Even when we are not in a relationship, our sexuality usually remains a key part of who we are and how we choose to live.
If you have Crohn’s or Colitis you may find that your condition can affect you in a number of ways. A common cause for concern, although people don’t always like to talk about it, is the potential impact of Crohn’s or Colitis on sex and sexual relationships.
This information has been written for people with Crohn’s or Colitis and their partners to provide information on this topic. It looks at how common Crohn’s or Colitis symptoms and treatments, and the feelings often associated with these, can affect the physical and emotional aspects of a sexual relationship. It also includes some suggestions that might help you deal with any difficulties, and details of other sources of help and advice.
Many of the issues covered in this information are likely to be very similar regardless of sexual orientation. However, people with Crohn’s or Colitis who identify as lesbian, gay, bisexual or transgender may be concerned about whether to talk to their IBD team about their sexual relationships. Whatever your sexual orientation, you may be concerned about how some treatments may affect your sexual practices.
In the UK, the age of consent to any form of sexual activity is 16 years old for both men and women. The sexual health charity FPA have further information on this.
If you are having sex, it is important to consider use of condoms to protect against sexually transmitted infections (STIs) and pregnancy. Visit the NHS website for further information on contraception.
Women with Crohn’s or Colitis taking oral contraceptives can be at increased risk of developing blood clots. Speak to your GP or IBD team if you have any concerns about contraception, and how that might be affected by your Crohn’s or Colitis, or medicines you might be taking for your Crohn’s or Colitis.
Tiredness and fatigue
Fatigue or extreme tiredness is a very common symptom of Crohn’s and Colitis. Diarrhoea, painful cramps, anaemia, and poor appetite or problems absorbing nutrients can leave you weak and lacking in energy.
As a result, you may be feeling just too tired for sex, especially during a flare-up and perhaps even too tired to explain.
However, if you can, you may find it helpful to talk to your partner about your tiredness. (See Talking to your partner for more about this.) It isn’t always easy for people in good health to understand fully just how exhausting IBD can be. Our information on Fatigue may be useful in this situation. This includes suggestions of ways to deal with fatigue and tiredness. It is also worth talking to your doctor about your symptoms. Fatigue can be difficult to treat but it may be that your tiredness or fatigue can be reduced by a change in medication or by treatment with an iron or vitamin supplement.
If you feel very tired at night, it might be worth timing sex for when you are less tired. It may also help to step back a little, and rather than always trying to have full sex, to look for other ways of being intimate with your partner. See the section on Being intimate.
Fistulas or abscesses
Some people with Crohn’s or Colitis, especially those with Crohn’s Disease, can develop abscesses, fistulas or scarring of the skin around the anus or around the vagina. (A fistula is an abnormal passageway or link between the bowel and the skin or other surrounding organs. For more detail, see our information on Fistulas.) These complications can be embarrassing and may make sexual intercourse extremely painful, or even temporarily impossible. If you have scarring of the skin, abscesses or fistulas, you may find using a lubricating jelly before penetrative vaginal sex is helpful. However anal sex must be avoided if you have significant stricturing (narrowing) of the anus, or abscesses or fistulas in this area. Make sure your doctor is aware that you have a fistula or abscess as these problems can often be treated medically or with surgery. Your doctor or IBD nurse will also be able to advise you on how to manage your fistula on a day to day basis, including which sexual practices are safe.