If you have inflammatory bowel disease, most of your treatment has likely been focused on…
Does talking about sexual health make you uncomfortable? For many women, discussions about sexual health start and end with 8th grade health class. This can make it very challenging to talk to your doctor about sexual health when the time comes. But this needs to change, especially for women with IBD who are experiencing sexual dysfunction.
Sara N. Horst, MD, MPH, a gastroenterologist at Vanderbilt University Medical Center, is helping to break the silence. Read on for her expert advice about sexual health and IBD.
Let’s talk about sex
One way to make the conversation about sexual health easier is to gain a deeper understanding of your body.
According to Dr. Horst, the “female sexual response cycle is complex and coordinated by many organ systems.” This includes your brain, hormones, and blood vessels.
There are many factors, both inside and outside of your body, that can influence your sexual response. It can be “impacted by personal experiences and influenced by cultural norms, societal and religious beliefs, general health status, interpersonal relationships, physical health, and previous experiences,” says Dr. Horst.
Sexual dysfunction in women
If you are experiencing some type of sexual dysfunction, it can feel very isolating. Dr. Horst tells us that sexual dysfunction is common, but unfortunately, the research on it is lacking.
Even though your friends and family may not be open to discussing it, Dr. Horst says that “40% of women report sexual problems at some point in their lives in the US!” She also notes that this number “increases as women age.” This doesn’t account for the cases of sexual dysfunction that go unreported.
Sexual dysfunction categories
There are three main categories of sexual dysfunction, according to Dr. Horst.
1. Sexual desire/arousal disorders
This category includes low and absent libido, or “hypoactive sexual desire disorder”, which is the most common disorder in the category.
Dr. Horst explains that these disorders “can be situational or related to age, chronic disease, gynecological disorders, [and] even use of certain medications.”
2. Orgasmic disorders
Disorders that cause a delay or inability to have an orgasm during sexual stimulation are grouped into this category.
3. Genito-pelvic pain/penetration disorders
This category includes vaginismus, a condition that’s characterized by an involuntary spasm of certain pelvic muscles that can make penetration difficult.
It also includes a disorder called dyspareunia, or pain in the pelvic area during or after intercourse.
Sexual dysfunction in women with IBD
Now that Dr. Horst has educated us about sexual dysfunction, let’s talk about what women with IBD need to know about sexual health.
Dr. Horst says that “IBD can affect sexual function” and goes on to tell us that “40-60% of women with IBD and 44% of men with IBD have reported dysfunction in studies!” As we’ve already talked about, many people are embarrassed to discuss these issues with their doctors. “In one study, only 40% of patients talked to their doctor about it,” says Dr. Horst.
Dr. Horst provided us with a comprehensive list of risk factors for sexual dysfunction:
- Increased IBD activity
- Things that can affect pelvic floor muscles such as perianal disease and pelvic surgery history
- Things that can affect body image such as surgery or an ostomy bag
- Hypogonadism in men (also known as testosterone deficiency)
- Medications such as corticosteroids, opioid medications, or certain antidepressants such as selective serotonin reuptake inhibitors (SSRI)
Treatment options for sexual dysfunction
Thankfully, there are many treatment options for sexual dysfunction.
According to Dr. Horst, treatment is “very individualized depending on the type of sexual dysfunction.” This means that it’s essential to work with your doctor to determine the root causes. Your doctor can then help you find the best treatment options.
If there is pelvic floor muscle involvement, treatment includes a “multidisciplinary approach with [your] gynecologist, gastroenterologist, surgeon, [and] mental health provider.” Dr. Horst also emphasizes that a specialized type of physical therapist called a pelvic floor physical therapist can be helpful.
It’s a good idea to include a mental health provider in the treatment of sexual dysfunction. Dr. Horst tells us that this is especially important if the dysfunction is “rooted in [a] mood disorder, body image issue, [or] relationship issue.”
Up until now, you may have felt like sexual dysfunction is a burden that you need to deal with alone. We hope you have learned that it can be a common issue for women with IBD and that it’s treatable. Our goal is to continue to remove the stigma around sexual dysfunction in order to encourage women to seek help!
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3. Sanders J, Gawron L, Friedman S. Sexual satisfaction and inflammatory bowel disease: an interdisciplinary clinical challenge. Am J Obstet Gynecol 2016;215:58.
4. Zhao S, Wang J, Yangzhou L, et al. Inflammatory Bowel Diseases were Associated with Risk of Sexual Dysfunction in Both Sexes: A Meta-analysis. Inflammatory Bowel Diseases 2019;25:699.
Katelyn Collins, RD is a registered dietitian and health writer specializing in digestive health. Katelyn’s personal experience with a digestive condition first sparked her passion for nutrition and health. Since then, she has been a vocal advocate for the digestive health community and has dedicated her own nutrition practice to serving those with digestive conditions.