reported impaired desire (97%), arousal (58%), lubrication (50%), orgasm (53%), satisfaction (50%), as well as the presence of pain (54%). In both men and women, patients with active disease (a flare-up) and those who also had depression were more likely to report dissatisfaction than patients with inactive disease or who did not have depression.

The authors point out that these problems are significantly impairing quality of life, and that physicians need to start assessing patients at-risk for dissatisfaction in their sex life. People with IBD are clearly among those in the risk population, yet only 6 of the 47 patients included in the study were asked about sexual function by their physicians. Other studies have demonstrated that patients with IBD often struggle with body image issues and have body image dissatisfaction, especially when taking steroids or during an IBD flare-up.

Talking To Your Doctor, And Receiving Treatment

The good news is that once issues with intimacy are discovered and diagnosed, in many cases they can be treated.

Treating the underlying symptoms of IBD is, of course, the first step towards a better quality of life. After that, treating depression can also be productive in helping improve body image dissatisfaction and sexual issues. In cases of pelvic floor problems after having surgery for IBD, women might be referred to a gynecologist for treatment. Erectile dysfunction is also treatable, and can be evaluated by a urologist. Side effects of medication may also be manageable with a dosage change or a treatment change. Of course, none of this can take place unless someone starts the conversation about sex. If your doctor doesn't ask, start the conversation yourself. Remember, it's understandable if you are uncomfortable discussing sex with your doctor, but most physicians have heard it all before, and they can only help you if they know about the problem.

Sources:

Mahmood S, Nusrat S, Crosby A, Zhao YD, Ali T. "Assessment of Sexual Dysfunction Among Inflammatory Bowel Disease Patients." Program No. P1076. ACG 2014 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology. 5 Feb 2015.

McDermott E, Mullen G, Moloney J, Keegan D, Byrne K, Doherty GA, Cullen G, Malone K, Mulcahy HE. "Body image dissatisfaction: clinical features, and psychosocial disability in inflammatory bowel disease." Inflamm Bowel Dis. 2015 Feb;21(2):353-360. doi: 10.1097/MIB.0000000000000287.

Saha S, Zhao YQ, Shah SA, Esposti SD, Lidofsky S, Bright R, Law M, Moniz H, Samad Z, Merrick M, Sands BE. "Body image dissatisfaction in patients with inflammatory bowel disease." Inflamm Bowel Dis. 2015 Feb;21(2):345-352. doi: 10.1097/MIB.0000000000000270.

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