Before we get started, let’s cut to the chase: 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 and ostomy are complex subjects with many facets: the physical, emotional, and psychological pressures are major influences in ones’ life. Below, we will break down these issues to directly discuss the physical considerations (both after surgery and ongoing), and then the psychological and emotional considerations for sex and ostomy.

Physical (Post-Surgical)

For a new ostomate, the first few months after surgery can present many unique physical challenges. Depending on the type of surgeries performed, medications administered, and which body parts are affected will determine how soon you can perform sexual intercourse. Most anxieties of post-surgery ostomates about sex are alleviated after a few months, and over time, as the body heals, most will find they can have sex just the same as before they had their surgery.

Physical factors aside, here are a few psychological issues faced by post-op ostomates are:

1. Initial anxiety due to physical changes & fear of injury
2. Feelings of loneliness or a sense of rejection
3. Inability to achieve an erection / lubrication / orgasm

Sex and Intimacy Tips for Post-Op Ostomates

• For a partner of a new Ostomate, being supportive and patient are the best things you can do.
• Don’t fret – sex drive and the bits-and-pieces usually rebound to full function again.
• Intercourse can be painful the first couple times after surgery, especially if you haven’t had any for several weeks/months.
• Sex doesn’t have to mean penetration. Oral, petting (foreplay), masturbation, toys, and any number of other sexual activities can be enjoyed.

Physical (Ongoing)

After a full recovery from surgery and regular sexual function and desire returns, more thoughts and concerns arise about sex. Some common concerns and some information about them:

1. Fertility / Ability to Have Children – Most women can still conceive after Ostomy surgery without problem. Most men will also remain fertile, even if they cannot achieve an erection for a period after their surgery. Even if sexual ability is limited by surgery (due to surgery’s affects on the urological system and sexual nerve pathways), artificial insemination may be an alternative.
2. Injury to the Stoma – Ensure you/your partner is in a position that will not cause discomfort or damage the stoma.
3. Sexual Positions – Ostomates will find they can still enjoy sex in most positions. If some positions are uncomfortable or compromise the appliance, try something different until you find the best ones for you.
4. Odor – Many ostomates worry about odor and this can be a psychological factor as well. Before sex: don’t eat foods that create odors/gas, clean the skin around the stoma and wear a fresh pouch or empty and clean a drainable pouch prior to sex.

Sex Tips for Physical Issues and Ostomy

• Communication is key in any sexual relationship. Ostomy and sex is no different. Let your partner know they won’t injure your stoma by having sex and communicate openly if something feels uncomfortable.
• Important – no sex in or around the stoma. No anal sex.
• For odor management, also try DEVROM internal odor control tablets and Hollister’s m9 Drop Deodorizer for pouches (a little goes a long way!). Burn candles and/or incense.
• Empty the pouch beforehand when time allows. Keep everything clean and neat beforehand.
• Check all fasteners and adhesives to ensure they’re secure.

Psychological & Emotional

Ostomy can be hard for both the patient and the healthy partner. In some instances where a patient has had surgery for debilitating health problems like cancer, the healthy partner helps to take care of the ostomate and certain bodily functions. Working through these hard times without sex can takes a toll on intimacy and it can take time for these couples to adjust and return to a healthy sexual lifestyle again.

There are some common psychological considerations for ostomates and sexuality. And they mainly have to do with…

– Desirability/Attractiveness: “Will my partner still want to have sex with me?” or “I don’t look like I used to.” Truth is, we put a lot of pressure on ourselves to appear a certain way and become sensitive to our differences when compared to others. Even further, we often assume that others judge us the same way we judge ourselves. But imagine if your partner, someone you care about, had the same condition and how you would feel about them. What would you be thinking, or how would you react? Most find their partner has a sensitivity and understanding towards the ostomy.

– Breaking the Ice/Fear of Rejection: For those who meet their partners after surgery, an ostomate has to find the right time to tell a partner about their ostomy. But when and how? What do you say? The best advice would be to tell someone earlier than later. When it comes to one’s health, it’s best to present the facts at face value with confidence and understanding that the person you’re telling may not understand what an ostomy is and how it affects your life. Explain the stoma, the surgery, and how it affects your physical abilities. Let them ask questions with the knowledge that they might not understand what to ask, or how to ask. Be patient. Typically, this understanding tone will be returned in full, but even if you are rejected, don’t blame it on your stoma – simply do what all single folks do and go fishing again. 🙂

Sex Tips for Psychological Issues and Ostomy

There are some things you can do as an ostomate to increase your confidence Below are some things many ostomates do to increase confidence for intimacy:

1. Wear a small, low-profile pouch such as Convatec’s Mini Pouch or stoma cap before intimacy. These pouches are more discreet, so they’ll be less invasive.
2. Wear a pouch cover such as C&S Pouch Covers or soft satin My Heart Ties.
3. Many ladies also choose to wear a comfortable satin slip or camisole to bed with them. Men may wear a belt or similar support along with a pouch cover.

Mini-Pouch Options

Here are some of the best options for low-profile mini-pouches:

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  Coloplast Mio Mini-Pouches – The Mio pouch line incorporates Coloplast’s latest BodyFit technology that conforms to the body’s contours and allows for a more flexible fit and a softer material that feels more like clothing than an appliance. The Mio line is pricier, but for comfort and performance you may want to keep them around, even if just for occasional use.




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  Convatec’s Mini Pouch – Convatec’s smallest pouch is just 5 inches and opaque, making it a great and affordable choice.




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  Coloplast’s Assura Mini Pouch – Coloplast Assura is a popular line of pouches; these 1-piece closed pouches are cut-to-fit to conform to the stoma.




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  Hollister Premier Mini Pouch – Hollister has a 7 inch mini-pouch in their Premier line of 1-Piece pouches that feature a SoftFlex barrier that is gentle on the skin.

A Few Last Thoughts…

There are some cases where physical impairment may prevent one from having sex. This can happen sometimes based on previous health and the types of surgery needed. Some types of colorectal cancer can result in removal of the nerve pathways that cause erections. In some cases, colorectal surgery can result in the vagina changing shape and structure. All of these physical changes can limit some types of sexual activity.

Homosexual couples deal with all of the same issues as straight couples. No matter your sexual preferences and difficulties faced, consult these issue candidly with a health care professional that understands your surgery. They can provide you with advice specific to your personal needs.

Additional Resources on Sex and Ostomy:

Please feel free to leave your comments with additional tips, suggestions and thoughts!