Ulcerative colitis (UC) may be associated with sexual issues such as low libido and erectile dysfunction. Talking with a doctor can be the first step toward managing sexual dysfunction related to UC.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
UC is the most commonTrusted Source type of inflammatory bowel disease (IBD). It causes inflammation in the large intestine, which can lead to several symptoms within the gastrointestinal system and other parts of the body. It is a chronic condition, meaning it does not naturally go away on its own, and there is currently no cure.
Whether directly or indirectly, UC is associated with increased rates of sexual dysfunction. These dysfunctions may result from the physical symptoms of UC, the psychological and social effects of those symptoms, or a combination of both.
This article reviews the types of sexual dysfunction associated with UC and discusses how to manage them.
common psychological causes of low libido include depression or high levels of stress or anxiety, which are commonTrusted Source in people with UC. These feelings may stem from physical discomfort, a perceived lack of control over one’s own body, or even from the tension of deciding what to share with a sexual partner.
Body image issues
Living with any chronic condition can potentially lead to negative mental health outcomes. Some of the symptoms of UC, such as urgent bowel movements, diarrhoea, and rectal bleeding, might lead people to feel despair, hopelessness, or unhygienic.
Additionally, it is not uncommon for a person with UC to eventually require surgical procedures. These might cause scarring or necessitate the use of an ostomy bag for stool collection.
These factors could cause people with UC to feel negatively toward their bodies, particularly so from a sexual perspective. About 70% of people with UC experience body image issues, especially those who have undergone surgery.
Pain during sex
A common symptom of UC is abdominal pain. Pain of any intensity can be both distracting and distressing, and these feelings can conflict with sex and intimacy.
Pain may lead people to avoid or prefer not to have sex. Pain that arises during sex may lead people to stop sexual activity or at least to lose engagement. Even during times when pain is not present, the prospect of the return of abdominal pain could potentially cause people to avoid sexual activity.
Erectile dysfunction
Erectile dysfunction is the inability to get or maintain an erection. People with UC are more likelyTrusted Source to develop erectile dysfunction than those without the condition. The exact reasons for this link are not yet known, and research is ongoing.
One particular surgical treatment for UC called a proctocolectomy — the removal of the colon and rectum, in part or in whole — is associated with postsurgical erectile dysfunction. Between 0% and 26%Trusted Source of males experience erectile dysfunction after this procedure.
There is only limited evidence that medications for UC could lead to erectile dysfunction.
Discomfort from UC symptoms
Other symptoms of UC might cause people to avoid sex or intimacy. These can include:
- fever
- nausea
- fatigue
- an urgent need to have a bowel movement
These symptoms are broadly associated with feeling physically unwell and could cause people to seek restful and restorative behaviours, such as sleeping while avoiding physical activity — including sex.
People with UC can talk with their doctors to agree on a treatment plan to help reduce or manage these symptoms.
may cause erectile dysfunction and anxiety around sex and intimacy.Some medications to help treat UC may also affect sexual function. For example, corticosteroid use may increase the riskTrusted Source
of sexual dysfunction in females with IBD. It may also be associated with a decrease in sexual pleasure and ability to orgasm.
Other medications used to treat symptoms or conditions related to UC, such as selective serotonin reuptake inhibitors and opioids, could also contribute to an increased risk of sexual dysfunction.
Addressing sexual dysfunction and UC
UC-related sexual dysfunction can often be difficult to address due to the general discomfort people may feel around discussing their sexuality.
For people with UC experiencing sexual dysfunction — or concerned about developing sexual dysfunction — talking with a doctor may be a helpful first step toward preventing or improving symptoms. A different or additional treatment option may be available depending on the specific cause of sexual dysfunction.
People might also consider sharing their concerns with their sexual partners. This may help improve their ability to remain sexually intimate. While a person may not be able to be as spontaneous with sex, increased communication can help them maintain a healthy sex life. They may also be able to find other ways to be intimate with their partner that do not involve sexual intercourse.
Specialists, such as psychologists or sex therapists, can also help people manage body image issues, depression, and anxiety.
Summary
Ulcerative colitis (UC) is a lifelong condition, and learning to live with it in all areas of life is important for feeling whole and fulfilled. This applies just as much to sex and intimacy as to any other aspect of life.
UC or its treatments may lead to sexual dysfunction in one form or another. This is not uncommon, and it is natural for people to feel emotional about it.
Openly communicating with a doctor and sexual partners provides the greatest opportunity to address sexual dysfunction related to UC.
Some medications to help treat UC may also affect sexual function. For example, corticosteroid use may increase the riskTrusted Source
of sexual dysfunction in females with IBD. It may also be associated with a decrease in sexual pleasure and ability to orgasm.
Other medications used to treat symptoms or conditions related to UC, such as selective serotonin reuptake inhibitors and opioids, could also contribute to an increased risk of sexual dysfunction.
Addressing sexual dysfunction and UC
UC-related sexual dysfunction can often be difficult to address due to the general discomfort people may feel around discussing their sexuality.
For people with UC experiencing sexual dysfunction — or concerned about developing sexual dysfunction — talking with a doctor may be a helpful first step toward preventing or improving symptoms. A different or additional treatment option may be available depending on the specific cause of sexual dysfunction.
People might also consider sharing their concerns with their sexual partners. This may help improve their ability to remain sexually intimate. While a person may not be able to be as spontaneous with sex, increased communication can help them maintain a healthy sex life. They may also be able to find other ways to be intimate with their partner that do not involve sexual intercourse.
Specialists, such as psychologists or sex therapists, can also help people manage body image issues, depression, and anxiety.
Summary
Ulcerative colitis (UC) is a lifelong condition, and learning to live with it in all areas of life is important for feeling whole and fulfilled. This applies just as much to sex and intimacy as to any other aspect of life.
UC or its treatments may lead to sexual dysfunction in one form or another. This is not uncommon, and it is natural for people to feel emotional about it.
Openly communicating with a doctor and sexual partners provides the greatest opportunity to address sexual dysfunction related to UC.