LET’s get it on
For most ostomates, a stoma has little or no effect on the ability to enjoy sex, regardless of sexual preferences or lifestyle before surgery. Sexuality is a diverse and deeply personal thing, affecting who we are and how we express ourselves. It forms the sexual feelings and attractions we feel towards others. No matter how important sexuality is to you, we all have thoughts, desires and attractions and values that are unique to us.
It is normal, following surgery with the formation of a stoma, to feel less sexually confident and we will do our best to address these concerns here tastefully but honestly.
There are many things that you are having to come to terms with following ostomy surgery; your condition, the stoma, the change in your lifestyle and routine and most importantly your confidence.
You may feel unattractive and fear rejection from your partner or loved ones There is also the factor of the unknown, such as not knowing if things will feel different, and worries about the potential risk of pouch failure, during moments of intimacy and these feelings are natural. It is important that you discuss these concerns with your stoma care nurse, who is well qualified to address your questions and any worries that you may have.
It is also vital that you talk honestly and openly with any current or future partner as they have shared your experience and may actually be feeling the same way.
COMMON concerns and feelings
- Initial anxiety due to physical changes and fear of injury
- Feelings of loneliness
- Fear of rejection
- Fear of embarrassment
- Inability to achieve an erection / orgasm
Let’s Talk about Sex
When is sex safe after surgery?
Allow time to recover your strength and for you both to feel confident and comfortable. Promote intimacy by touching, holding and kissing.
Remember – intimacy need not involve sexual intercourse. Find the most comfortable position and experiment with different po
Allow enough time for healing before trying to regain your full sex life but do not forget about touching, kissing and sharing a bed as these can help provide the intimacy that you and your partner need.
When should I tell my new partner about my stoma?
If you already have your stoma when you meet your partner you may have a number of worries such as when should I tell them, and how will they react. Get to know the person first.
You will know when the time feels right, though ideally before you initiate intimacy as this will make the experience less stressful. If it doesn’t turn out as planned don’t blame it on the fact
that you have a stoma. This can happen to anyone and is always painful.
The most common problem for men tends to be related to achieving or maintaining an erection long enough to ejaculate. In some cases, some types of colorectal cancer can result in removal of the nerve pathways that cause erections, but in most cases it is just a case of time and patience. Erectile dysfunction can cause a lot of anxiety before sex, especially if it has happened to you already and you are worried it may happen again, and during sex if things are not going to plan.
Remember, knowing that this could be an issue means you should try not to put pressure on yourself as it can add to the affect. It may take time after your initial recovery to achieve this but if you continue to experience problems speak to your stoma care nurse as it is a common issue that they will have experience with.
The most common problem for women after surgery is the possibility of vaginal dryness which can be uncomfortable and can reduce pleasure. It may even be enough to put you off. In some cases, colorectal surgery can result in the vagina changing shape and structure. This can be overcome by using a lubricating jelly or lubricated condoms. Your doctor may also be able to advise you of other solutions suitable to your individual situation. Be patient – try to relax and not get stressed. Should problems arise, they are often temporary.
Tips to help prepare
- Discuss with your partner in advance where you would like the evening to go. This will help to set expectations and reduce any undue anxiety. Remember you may just
want to go to first base! Relax! Create a romantic atmosphere and maybe even go through the ideas of different positions that you can try. Doing this in advance not only helps to prepare, it also helps to break the ice and get you both in the right mood.
- You may have a ritual that you like to go through like washing, brushing your teeth, wearing something sexy or lighting candles.
- Empty or change your pouch before and maybe even pop in a sachet of Trio Pearls® super absorbent gelling sachet. This can give you peace of mind and help to avoid leakage. The gel is designed to flatten under pressure, so is ideal for this type of activity.
- You could ask your stoma nurse about the use of loperamide to thicken your output to avoid accidents
- It may even be possible for you to wear a smaller more discreet pouch temporarily, fondly referred to by ostomates as ‘shag bags!’. Most manufacturers of pouches have mini bags which you can request.
TRACEY’s T I P
Tracey Virgin-Ellsiton- Stoma Care nurse
I’m worried about my pouch – will it come off, or leak under pressure?
“It is normal to worry when trying something new, but in reality in most cases it will be fine. You’ll only need a little preparation. Empty the pouch beforehand, and, for women, think about wearing something to bed that makes you feel confident and comfortable. And, having a sense of humour about it all helps, too.”
Minimise anxiety – it’s a bit like your first time, most people rarely enjoy their first time because they are too busy worrying if they were ok, but it always gets better! If you can address most of the things that you are worrying about you are more likely to enjoy your first experience with a stoma.
Libido – sex drive and the bits-and-pieces can be affected by stress and tiredness. It is normal to feel both but with time, and support from your partner, you will find they will return to normal again.
Take it easy – intercourse can be painful the first couple of times after surgery, especially if it is fairly soon after surgery or if it has been several weeks/months since your last time.
Variety – sex doesn’t have to mean penetration. Foreplay, oral, masturbation, toys, and any number of other sexual activities can be enjoyed.
Prepare – for odour management, Trio Pearls® has an active deodorizer called NanoActive™, it will not only deodorize but also thicken output to avoid leaks too. Burn candles and/or incense. Empty the pouch beforehand when time allows. Keep everything clean and neat beforehand and pop in a sachet of Trio Pearls®.
Check all fasteners and adhesives to ensure they’re secure.
For a partner of a new ostomate
- Your partner needs you to be supportive as they will be going through many emotions that are not even relating to sex
- Being patient with them will help them more than you know, but its important that they know you are ok with this
- Showing them that you still find them attractive and showing interest in their stoma will help them realise that you are not bothered by it
- Listening to what is making them feel awkward will help you to know how you need to respond to them, it may be something you never even thought of