Men’s Health: Sexual Issues and Fertility with an Ostomy or IBD

Men’s sexual health and fertility with an ostomy or IBD is not often talked about. Sexual issues include erectile dysfunction, dry orgasm and fertility. Men also experience low libido, low self-esteem, poor body image which can all lead to depression, lack of confidence and not even trying to have sex.

In a small study of 100 patients who were sexually active before surgery, 50% reported that they didn’t even try to have sex post-surgery. That is a surprisingly high number. Of the other 50% who did have sex, 70% reported that they had no issue. This shows that body-image, low self-esteem, self-perception all play a big part for men.

I talk with Dr. Neil Nandi, GI specialist and Associate Professor at University of Pennsylvania to discuss Men’s Health with an Ostomy or IBD in this video. (The full episode link is available below). His Instagram is: @fitwitmd 

It’s time for men to talk

Men typically find it more difficult to ask for help. There is still this stereotypical behavior that it’s taboo to talk about sensitive issues or open up about their feelings.

It’s time to open up and break the mold. When you express yourself, admit that there is an issue or ask questions about these intimate issues, it becomes a sign of strength and a way of educating yourself. This will benefit not just you but all your relationships.

Thankfully the medical professionals over the last 15 or so years are realizing that disease and surgeries have a big influence on your sexual health and self-perception. They are hopefully asking you if you are having issues. But also as a patient you can help educate your doctor by sharing what is going on with you.

Remember, there are plenty of other males experiencing similar problems but you won’t know unless you ask!

Sexual function with an ostomy

For the most part, having an ostomy should not interfere with sexual function. However, if you have deep pelvic surgery or if some or all of the rectum is removed it can increase the risk of nerve injury and erectile dysfunction.

Some males with urostomies experience a dry orgasm but they don’t typically experience erectile dysfunction.

It is always wise to ask your surgeon about the ways that your sexual function could be affected with your particular surgery.

Male fertility with an ostomy

Mostly there is a very low chance of infertility with an ostomy. What to consider is the ability to ejaculate.

If you are planning to have children and have yet to undergo proctectomy or more pelvic surgery you may want to consider freezing your sperm. These surgeries could have a slight affect on erectile function. 

As mentioned above some urostomates experience dry orgasm. This would be another reason to freeze sperm presurgery.

Some medications affect male fertility, as does nerve stimuli or if there is active IBD disease that penetrates near the testes which is uncommon.

Effects of radiation treatments and sexual function

The radiation oncologist maps out exactly the area where radiation beams need to be and they try to avoid the sexual organs. But as with anything, there are risk factors and you should ask your doctor about them or talk to another patient who has undergone surgery or radiation.

Ways to enhance your sexual Function

The well known drug Viagra can be useful for achieving erection. Other ways to help performance are by using actual penis pumps or penis rings. (More in the full episode)

If you are having performance issues, low self-esteem, or feel nervous then talk to someone. It could be a sex therapist, your doctor, seek help through Elaine’s program, or you may need pelvic floor physical therapy.

Same Sex Issues

This can be very challenging when it comes to anal sex. If you have a flare-up from IBD then it’s advised to abstain from anal sex but there can be anal foreplay. If you undergo a full proctectomy then this will be a major concern and should be discussed with your partner and surgeon. Other health conditions can also come into play and affect the ability to have anal sex

Resources

Full Episode Men’s Health: Sexual Function and Fertility with Ostomy or IBD