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Not Tonight, Honey - - I Have IBD

Lack of sex drive is not uncommon in IBD

By Amber J. Tresca, About.com

Updated: August 17, 2007

About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

Adults with Inflammatory bowel disease (IBD) may experience a loss in their sex drive. This side effect can be frustrating for both the person with IBD and for their partner.

What causes this lack of sex drive?

The causes are varied, and in many cases, several causes may dampen the libido.

Sheer fatigue is a major factor. Dealing with a chronic illness is downright exhausting. Getting up in the middle of the night to use the toilet, repeated bouts of diarrhea or vomiting, malabsorption or loss of nutrients, and chronic pain all make for a tired person.

Another culprit can be the medications that people with IBD take to squelch a flare up or to prevent a new one. Prednisone can affect the sex drive, too, in addition to all its other charming side effects.

More common in Crohn's disease than ulcerative colitis, fistulas can be a major block to romance. Fistulas, particularly recto-vaginal ones in women, could make sex messy and painful.

For some, the last and most complex reason is a poor self-image. Let's face it -- spending a lot of your time in the toilet is not going to help you feel like having sex.

So what's a person to do?

Addressing nutritional issues can be an answer for some people. Low levels of iron, folic acid and vitamin B12 in particular can lead to anemia, and leave a person feeling very tired. With proper supplements, either by mouth or through injection, iron and B12 levels can be raised to combat the anemia. It's easier to get your blood warmed up when you've got the right amount pumping through your veins.

Prednisone is a fact of life for many people with IBD. Patients often work toward reducing the use of prednisone as soon as possible because it can play havoc with so many body functions. With dosage decreases as small as 1mg, tapering down from 40 mg to 5 mg or 10 mg a day can be a long process. The good news is that once prednisone is stopped, many side effects (including an altered sex drive) are usually reversed.

Until fistulas are treated effectively through medication or surgery, they can affect sexual desire. A lubricating jelly may help in some instances of recto-vaginal fistulas that are causing discomfort.

A more time-consuming issue is the one of body image. Open communication can go a long way to helping problems in the bedroom. The well partner can be assured that the lack of sex is not rejection; the lack of interest really is due to the disease. The partner with IBD needs reassurance that he is still attractive and that the well partner is committed to seeing the problems through to a solution.

Keep in mind that healthy adult relationships are more than just sexual gratification. There are also the benefits of companionship, trust, and friendship. Finding a way to work through this hurdle, as you have through all the others that IBD has put in your path, will bring you closer together as a couple.

Sources:

University of Illinois Medical Center. Personal Questions on Sexuality: Answered by Experts. University of Illinois Medical Center at Chicago 2006. Aug 14 2007.

Johns Hopkins Medicine. Anemia and Fatigue. The Johns Hopkins University 2006. Aug 14 2007.

Sara M. Silberman. Intimate Relationship of Sex and IBD. The Crohn's and Colitis Foundation of America 2007. Aug 14 2007.

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