Sex and intimacy after stoma surgery

Intimacy and sex are a natural part of your life and having fulfilling intimate relationships is as important after your surgery as it was beforehand. While the operation may have changed your body, it hasn't changed who you are.

The sooner you start feeling comfortable about the changes to your body the better - it is not your stoma that determines your limitations in regards to intimacy.

Physically and emotionally you will know when you are ready to restart your love life. Although you may initially be worried about how to make the first step, its important that you and your partner both take this new journey together.

It takes time to adjust

What is also important is acceptance - from both your partner and yourself. Avoid putting pressure on yourself and each other. Try and accept that it is okay if it takes a little while before your intimate life is back to what it was before.

Sex is more than intercourse

Remember that intimacy is much more than intercourse, and can be fulfilling and fun in its own right. Take time to simply enjoy each other, then feeling ready for intercourse might well come naturally in time.

It is important to be able to discuss intimacy with your partner in a relaxed, non-pressured manner. Even if doing so makes you feel embarrassed at first, you can almost be positive that it will only deepen the bond of respect and trust between you. This is also true if you are dating or thinking about meeting someone new.

Be open to discussing your feelings as well, so that you are both being honest and open.

Also, you shouldn't misinterpret it as rejection, if your partner is worried about hurting you. Instead share your concerns and listen to your partner's concerns. These typically include:

• Physical limitations such as vagina dryness or problems with erections
• Pain
• Fears in terms of odour, leakage or rejection
• Anger, resentment or guilt, that interfere with the desire to have sex

Keep in mind that your attitude is probably the most important ingredient for a happy sex life. So do whatever you feel you need to do to feel relaxed, free, and at ease with your body. And talking about these issues is a giant step forward.

How will the surgery affect my sex life?

Intimacy following stoma surgery very much depends on the nature of the operation you've had. For instance temporary or permanent impotence and/or discomfort could be the result in case of the removal of the rectum or bladder, although most men have no problems reaching orgasm.

If you experience impotence you should contact your stoma nurse – there are several options to minimise the problem. It is important to try and talk openly with your partner about the changes, even if you are feeling self-conscious.

Do not shy away from talking to your stoma nurse, who is used to discussing such issues and will be able to help you in many ways, both with advice and with accessories.

Is there anything I should avoid altogether?

As a general rule you should talk with your doctor about any types sexual activity you should avoid.

Depending on the reason for your surgery you might need to avoid anal intercourse. If you are a woman and have had vaginal reconstructive surgery, you will need your doctor to advise on whether it is safe to resume.

How can I avoid pain during intercourse?

While it can help to experiment with sexual positions that shifts weight away from your ostomy, supporting yourself with a pillow, and the use of sexual lubricants, the most important help is to talk openly with your partner about these changes, and to try not to feel self-conscious because of the operation.

Also remember that there are other ways of having sex than intercourse.

What to do with my pouch?

Firstly, keeping the pouch clean and empty is a good idea. You may want to put a new pouch on beforehand, and there are several good options if you'd like to use a smaller pouch.

Some people switch to an ostomy cap. Other people may switch to a smaller mini-pouch or a closed-end pouch. All of these choices are smaller, less bulky and more discreet.

What can I wear to feel more confident?

Men might consider wearing a tank top that covers the pouch or a cummerbund-type garment to help secure the pouch.

If you are a woman, intimate apparel such as a chemise, a corsage or camisole can help you feel attractive while still covering your pouch completely. Crotch-less underwear might also be an option to provide more support for the ostomy, as your body moves.

Another product option is a pouch cover, which can come in an array of different colours. This may allow you to feel more confident.