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So you’ve had ostomy surgery, you’re recovering, and at some point a pretty normal question enters your mind:
What about sex?
I actually think reaching the point where you’re asking that question is a good thing. You’ve been through a major surgery. There may have been a period when sex was pretty far down the list of things you were thinking about. Now you’re starting to feel better and thinking about getting back to this part of your life.
But that doesn’t mean you won’t have concerns.
What am I going to do with the pouch? Could I hurt my stoma? What if I have a leak? Is my body going to work the same way it did before surgery? And maybe the biggest question: Am I actually going to feel comfortable being intimate again?
I had some of those same concerns. What I eventually discovered was that sex with a stoma really can be a lot more normal than you might imagine when you’re first recovering.
Don’t Rush Back Into Sex
The first thing I would say is simple: don’t rush it.
You’ve had major surgery, and your body needs time to heal. Talk with your surgeon or another healthcare professional about when it may be appropriate for you to resume sexual activity.
But there’s another part of readiness that I think is just as important.
Check in with yourself.
You can be physically healed and still not feel emotionally ready to have sex. Your body may look different. You may suddenly have a pouch attached to your abdomen. You may feel self-conscious about being naked in front of someone.
That’s real.
For me, I had sex about two or three months after my first surgery. I was in a relationship at the time, and honestly, it happened pretty spontaneously. I didn’t create some elaborate plan for returning to sex.
I was definitely anxious at first. But once I got past that initial anxiety, what surprised me was how normal the experience felt. It was essentially the same part of life it had always been.
That was reassuring.
What Do I Do With the Pouch?
This was probably my biggest practical concern.
What exactly am I supposed to do with this bag while I’m having sex?
For me, wearing an ostomy support belt made a big difference. I wore my Stealth Belt, which held my pouch securely against my body. I didn’t have to think about the pouch moving around, becoming visible, or generally getting in the way.
Psychologically, that helped me too.
There’s nothing wrong with having your pouch exposed during sex if you’re comfortable with that. There’s also nothing wrong with wanting it covered. The important thing is finding whatever makes you feel comfortable enough to stop thinking about your ostomy and actually enjoy the experience.
One simple thing I recommend is emptying your pouch beforehand. A flatter, empty pouch was simply more comfortable for me and gave me one less thing to think about.
You already have enough going through your mind the first few times. Anything that removes one of those worries can help.
Protecting Your Stoma and Preventing Leaks
A question people understandably have is whether sex can hurt the stoma.
In my experience, I didn’t have problems with my stoma during sex, but I was conscious about protecting it and avoiding unnecessary pressure or rubbing.
I also used a stoma guard, which is a hard protective plate worn over the pouch and stoma. For me, combining that protection with an ostomy support belt increased my confidence because I wasn’t worrying about accidentally bumping my stoma.
That doesn’t mean everyone needs to do exactly what I did. It’s simply what worked well for me.
Leaks are another understandable concern. Sex is probably pretty high on the list of places where nobody wants to suddenly discover a leaking appliance.
Beforehand, I would make sure the pouch was empty and check the barrier to make sure I had a good seal. If you already have irritated skin around your stoma, that’s another reason to be careful about pressure and friction.
And especially when you’re first getting back to sex, being a little gentle makes sense. You’re learning what feels comfortable with a body that has been through a significant change.
If something does happen, stop.
Take care of the problem and then decide what you want to do from there. An understanding partner is going to understand.
When Your Body Doesn’t Respond the Way You Want
Sometimes the challenge after surgery isn’t the pouch at all.
It’s your body.
Before my surgery, my surgeon discussed risks that included the possibility of problems getting an erection. Fortunately, that particular complication didn’t happen to me.
But there have still been times when my body simply didn’t respond sexually the way I wanted it to.
That can be frustrating, especially when you’re already wondering whether life is ever going to feel normal again.
What I learned was not to immediately assume that one difficult experience meant something was permanently wrong. My body had been through surgery. Healing and adjustment take time.
There are also many forms of intimacy that don’t depend upon intercourse. There’s affection, touching, kissing, cuddling and simply being close to another person.
And if you continue having physical difficulties, talk to your doctor. There may be options available. In the video I discussed erectile dysfunction medication for men and lubrication for women as examples, but the right approach is something to discuss with a healthcare professional based on your individual circumstances.
The important thing is not to quietly decide that your sex life is over.
Communication Makes a Difference
Sex involves another person, which means comfort isn’t only about you.
If you’re in a relationship, talking about your concerns can remove a surprising amount of anxiety.
You might wonder whether your partner is uncomfortable seeing your pouch. Instead of trying to read their mind, you can simply talk about it.
Would you both be more comfortable with the pouch covered? Does it matter at all? Is there something either of you is nervous about?
Those conversations don’t need to be dramatic.
For me, the goal is simply to get those concerns out into the open so they don’t follow you into the bedroom.
There’s also something reassuring about discovering that the thing you’ve been worrying about may not be nearly as important to your partner as you imagined.
You’ve probably spent far more time thinking about your stoma than they have.
And ultimately, this should be enjoyable for both people. Being able to communicate, laugh when something doesn’t go perfectly and adjust together can take a lot of pressure off the experience.
Getting Back to an Important Part of Life
There’s something bigger here than sex.
After ostomy surgery, so much of your attention can become focused on your body.
You’re learning how to manage an appliance. You’re checking your skin. You’re thinking about leaks. You’re figuring out clothes, food, exercise and a hundred other things that used to happen without much thought.
Then gradually, life starts getting bigger again.
You start doing things because you enjoy them rather than because they have something to do with your ostomy.
Sex and intimacy can be part of that.
So when you reach the point where you’re thinking about having sex again, I think there’s reason to be excited about it. Prepare yourself. Make sure your body is ready. Empty your pouch. Check your appliance. Protect your stoma if that makes you more comfortable. Communicate with your partner. Experiment with what works comfortably for both of you.
And then try to let yourself enjoy it.
Your first experience might not be perfect. Your body may surprise you. You may be nervous. You might have to make some adjustments that you never had to think about before your surgery.
That’s okay.
I had moments when things didn’t work as well as I wanted them to. Those moments passed.
What mattered more was discovering that this part of my life was still there.
An ostomy changes some of the mechanics of living. It may require preparation, patience and a sense of humor from time to time. But it doesn’t have to take away intimacy, connection or pleasure.
Sometimes moving forward after surgery isn’t about getting your old life back exactly as it was.
It’s realizing how much life you still have in front of you.
