Sex for Someone With a Stoma Is Less Complicated Than You Think

Getting reacquainted with your sex life after adjusting to life with a stoma—a small opening in the stomach that connects your digestive or urinary system to an ostomy bag—can be challenging. People with stomas have to learn to become comfortable with their bodies again, and on top of this, they may worry about what their partners might think. 

But there's no shame in having a stoma and ostomy bag. An estimated 450,000 people have stomas in the United States, all of whom deserve to enjoy as fulfilling a sex life as anyone else.

An ostomy bag doesn't physically limit sex

An ostomy procedure relieves symptoms of inflammatory bowel and bladder disease, such as Crohn's, ulcerative colitis (UC) or colorectal cancer. Parts of the bowel that are too damaged by inflammation are often removed during ostomy operations. Afterward, you're left with a stoma.

According to UCLA Health, stomas are usually pinkish red in color—a bit similar to the skin on the inside of your cheek—and protrude from the stomach or abdomen, if slightly. A stoma typically isn't painful to the touch and shrinks over time.

YouTuber and artist Emily Parris, who had a colonoscopy after ulcerative colitis complications, pointed out that sex for someone with a stoma isn't physically different than before surgery and doesn't typically present any major physical challenges, such as discomfort or pain, especially when healed.

"People with ostomy bags are able to work out, run, swim, hike and have sex just like any other able-bodied person would," she said.

When it comes to physical comfort, timing sex to fit in with your healing process is key. Parris said that for some, "it might mean waiting longer postsurgery to feel that you have enough energy for that type of physical exertion," but that once you've properly healed, sex is possible. 

Dealing with a stoma for the first time during sex

For her, the biggest challenges aren't physical, but instead mental. When Parris had her colon removed, she'd just ended a long-term relationship. This made approaching sex for the first time after her surgery even more anxiety-inducing.

"Set expectations with yourself that sex might not be quite the same and that's OK," Parris said. "Do you feel more comfortable wearing a shirt? Do you want to wear a wrap to hold your ostomy bag close? Are you more comfortable with the lights off or in a certain position? While some of these things you will need to figure out through trial and error, it's important to discuss with yourself where you feel comfortable."

Wraps or bands are used to keep ostomy bags and stomas hidden. They cover a person's abdomen and typically have a pocket or two where the ostomy bag sits inside. Queer blogger and mental health advocate Nathan Wheeler, whose ileostomy—where the bowel is diverted through an opening in the stomach—led to the "Barbie butt," said he feels most comfortable with a wrap during sex because it allows him to "forget about the bag" in the moment.

Parris suggested being open with a partner about having a stoma and ostomy bag early on in the relationship. The next step is to talk about how this might play into sex for both of you. Keep the conversation fun and sexy. "If you don't make a big deal out of it, your partner won't, either," she said.

Eradicating the stigma

One of the biggest misconceptions around stomas is that they smell often or all of the time, which is far from reality. Parris explained there is a noticeable odor when removing and emptying a colostomy bag, which is just like "when anyone goes to the restroom to relieve their bowels." But outside of this, there should be no odor at all.

Concerns around leakage are also unfounded, because a properly sealed ostomy bag won't leak at all. This feature is especially important to prevent infection around the stoma. Ostomy bags are designed so no urine or fecal matter touches the skin of the person it's attached to, let alone somebody else.

Both Wheeler and Parris noted anxiety and mixed feelings about their stoma. When it comes to feeling comfortable in your own skin, inviting someone to explore this with you and getting out of your head can be challenging.

"Apart from that internal struggle," Wheeler said, "the bag and stoma itself doesn't stop you from doing anything when it comes to passionate sex. So, enjoy."