Sexual Issues with an Ostomy or IBD

Sexual Issues with an Ostomy or IBD

Sexual Issues with an Ostomy or IBD: Physical Therapy for the Pelvic Floor – as featured on

You’re Not Alone if you’re having sexual issues

Sexual Issues with an ostomy or IBD are commonplace. People can experience sex problems pre or post-ostomy surgery. With IBD or bladder issues the constant bathroom habits can lead to sexual dysfunction. Cancer treatments can also affect function.

Unfortunately, many people are embarrassed to talk about sexual issues and think that nothing can be done. 

You may feel so alone, wondering why it hurts so much, why you can’t enjoy it, or why you can’t get an erection, ejaculate or orgasm. 

The good news is, you are not alone and you can seek help.

I talked with Meghan Markowski, Expert Pelvic Floor Physical Therapist, from the Brigham and Women’s Hospital in Boston, MA. We discussed “Pelvic Floor Issues for All Genders: Sexual Concerns, Bladder and Bowel” and as they relate to having IBD or Ostomy

This short video clip details more about sexual issues.

To watch the Full Episode see the link at end.  

Types of sexual issues

Sexual issues happen in all genders. Problems that people experience include painful intercourse either vaginal or anal, abdominal or pelvic pain, low libido, incontinence during sex, muscle tension, issues with erection, ejaculation and orgasm. 

Reasons for sexual Issues

The pelvic floor muscles are involved during sex, urination and defecation. Therefore Pelvic Floor problems can involve sex, bladder and bowel issues and they can be interrelated.

The muscles may need to be retrained from years of over or underuse.

People with bladder or bowel issues may have increased problems. This can be from years of clenching while trying to make it to the bathroom, having incontinence, perianal disease, fissures, fistulas, rectal prolapse. The muscles are most likely overused and are in a state of contraction.

Cancer treatments can cause a host of problems as can giving birth.

Physical Therapy for the Pelvic Floor

There is a specialized field of Physical Therapy (PT) for the Pelvic Floor. These PT’s are especially trained to evaluate and examine the function and dysfunction of the muscles of the pelvic floor. This is not something that a regular PT can do. 

Many people, even medical professionals are not aware of this type of PT and how it can help, even though it has been around for quite sometime. It can greatly benefit you. If you are  experiencing any issues, try to get a referral.

Role of the Pelvic Floor

As mentioned the pelvic floor muscles are involved during sex, urination and defecation. It is the base for the organs to sit upon and reflects on our posture and even breathing. 

Just like with anywhere else in the body, structural and muscular imbalances happen. Therefore it happens in the pelvic floor but you can’t see these muscles. 

Pelvic Floor Physical Therapy with an Ostomy

If you have an ostomy you can still benefit from pelvic floor physical therapy.

A qualified pelvic floor PT will take your history, evaluate and examine internally and externally. If you’ve had organs or rectum and anus removed you can still have this type of PT.

Exercises and an appropriate game plan will be prescribed.

The length of treatment will vary depending on the patient.

Other Approaches

Issues such as depression, low self-esteem, poor body image and fear around your ostomy are all things I address in my “Surviving to Thriving” program. There is a full section about Intimacy and Relationships. Or you may wish to consult a sex therapist or reach out for some other type of support.

Other Resources

Elaine’s other relevant blogs:

Full Episode: “Pelvic Floor Issues for all genders: Sexual Concerns, Bladder and Bowel 

Make sure to grab your FREE GUIDE: ‘3 simple ways to eliminate fears about your ostomy” by visiting Elaine’s website

About Elaine

Elaine O’Rourke is an Ostomy/IBD Health Mentor and the creator of the program “Surviving To Thriving: Overcoming Ostomy Challenges So You Can Live a FulFilling Life”.  She is a certified Yoga Therapist & Teacher since 2003, Sound Healer, EFT & Reiki Practitioner, Recording Artist and International Retreat Leader. Her lighthearted and fun personality shines through her teachings/programs as she loves to inspire others.  She is a contributing writer to the national Phoenix Magazine and UOAA, presenter at the UOAA National Conference and speaker at Girls with Guts retreat.  

YouTube: Elaine O’Rourke Yoga, Ostomy, IBD