Why an ostomy shouldn’t mean the end of intimacy...
There are no two ways about it: having an ostomy and learning to live with a stoma is daunting. There’s so much to get used to and, no matter how positive you are, the changes you face can sometimes be overwhelming.
It’s natural to feel worried or apprehensive about many aspects of life with a stoma, including whether you will be able to enjoy a sex life and, if so, what to expect? This is true, whatever your sexuality and whether or not you are in a relationship.
In the early days, your confidence will probably have taken a knock and you may feel that you don’t have much dignity left! That’s entirely understandable but be reassured - you will adjust. We’re all different and there’s no precise timespan for this so don’t be too hard on yourself. Whatever type of ostomy you have, colostomy, ileostomy or urostomy, take all the time that you need.
We’re taking a look at some of the myths and misconceptions around the subject and have put together some suggestions to help you and your partner – or prospective partner - to adjust and learn how to enjoy intimacy again, or for the first time.
Sex with an ostomy is all about the four Cs: taking care of yourself and your stoma, regaining your confidence, being considerate towards each other, and being comfortable.
Ostomy and sex – fact or fiction?
Having an ostomy means that I can’t have sex…
Definitely not true! You need time to recover from surgery and may have to make some slight adjustments, depending on the type of surgery you’ve had; for example, the sort of position that feels comfortable but there is no reason why you shouldn’t enjoy sex again. And, of course, sexual pleasure is not something fixed or static; it changes, gradually, and we respond in different ways, at different stages of our lives, and depending on what else is happening to us.
Having an ostomy means that I won’t be able to enjoy sex in the way I used to…
Well, you might have to make a few changes and be patient but if you and your partner are prepared to take things gently, to listen to each other, and to explore a little, you should find that sex is as enjoyable after an ostomy as it was before.
Having an ostomy means that I won’t be sexually attractive…
This is completely understandable and it’s a feeling shared by anyone who has had a mastectomy or any surgery that has altered their appearance. But it is not necessarily true – as many people who have adapted to life after an ostomy will tell you. If you are already in a relationship, your partner will know what having a stoma has involved for you.
Your specialist nurse may have discussed with you and your partner the impact this can have on your physical and emotional relationship – and the importance of taking time to adjust (see below).
If you don’t currently have a partner but hope to have one in the future, and to have a fulfilling sex life, it’s a question of gradually learning to rebuild your confidence and then taking things one step at a time when you embark on a new relationship.
The stoma odour will put my partner off having sex…
This is something ostomates (people who have a stoma) are often worried about but there are some excellent products available that prevent odour and give you the reassurance you need. You can find odour neutralising gels and sprays in the ostomy section of the Live Better With online shop, all designed to help you practise good ostomy and stoma hygiene and care.
Having sex will put pressure on my stoma and could hurt me…
The way you move and the body contact you have during sex shouldn’t damage or hurt your stoma. For extra comfort and reassurance, in particular during the early stages of adjusting to life after an ostomy, you could think about wearing a light control support belt that will hold everything in place. And we probably don’t need to say it but, just in case… you should never put your fingers, a sex organ, or other objects, such as sex toys, into your stoma.
How to discover the joy of sex – with a stoma
Take care of yourself and your stoma
It takes time to learn to cope with the practicalities of living with a stoma but you will gradually become accustomed to a new routine, finding out the type of stoma equipment, clothing, and care routine that suits you best you best. Get into the habit of emptying your ostomy pouch a short while before you prepare for intimacy. You’ll feel more comfortable and more confident, and you won’t have to risk spoiling a special moment!
Feeling confident after an ostomy - don’t rush
It’s important to take your time, whether you’ve just had an ostomy or you’ve been living with a stoma for a while. Having full sex is just one part of intimacy, not the only part. Don’t forget the importance of gentle touch. Take it slowly: allow yourself time to build up your confidence about yourself, your appearance, and your feelings. Some people find that they feel more relaxed wearing a soft bamboo, cotton or silk top that covers their torso and pouch.
Be considerate to each other
This is the single most important step you can take towards a happy sex life with your current or prospective partner: talk to your partner and listen to them too, mutual consideration is vital for intimacy. Do tell them how you feel and share your concerns; they will have concerns and feel anxious too. Take time out to reassure each other, before, during, and after sex.
Keeping everything comfortable
Some ostomy pouches have a comfort panel that will protect your partner’s skin. You can also use a cotton cover to prevent rubbing and, if you’re worried about your pouch coming adrift, an ostomy support belt (see above) will give you that extra layer of reassurance. You could also try a stoma cap/plug, which is smaller, less noticeable, and designed to be worn for short periods. If you also have a hernia, you may find that wearing a specially designed support vest helps you to feel more secure.
Ostomy intimacy knickers, which feature a discreet split crotch, give women ostomates extra stoma security, without having to compromise on style or sexiness!
Sex, stomas and cancer treatment – read all about it
Having an ostomy might have been just one part of your cancer treatment and you may have other treatment that could have an impact on your sex life. We’ve put together a list of free online articles and leaflets about cancer, sex, and living with a stoma that you may find helpful.
- The Live Better With Guide to Cancer and Sex has plenty of information and advice on what to expect and how different types of treatment can affect you and your sex life.
- Healthcare company, Hollister, has published an excellent online guide, Love and Sex with a Stoma, available as a free downloadable pdf via NHS Networks here.
- Intimacy and Sexuality For Cancer Patients and their Partners: a booklet of tips and ideas for your journey of recovery – produced by a specialist medical and sex therapy team and published by the Sexual Advice Association. Download a free copy here.
- The Live Better With guide to ostomy underwear
- The Live Better With guide to living with bowel cancer
- The Live Better With article How does a colostomy bag work?
For more help, advice and information
UK organisations that offer specialist information, advice and support:
Visit the Live Better With Cancer Community Forum – for information, advice, and tips on ostomy and sex and to share your own questions and suggestions.