If you were sexually active prior to your surgery and this is important to you, then there is no reason you cannot be sexually active after your surgery. Of course it is always best to discuss with your Surgeon or Stomal Therapy Nurse (STN) when returning to a full sex life is possible, remembering the physical healing of your body may mean some limitations for a short time. Depending on why you have needed a stoma and what surgery has been done your doctors may have already talked to you about what this means for you, but if not, then ask to speak to your doctor specifically about this. You may find talking with your STN also helpful, they are good listeners and may offer you the reassurance you need, with some helpful advice thrown in. It is very normal to be anxious about sex now that you have a stoma.
If you are in a relationship try to be open and honest with your partner about how you are feeling. They may be as nervous as you are about the stoma, the pouch and how sex is going to go, but talking about your feelings together will help. The desire for sex, the physical arousal and the body’s abilities may be different for a while or may have changed entirely, but do remember that touching, kissing and cuddling are all ways to feel intimate and connected to your partner. Seek help if you are really struggling, by talking with your GP.
If you are not in a relationship, and are ready to start dating again after your surgery, you will know when the time is right to share details once you are comfortable to do so. When someone really cares about you, the fact you have a stoma should not matter.
If you are part of the LGBTQ community talk to your doctor or STN openly, sharing your situation and feelings will help discussion around your specific needs. If you are a gay male and have had surgery that includes removal of your anus you need to be aware that penetrating your stoma with anything is likely to cause significant damage.
If you normally use contraception, these will need to be continued after your surgery, as having a stoma will not affect your fertility. If you are female, you have an ileostomy and normally use the contraceptive pill, it is important to discuss this with your doctor or family planning clinic. Absorption of some medications can be affected when you have an ileostomy.
To feel relaxed and comfortable in the lead up to sex, some tips include:
- Change or empty your pouch prior, be happy that it is secure
- A smaller pouch may be a possibility, depending on the type of stoma you have and
- If you have an ileostomy it may be best to not eat a big meal prior, so your stoma is less active
- If you have a colostomy, deodorisers in the pouch may be helpful if you find gas an issue. Your STN may offer you some advice.
- There are some products on the market that may be worn to make your pouch more discreet, such as the Aurum Plus range which is available in sand or black.