Stoma surgery is a major change to your body, and it’s natural to have questions about how it will affect your sex life. The good news is that having a stoma doesn’t mean you have to give up intimacy or sex; it won’t harm your stoma. In this guide, we’ll cover practical tips for having sex with a stoma, how surgery may affect sexual function, and how to build confidence in intimate relationships.
Can you have sex with a stoma bag?
Yes, you can have sex after stoma surgery. There’s no strict rule on when you can resume sexual activity after stoma surgery, although it is generally advised to wait for at least a week and up to 6 weeks. Listen to your body and don’t rush. It might take you a while to get to the point where you feel comfortable having sex again, and this is okay.
With the right steps, you should be able to live life as normal following stoma surgery, including intimate relationships and sex. Your stoma does not have any nerve endings, and so should not hurt or have any sensations during sex. In fact, it should have a very minimal impact on your sex life – if any at all.
You might feel embarrassed, but it’s important to bring sex up with your stoma nurse, ideally before surgery and especially if you are experiencing sexual problems after surgery. They can offer individualised advice for you.
How stoma surgery can affect sexual function
Stoma surgery can sometimes affect sexual function for men because it may damage the nerves responsible for erections, resulting in erectile dysfunction or reduced ejaculation. For some people, function comes back over time, but for others it doesn’t. There are treatments available, so talk to your stoma nurse about this.
For women, stoma surgery can result in some dryness, so the use of a lubricant may be helpful. Remember not to use an oil-based lubricant with condoms, as they can affect their reliability.
Open surgery is more likely to result in sexual dysfunction than keyhole surgery. Other treatments, such as radiotherapy, may also impact sexual function.
However, it should be noted that some reduced feelings of desire and pleasure may not be physical and caused by the surgery itself. It could be caused by anxiety or an emotional response to the surgery, or even fatigue. That’s why it’s important to give yourself time, and communicate openly.
Communication with your partner about sex with a stoma
You might experience problems with your body image or self-esteem following surgery. Remember that you are still the same person that your partner was attracted to before surgery. It might help to voice your concerns to them and ask for reassurance if you are feeling anxious or insecure.
The chances are, your partner is just as anxious as you. Reassure them that they can’t harm your stoma during sex. You might want to send them this guide to read: Supporting your partner with a stoma
Communication is key both before and after sex, so be sure to establish boundaries and make it a relaxed experience. The most important thing is that you both enjoy it. Take it slowly and do what feels right.
You are just human, and sex won’t always be perfect. Keeping it lighthearted and fun can help to diffuse any tension. Your stoma may make a noise, but it’s okay and can happen to anyone with or without a stoma – just laugh it off!
If you are single
There is no right or wrong time to tell a new partner about your stoma. You may not want to tell them at all. However, if you are hoping for it to be a long-term relationship and/or for it to involve sex, it’s probably best to get it out in the open sooner rather than later. It might help to have something prepared to say to ease any nerves.
Finding comfortable positions for sex with a stoma
Depending on the extent of your surgery, you may find certain sexual positions uncomfortable. This might be because your internal organs have moved marginally during surgery or because of scars. Experiment until you find a position that is pleasurable.
You can have sex in ways that do not involve penetration if it is uncomfortable for you or you do not feel ready. You can also engage in non-sexual physical affection to slowly build up your confidence, like hand-holding, cuddling and massages. These NHS leaflets have lots of helpful information, including for members of the LGBTQ+ community.
Be cautious if partaking in anal sex if you have a perineal wound. Anal penetration is not possible for Barbie/Ken butt surgery patients.
Never insert anything into your stoma. It can cause serious injury and is very dangerous. It may result in further surgery being required.
Preparing for sex with a stoma
Taking a few steps before engaging in sexual activity can help you to feel at ease:
- You may wish to empty/change your pouch.
- Some manufacturers offer smaller stoma bags which you may want to opt for during sexual activity as a more discreet option. Remember, though, that they have a lower capacity and may need emptying more often.
- However, you can use your normal appliance if it’s most comfortable and secure for you. Some stoma bags can be folded up.
- If properly sealed to your skin, there’s no reason why your stoma bag would come off or be unsecure during sex. But if this is a concern causing you anxiety, you could try improving the adhesion using flange extenders.
- You may also want to wear a stoma belt to keep your bag secured to your abdomen during sex.
- You might want to use a stoma bag cover to make it feel less clinical and more aesthetically pleasing.
- You might prefer to keep some clothing on during sex to conceal your stoma bag. It’s completely up to you and there’s no wrong answer.
- You can wear the same underwear that made you feel sexy before you had your stoma. However, some shops sell specialist underwear designed for ostomates, such as M&S, cuiwear.com and Vanilla Blush.
- You might want to avoid foods that you know are likely to trigger stoma problems. Read more in our guide to foods to eat with a stoma
- There’s no need to worry about odour coming from your stoma during sex. Read our guide to stoma odour
Contraception
Speak to your doctor regarding the best contraception options when you have a stoma. Your stoma should not affect your ability to conceive.
If you have an ileostomy, oral contraceptive pills may not be fully absorbed due to the shortened small intestine, which means they may be less reliable. Your doctor can advise on alternative contraception methods that will be more effective for you.
Conclusion
Having a stoma is a significant adjustment, but it doesn’t have to stop you from enjoying intimacy and sex. Take your time, communicate openly with your partner, and don’t hesitate to seek support from your stoma nurse if you have concerns. With patience and the right approach, you can have a fulfilling sex life with a stoma.
Although all our articles are written alongside qualified medical professionals, this information is for guidance only and does not replace advice given by your healthcare advisors.
Further reading
Why is my stoma bag not sticking?
