Sex and the Single Ostomate Fact Sheet

So You Have an Ostomy

Individuals with ostomies have proven that they can achieve anything they desire. An ostomy alone is not a deterrent to any activities you are otherwise capable of and that includes your social life.

Whether a person desires companionship, active participation in sex, or a serious romance leading to marriage, how one's surgery will be accepted by a potential partner or friend is a normal concern.

Body image is the way we see ourselves in the mirror and like to imagine our appearance. Although the change seems so great to oneself, most others do not see the ostomy as changing in any major way the person they love. Harmony within oneself precedes harmony in a relationship.

Sharing the News

1. Whom. You can choose whom you want to tell. Sexual partners will naturally have to be told because, covered or uncovered, the stoma or pouch will be apparent during intimate moments. You should tell a prospective marriage partner, because being open and honest is important to the success of any marriage. In addition, the reaction to your disclosure gives a good indication of the person's feelings about the whole you.
    
2. When. You can pick your time to tell but it seems better to tell early in a relationship. This not only relieves your anxiety, but also if there is an adverse reaction the letdown is not as harsh as it might be later. Most people prefer to tell at a time when there is a calm and understanding mood with their partner. Do not wait until "discovery is imminent."
    
3. What. When you explain the surgery, do it clearly and confidently, with self-assurance. Start with a simple explanation. You need not be too detailed and technical at this point. Emphasize that this type of surgery was necessary and that managing your ostomy does not interfere with your activities and enjoyment of life.
    
4. Rejection. People do not fall in love with, or like, everyone they date. Nearly every would-be lover gets his or her share of romantic rejection. Individuals with ostomies are no exception. When you experience rejection your ostomy may seem to be the only reason for rejection; however, chances are it is really only a convenient excuse. Be sure it is rejection and not misunderstanding. Allow enough time for him, or her, to think it through.

Preparing For Sex

Just as you attend to personal hygiene when anticipating intimacy, ostomy hygiene is also important. Of course, good ostomy hygiene should always be practiced:

1. The covering for regulated or continent ostomies should always be clean and neat.
2. The pouch for other ostomies should be clean, neat and fastened securely. The pouch should be odor free and preferably opaque. If transparent, use a pouch cover.
3. Unless sex is absolutely spontaneous, the pouch should be emptied beforehand.

During intimacies, especially the first encounters after surgery or with a new partner, your partner may have a fear of hurting your stoma or dislodging your pouch or covering. Intercourse will not harm the ostomy nor will most positions disturb the pouch or covering.

Women can accomplish covering the pouch or stoma area by wearing a sexy shorty nightgown or crotch-less panties. Some men wear cummerbund type coverings, which encircles the midsection and the pouch can be tucked up out of the way. A pouch cover can be worn. There are many products available that can be purchased or you can make your own covering.

Physical Sexual Limitations

1. A physical impairment that affects genital sexual relations can occur with ostomy surgery, but people to whom this happens must realize there are also ways for them to enjoy sex, intimacy and marriage.
    
2. Extensive surgery in women may cause a physical impairment resulting in painful intercourse the first few times after surgery to remove the rectum. A decrease in clitoral feeling and possible inorgasm may occur.
    
3. Male potency can be affected by ostomy surgery because necessary surgical procedures may interfere with the nerve pathways that control the male's ability to have an erection or to ejaculate. Every male with an ostomy should consider psychological factors before jumping to conclusions that an erectile problem is physically caused.
    
4. Any man or woman who has doubts or questions about sexual function after an operation should discuss the matter with a medical professional.

Additional Concerns

Ostomy surgery knows no demographic bounds. It also happens to people who are homosexual. The same concerns and anxieties are present in gay or lesbian relationships. Apply the same principles for coping with telling, rejection, and preparing for sex.

Since the closing of the anus may present a sexual impairment for some individuals with an ileostomy or colostomy, modifications for sexual fulfillment are necessary. The fact that a person is homosexual should be confided to the physician or surgeon if it is at all possible.

Seek Professional Advice

Any sexual difficulty should be addressed by medical professionals, first the ostomy surgeon and/or the WOC(ET) or ostomy nurse. Referrals may be made to gynecologist, urologist, therapist or counselor.

Note: More detailed information can be found in the Sexuality Guidebook (Adobe PDF, 2.4 MB) which can be downloaded from this website.

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