Sex and pregnancy after a stoma operation
When to resume your sex life
Initially you might find that sex is the last thing on your mind. You will have undergone major surgery so take your time to recover until you are fit and healthy. In some cases you may have temporary nerve damage or scar tissue – these issues usually resolve themselves with time. Remember: there are no specific guidelines as to when to start having sex again. Everyone is different and it is best to be guided by your own feelings.
Having a stoma is a sudden change to your body and it may take time to adapt to the way your body looks. Do share your thoughts with your partner and continue to show warmth and physical affection towards each other. Although you may be shy at first, your stoma should not affect your sex life and vice versa. Some of the following may help.
- Change your bag before sexual activity
- Try experimenting with attractive underclothing
- Stoma covers can prevent the bag from sticking to your skin and are available in many styles and materials
- A mini bag or cap can be used
Sometimes pain can be experienced during sex or the desire for sex goes. This is usually a temporary situation so do not be unduly worried. You may be in a new relationship and not yet started a sexual relationship. It is down to you as to when to inform your partner but it is probably better to let them know before you become intimate. If you would like further advice, organisations such as Relate may help.
Having a stoma should not affect your fertility but you should discuss this with your stoma care nurse or GP. For women who have had ileostomies, the contraceptive pill may not be ideal as it might be passed through the body before being fully absorbed. Again, discuss this with your medical team.
A stoma does not prevent a successful pregnancy and birth although it is wise to wait a while after surgery and seek medical advice before attempting to conceive. The stoma can protrude more than usual in mid pregnancy but it tends to revert to its normal size afterwards.
If you have had a urostomy, you can face specific issues. Impotence and other sexual problems often occur in men after bladder surgery: you will have been advised if impotence is a possibility. Your medical team will counsel you and may refer you to a urology specialist nurse. Younger men who have the surgery will probably be offered sperm banking. Don’t despair if you do experience impotence – there are several helpful solutions, such as penile implants, injections, tablets, vacuum pumps etc. In some cases after the operation there may be some local nerve damage or scar tissue that causes difficulties. Problems often resolve themselves with time and understanding. If the ability to have an erection after stoma surgery persists, do seek advice from your surgeon or stoma care nurses as there have been many advancements in treatment for erectile problems, sometimes as simple as taking a tablet.
Vaginal pain, vaginal tenderness or a lack of lubrication may make sexual intercourse painful for women following bowel surgery. This will tend to be short term and the tenderness will disappear as the inflammation and swelling from the surgery subsides. The following may help.
- Try a different position during intercourse
- A water soluble lubricant available from you chemist
- Treatment with a hormone replacement
- Oestrogen cream