Frequently Asked Questions
Any concerns should be addressed and doing so early in your recovery will create more openness and honesty between you and your partner. Waiting until just before the first time you have sex might be a set-up for unmet expectations, disappointments, and intimacy problems down-the-road. Issues you might want to address include:
Pouches are odor proof, but if you’re concerned, deodorizers are available and can be put in the pouch just prior to sex. There is also a tablet called Devrom that is available where most ostomy supplies are sold. When this is taken regularly it completely removes any odor from the stool.
As you get used to your ostomy and start enjoying sex again, you might worry about your pouch leaking. Before having sex, empty your pouch. You might even want to put on a brand new pouch. You can use an opaque pouch so that if there is stool in the pouch during love-making, it’s not as obvious. You can tape the flange and pouch down to secure them to your belly so they don’t accidentally come apart.
You may wonder if you’re ever going to get used to having your stoma on your belly. Gradually, you will begin to accept this change in your body image. You will initially be aware of your stoma in all situations, but over time you’ll think about it less and less. Some people find it helpful to give their stoma a name, such as “redhead” or “rosebud”. This helps to be more objective about dealing with your stoma.
If you’re feeling self-conscious about how you look or are concerned about how your partner will view your ostomy, the pouch can be concealed with an attractive cover. Zippered underwear or boxer shorts can be worn by men and crotchless underwear are available for women which will completely cover the pouch. An undershirt or nightgown can also be worn, or a tube top can be pulled down around your waist. Some stomas can be covered with a stoma cap. This doesn’t have to be a forever thing. As you ease back into sex, you might choose to skip the cover-ups.
You might want to consider making love by candlelight or putting a colored bulb in the bedside lamp. Of course, you can always make love in the dark.
At times, the stoma can make unexpected noise which can’t be controlled. No matter when the noise occurs, it can be embarrassing. Coming to terms with the noise factor will help you deal with it gracefully. Many people find it helpful to handle these situations with a sense of humor, making light of the noise. A gas reducing product, Beano, can be used to decrease gas prior to social and sexual relations. Being mindful of what you eat can also help. Avoid beans, fatty and spicy foods, and carbonated beverages to reduce gas production.
The stoma has no nerve endings so will not hurt with various positions during sex. A small amount of bleeding can occur when there is friction against the stoma because there are many blood vessels in the stoma itself. This is not serious and should be expected. If there is a large amount of blood, consult your surgeon.
It is always tricky to approach the topic of your ostomy when you are dating and exploring intimacy. Honesty is the best policy. When you feel comfortable with your partner, explain that you have an ostomy and why. It’s helpful to discuss it up front before entering into an intimate situation. You are who you are, and if you are comfortable and confident about your body, this will help your partner to accept you and feel at ease in your personal and sexual relationships.
Your fertility may be affected by surgery, chemotherapy, or radiation. For men, if your prostate was removed during surgery, you will be unable to produce semen and therefore will not ejaculate. Other treatments might also affect your sperm count, making it difficult to conceive a child. For women, various treatments might also affect your fertility. If you’d like to have a child in the future, speak to your surgeon or physician prior to starting treatments. Men may be able to donate sperm for future use. Women may be able to harvest eggs to be stored for pregnancy down the road.
If you are a male, usual methods of sex might change with the creation of an ostomy. If your rectum has been removed, anal sex is no longer an option. Your stoma should not be used as a substitute for anal intercourse. You can damage your stoma by doing so. There is a possibility that during surgery, your rectum can be left intact. Speak to your surgeon about your sexual orientation prior to surgery and options for sex afterward. For both males and females, alternate forms of sexual expression should be explored. Masturbation, oral sex, and sexual enhancers can be considered. For men see the discussion on impotence.
Your surgery, recovery, and adjustment to your ostomy can influence your desire for sex, arousal, or ability to reach orgasm. Your surgery might affect the sensation in your pelivs. It often takes up to 6-12 months to recover sexual function after surgery. Once you’ve recovered and can think about intimacy again, recapturing your sexuality is an important piece in returning to a whole person. With your partner’s help, resume familiar foreplay and patterns one step at a time. Be open to new forms of sexual expression. You may have to work up to intercourse. Be patient with yourself but keep trying.
It is natural that you might feel nervous about having sex. Remember to talk to your partner about your feelings. Prior to relations, you can practice relaxation techniques such as soft music and a warm bath, meditation, or a back rub. If you can’t overcome your anxiety and suspect there may be an element of depression, talk to your doctor. You may need an anti-depressant to get you back on track to feeling yourself.
Return to a regular exercise program as soon as you can. Exercise will help energize you, help keep your weight in check, and promote a healthy sleep schedule. It can also help reduce anxiety and depression. Plan for sex during the time of day when you feel the best. Eat a healthy, balanced diet to stay strong.