For many people, inflammatory bowel disease hits during the years when love and sexuality matter most – and from the very start, it leaves its mark on their sex life. Researchers are now calling for sexual problems to be addressed from the very start of treatment.
One in four people newly diagnosed with inflammatory bowel disease report that they have already noticed how the disease affects sex. For many, problems such as lack of desire, difficulty becoming aroused, pain during sex or lack of orgasm begin long before the actual diagnosis.
A new study shows that the disease wears down not only the body but also intimacy – with many already experiencing sex problems by the time they are diagnosed with inflammatory bowel disease.
The study also shows that the severity of the disease does not determine whether sex life will suffer. Instead, one of the main decisive factor is the sudden, overwhelming need to rush to the toilet.
That is why a researcher behind the study would like to see people with inflammatory bowel disease treated more by drugs that specifically target the need for urgent toilet visits, which may also reduce the sexual dysfunction many experience.
“It is well known that having severe inflammatory bowel disease for many years can affect both desire and sex life. But how sex life is affected right at the time of diagnosis is less well known, and we are highlighting this in this study,” explains a researcher behind the study, Mohamed Attauabi, MD, PhD from the Department of Gastroenterology at Herlev Hospital and Copenhagen IBD Center, Denmark.
The research has been published in Alimentary Pharmacology & Therapeutics.
When illness strikes the body – and sex life follows suit
It is no secret that chronic illness can damage your sex life.
Chronic illness often goes hand in hand with sexual dysfunction – and living with a bowel disease that brings both stomach pain and sudden toilet urgency can clearly dampen sex drive.
It can also interfere with erections and ejaculation.
Chronic illness is also linked to lower quality of life – as is sexual dysfunction.
“When we talk to people with inflammatory bowel disease and ask them what matters most in their lives and affects their quality of life, poor sex life is one of the most important factors. This is especially true for young people and for those with stomas or rectal disease,” says Mohamed Attauabi.
Desire fades even before diagnosis
In the study, conducted by researchers from Herlev and Gentofte Hospital and Amager and Hvidovre Hospital, 289 people newly diagnosed with inflammatory bowel disease were asked whether they had experienced signs of sexual dysfunction within the past month, such as reduced desire, problems with arousal or pain during sex.
The participants responded to the questionnaire about a month after diagnosis.
The participants were on average about 40 years old (half were between 18 and 39 years), and just over half were women.
As part of the Copenhagen IBD Inception Cohort Study, the researchers also collected detailed information about how ill each person was and what type of bowel disease they had – so they could determine whether the sexual problems were related to the nature of the disease.
Many lose their sex drive right at the onset of the disease
The results show that many people with inflammatory bowel disease already struggle with their sex life at the moment they are diagnosed, with 29% of the women and 17% of the men with ulcerative colitis reporting sexual dysfunction.
The same was true for 23% of the men and 25% of the women with Crohn’s disease.
Some said that sexual dysfunction was rare, but it was frequent for three quarters of the respondents.
The severity of the disease itself turned out not to be linked to the risk of sexual dysfunction.
However, one symptom plays a major role: the sudden and overwhelming urge to go to the toilet immediately – what doctors call bowel urgency. The more prominent the bowel urgency, the greater the incidence of sexual dysfunction.
“We consider the finding that 25% of the people newly diagnosed with inflammatory bowel disease reporting sexual dysfunction as a very high number. But it is surprising that sexual dysfunction is not related to the severity of the disease. This means that we need to be aware of this for all patients and not just those with the most severe form of the disease,” notes Mohamed Attauabi.
Treatment focus shifts from gastrointestinal symptoms to more broader parameters, including the quality of life
Mohamed Attauabi explains that there has been a shift in research into inflammatory bowel disease.
In the past, treatment mainly focused on stomach pain, diarrhoea and bloody stools. Today, the long-term goals also include improving the quality of life and easing fatigue and other everyday limitations – what doctors call disability.
Studies of sexual dysfunction fit into this context.
Another focus is the fact that inflammatory bowel disease is a systemic disease that affects not only the intestines but also other organs.
“We focus on what is important for our patients to have addressed. When we talk with them, we hear that sexual dysfunction weighs heavily on them and greatly affects their quality of life,” says Mohamed Attauabi.
New drugs may restore desire
So can anything be done about it?
Today, doctors in departments of gastroenterology in Denmark have very limited access to psychologists, gynaecologists or sexologists for systematic treatment or screening – so they can do little to address sexual dysfunction among people with inflammatory bowel disease.
However, there is an opportunity to do something.
Mohamed Attauabi says that many studies are currently being conducted on which symptoms various drugs are effective against, and there are indications that some drugs effectively reduce bowel urgency.
This suggests that this type of treatment could benefit some people with inflammatory bowel disease and sexual dysfunction.
“Bowel urgency also strongly influences the quality of life. That is why we have begun to take a keen interest in this. We need more research into the link between inflammatory bowel disease and sexual dysfunction, and this should be done in interdisciplinary collaborations that can examine the problem and treatment options from different angles. In addition, we also need to examine how inflammatory bowel disease affects the sexes differently. For men, the problem is often erectile dysfunction, and for women it is reduced sex drive, problems achieving orgasm and disturbances in sexual arousal. So the problem needs to be tackled differently for men and women,” concludes Mohamed Attauabi.
