Relationships and Intimacy

Sex has many health benefits. Research into the mind-body connection shows that what we feel emotionally can impact us physically and vice-versa. The positive emotions experienced in intimate sexual relationships could help us feel good physically as well.

In addition to the positive effects of intimacy in a caring relationship, research has shown that the benefits of regular sex include:

• Mood improvement

• Relief of depression

• Stress relief

• Increased self-esteem and sense of well-being

• Higher levels of the hormone oxytocin, which is linked to increased feelings of happiness and improved sleep

• Increased levels of endorphins, which help reduce overall sensations of pain

It’s important to keep in mind that many people who don’t have lifelong conditions see natural changes in their levels of desire and sexual activity over the course of their life. How you feel is natural for you at this point in time. Yet many things affecting your level of desire can be managed – as can effects on self-esteem.

Physical intimacy could be affected by:

• How long you’ve lived with Crohn’s or colitis

• The treatment(s) you are on

• Whether you are experiencing a flare-up or active disease

• Specific symptoms. More about this below. 

Physical symptoms

Many people are familiar with the nausea, diarrhea, abdominal cramping and vomiting that are often part of living with Crohn’s or colitis. Long-term partners will be familiar with them too. Another physical symptom of Crohn’s or colitis are fistulas, which are “tunnels” of infection that can develop in the intestine and burrow their way to the skin or a neighboring organ. If the fistula is in the vaginal or anal areas it could cause pain during sex due to tearing. 

Depending on your physical symptoms, it might be something you and your partner – and your doctor – can manage together over the short and/or long term.

Speak openly and honestly with your health care provider when you meet, and take the time to describe how the symptoms affect intimate acts in detail. Your provider may have some suggestions.

Cognitive and psychological symptoms 

The physical symptoms of Crohn’s and colitis may impact your emotional state, causing fatigue, apathy and potentially even depression. Depression can reduce feelings of self-worth or desirability.

The good news is that some of these issues can be treated, both independently and with your health care team.

In the short term, assess what you feel you can do and discuss with him or her. You may suspect that your partner or date will settle for nothing less than sexual intercourse, but your partner may be open to adapting to what you can do at that time. Discuss sexual activities openly and honestly and invite him or her to share their thoughts and desires with you too. 

Also, don’t forgo intimacy completely; activities such as kissing, hugging, caressing each other and body massage could help you feel better physically. There is a lot you could do with your partner outside of sexual intercourse (penetrative sex).

Being willing to explore and engage in other types of physical intimacy could increase your desire and improve your self-esteem, making you less hesitant to be intimate.

Pay attention to what you say to yourself about your diagnosis: are you kind to your body or do you criticize it? Do you demand more from yourself than you are physically able to do? Just as you would to a good friend, celebrate what your body does despite Crohn’s or colitis. When you see your body in a positive way, you will feel good about your body, and this will create opportunity for intimacy.