The Connection Between Ulcerative Colitis and Male Sexual Function
Almost 40 percent of men say their sexual desire has decreased because of their Irritable Bowel Disease (IBD); over 25 percent say IBD prevents them from having sex and about 20 percent of men say it’s caused problems for them during sex. IBD is a chronic condition that affects 1.6 million people, and men are equally affected as women. It’s usually diagnosed between the ages of fifteen and forty. Of course, those are the years when men are the most sexually active. The disease causes numerous side effects and interrupts a man’s sex life both mentally and physically. Not to mention, treatments for IBD, like surgery and medications, can cause mental and physical scars too. Let’s discuss how IBD negatively affects male sexual dysfunction and what we can do to help improve sexual desire.
Effects of IBD
IBD, including ulcerative colitis and Crohn’s Disease, causes severe diarrhea, abdominal pain and cramping, fatigue, and weight loss. When a man’s IBD is flared up it has more severe effects like arthritis, blood clots, bowel obstruction, anemia, ulcers from the mouth to the perineum, fistulas, and anal fissures. These embarrassing effects definitely have an effect on a man’s sexual desire and self-confidence. IBD also causes systemic effects like chronic pain and arthritis which can affect sexual performance. One in three IBD patients complain of chronic pain and twenty percent have arthritis. Arthritis may make it difficult for a man to feel pleasure.
Sex Isn’t Necessarily Intimacy
Although a man may be able to be sexually active, there’s a difference between having sex and being intimate. When someone has sex, he or she can disconnect emotionally to fulfill a physical need. Intimacy involves emotional closeness. A closeness first to yourself and second to your partner. Many times, the effects of IBD causes depression and anxiety. This makes it difficult for a man to be intimate. Fear can also hold a man back, as in fear of failure to perform and fear of rejection. Too much sex without intimacy can lead to more depression and anxiety, leaving a man discouraged and wondering how he can ever be intimate with his partner. Men with IBD suffer from both physical and emotional ailments. When a man has active IBD, there is a direct link to erectile dysfunction and decreased sexual function. Depression affects men emotionally by impairing sexual function.
Decreased Sperm Count
Another side effect of IBD is a decreased sperm count. Recently, the World Health Organization (WHO) performed a study comparing men with Crohn’s disease, men with ulcerative colitis, and men in a control group. They found that men with Crohn’s disease had a lower sperm count and lower quality than those with ulcerative colitis and the control group. They also reported that there were no differences in sexual performance between the IBD group in remission and the control group. This makes sense because if the disease is in remission the symptoms are not affecting a man, therefore he’s not as self-conscious or anxious about performance in the bedroom. However, a decreased sperm count may lead to emotional problems between a couple trying to conceive a child.
Corticosteroid Therapy
Corticosteroids are commonly prescribed to treat IBD. Corticosteroids cause terrible body image issues because they can cause acne, mood swings, weight gain, stretch marks, and excessive hair growth. They can also cause nausea, muscle cramps, and nervousness. Having sex is a little difficult when you’re nauseous and dealing with muscle cramps. The only positive about corticosteroids is that as a man starts to go into remission the dosage can be backed down which reduces the side effects.
Stomas and Pouches
Severe IBD can require a man to have a stoma or pouch. A concern for a patient with IBD is how a stoma or pouch will affect intimacy and their sex life. Stoma surgery leaves a patient with a hole where a bag attaches to collect feces. The bag may have an unpleasant odor and cause a man to be self-conscious in sexual situations. Pouch surgery removed a patient’s colon and rectum and forms a pouch inside the body with the patient’s ileum connected to their anus. Most people who have pouch surgery say their sexual function increases because they are more comfortable than prior to surgery.
Benefits of Pouch Surgery
Pouch surgery for ulcerative colitis (UC) has helped to eliminate many symptoms of UC and improves a man’s life significantly. Following pouch surgery, about half of the UC patients report improved sexual satisfaction. In a long-term study, ninety percent of UC patients said they were satisfied with their sexual health following pouch surgery. Patients who have had UC pouch therapy report long term symptom relief, elimination of medications, and an overall more satisfying lifestyle.
Be Open with Your Gastroenterologist
Your gastroenterologist wants to help improve your overall life and that includes your sex life. If you feel stressed about your IBD and the effects it may have or is having on your day to day sex life, contacts your doctor. And be open to a discussion. Without communication between you and your doctor, you could develop worse symptoms like depression and withdrawal. Don’t be embarrassed. Remember the statists mentioned earlier? Almost 40 percent of men say their sexual desire has decreased because of their IBD, over 25 percent say IBD prevents them from having sex and about 20 percent of men say it’s caused problems for them during sex. You are not alone. Ask your doctor about depression medication or about reducing your corticosteroid use. Possibly consult a sexual health therapist to become more informed on different sexual positions to use if you’re in pain.
When you’re living with IBD so many things are affected - from your GI tract to arthritis to sexual dysfunction because of low self-confidence. The disease causes numerous side effects and interrupts a man’s sex life both mentally and physically. Embarrassing effects like bowel obstruction, diarrhea, and anal fissures definitely have an effect on a man’s sexual desire and self-confidence. When a man has active IBD there is a direct link to erectile dysfunction and decreased sexual function. Sperm count in men with Crohn’s disease is decreased and of lower quality than those with ulcerative colitis. With treatment for IBD, the greatest concern for a patient is how a stoma or pouch will affect intimacy and their sex life. However, ninety percent of UC patients said they were satisfied with their sexual health following pouch surgery. The most important thing for a man to remember is to be open and honest with your gastroenterologist. Their job is to help you improve your life both physically and mentally. They want to treat your IBD and that includes any sexual dysfunction you’re experiencing.
References:
http://www.gastrohep.com/news/news.asp?id=112671
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008960/
http://www.foxnews.com/health/2016/12/05/for-men-with-crohns-disease-sex-can-be-challenge.html
http://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/home/ovc-20343407
