Love and Sex for Persons with an Ostomy

The month of February is said to be the love month since it is the time of the year that Valentine’s day is celebrated. We get to wear red and enjoy sending and receiving chocolates, bouquet of roses, cards and what not. Ostomates get to enjoy this love month too. We are no strangers to success stories where couples even as ostomates and their partners have begotten and raised their own children. We hope that the information below will be able to dispel myths that people with bags no longer enjoy meaningful relationships and even sexual encounters with their love ones. It provides some general advice about sex and related matters for people who have had stoma surgery.

Love and Sex

People with an ostomy would definitely have many adjustments to do in order to sustain a relationship as a single or married person. Stomal surgery can affect sex both in the physical and psychological aspects. Any procedure that makes a person look or feel different is likely to have an effect on their body image. It can cause anxieties about personal attractiveness. Additional anxieties occur regarding sexual ability particularly the effect of the ostomy on one's partner, and the possibility of an "accident" with embarrassing consequences occurring.

Many ostomates wonder if they will be able to have children. They wonder how they will physically make love while wearing an appliance. The answers to these questions depend on a number of things namely: one’s illness, the type of operation one underwent, one’s age and gender, and one’s attitude.

Relationships and Self-confidence

When you are fully clothed, no one needs to know that you have an ileostomy, colostomy or urostomy. However, with no clothes on, the bag can hardly be ignored. One’s partners of long standing who have shared the experience of illness and surgery will share in the adjustment period. What is beautiful is that for a couple in a loving caring relationship, the novelty of the appliance soon wears off and it can be largely ignored.

However, this may not be possible when an ostomate has a new partner who is unaware of one’s earlier illness. It is wise to explain to a potential new partner that you have an appliance. One rehearses a short explanation before getting into the situation. Incidentally, if one tells a prospective partner about one’s stoma, it is always prudent to be prepared for the fact that one might be rejected. This is always an unpleasant experience; the only consolation is that people who don't have stomas get rejected as well. It is also true that if you get rejected it is not necessarily because of the stoma.

If a relationship is becoming serious, it is important to discuss the situation before the relationship gets physical. Of course, not all sexual relationships occur after you have had time to get to know someone well enough to discuss such matters.

In the final analysis, an ostomate has a choice in one’s social and personal relationships. This includes sexual relationships with long standing partners or new partners and indeed in non-sexual relationships with friends, relatives and work mates.

One can either present oneself to the world as a sick person or as a well person. If you think of yourself as a sick person and play that role, you will give people the impression that the only thing that matters about you is your stoma. If you do this, other people will very likely respond by treating you like an invalid. On the other hand, you can present yourself to others as someone who was ill and now has a stoma which is part, but not the only part, of your life. There are other aspects of you that are much more important that your stoma; your job, your family, your good looks, your wit, your charm or whatever. Others will take their cue from you. If you are able to show that while you recognize that you have your stoma, it is not important in terms of the way you want to live your life, then that is what will most likely occur. If you want to be an invalid and you want to be treated by other people as an invalid, you will never enjoy a good healthy relationships and sex life.

Making Love

How do ostomates make love? The answer is that they make love in exactly the same way as people without stomas do. All the conventional lovemaking positions are usually possible for ostomates. It is a matter of taste and a matter of what you are comfortable with.

Remember that being tender, loving, kissing and touching are all part of making love. You will need to take it gently and the tenderness and friendliness that are part of the pleasure of lovemaking is where you should begin.

The simplest problem facing the ostomate is the appliance that may impede movement and get in the way. If the appliance is emptied before intercourse it can be folded up and trapped down with some tape. Keep a nice cotton cover over the appliance at all times as wearing a cover stops it rubbing on yours and your partner’s skin.

The Male Ostomate

The greatest difficulty and the most common one, which men are likely to encounter post-operatively is impotence. It is a highly complex phenomenon and may occur in men of all ages and can occur for many reasons which have nothing to do with surgery directly.

The good thing here is that this problem can be corrected by simple changes in lifestyle.

Do you try to make love when you are very tired? Are you using drugs and/or alcohol in a way that is depressing one’s sex drive? Are you trying too hard to make love, rather that treating it as a natural ordinary thing to do? The correct attitude is to be sensible. Do not try to do too much and see if going to bed earlier when you are not so tired or drinking less, will help. If these simple remedies don't assist, then it is worth seeking a medical opinion. But remember, gentleness, tenderness and being relaxed, as well as having a positive self image, is essential to a happy and enjoyable sex life.

It is ascribed by science that impotence is more likely usual for men having a colostomy than an ileostomy because there is less damage to the tissues in the latter and therefore less risk to the nerve pathways. Surgery for bowel cancer is extensive and therefore more damaging.

Temporary impotence is not unusual following stoma surgery, so don't think that all is lost if, within a couple of months after surgery, you have not begun to have sexual relations. The healing process sometimes takes a long time. Even in the case of permanent impotence, all is not lost. Over the last few years medical science has developed surgical techniques that can help some impotent men, including ostomates.

The Female Ostomate

Having a stoma is not in itself a bar to having sex and having children. Normal birth with normal vaginal delivery is quite feasible and quite common. This is, of course, dependent on the reproductive organs being undamaged and working normally. Having a stoma as such will have no effect on these; the pre-existing disease however might.

As far as the mechanics of sexual intercourse are concerned, there are several typical problems which the female stoma patient might experience. The first of these relates to the way the perineal wound heals. (The wound left when the rectum is removed). It sometimes remain tender for a considerable time following surgery and thus sexual intercourse can be painful. A second problem is that the space left when the colon is removed sometimes allows the uterus to shift backwards. This can cause pain during intercourse. Thirdly, some female ostomates find that there is a decrease in feeling and sensitivity of the clitoris. This may be due to the fact that the nerve pathways to the clitoris are impaired in surgery. Another frequent problem is vaginal dryness making intercourse difficult and uncomfortable. Finally penetration may be painful and uncomfortable, simply because of the scarring of the tissues following removal of the colon or bladder.
There are a number of solutions. For dryness, a lubricating jelly can be used. Surgical reconstruction of the perineal wound, particularly if sinuses are present, is possible. Lastly, trying different sexual positions is also a good idea if penetration is painful. If the rectum has been removed the missionary position may be uncomfortable.

Conclusion

We have examined the issues in general terms because to try to detail the entire different alternatives from all the possible diseases, the three major types of stoma, the different types of relationships people have, people's different ages and sexual experiences, would lead to a very long and complicated discussion.

In the end the best advice is to keep things in perspective. Sex can be fun, sex can be great; but it is only part of life. It is not the be all and end all of living