Having sex when you have a stoma

If your surgery requires you to have a stoma (an opening on the abdominal wall) formed for bowel or bladder cancer, there is a high chance of permanent damage to the blood and nerves that supply the genital area. This may cause problems in getting and maintaining erections. 

A stoma can make some sexual positions uncomfortable. Having to change a stoma bag before sex may spoil the moment. People may worry that the stoma bag will fall off and/or they may have a bowel motion during sex.

If you’re worried about a noisy stoma, try playing music during sex. Having a stoma may make you feel self-conscious about the change in your body. This can result in sexual difficulties with your partner or make you feel anxious about new relationships. Stoma therapists can give advice and help with all the effects on sexuality that a stoma may cause. 

Occasionally problems may arise because partners are struggling with change. It can be helpful to discuss it if you feel there’s awkwardness between you. 

Your partner cannot damage the stoma so go with the position you are comfortable with.

Practical tips if you have a stoma

People with stomas sometimes worry about whether their bags will get in the way. If the bag is emptied before sex, it can be folded up and secured with some tape to your body to prevent it moving around. 

If the bag is not covered with fabric, some people choose to use a cotton cover during sex; this will prevent the bag rubbing on you and your partner’s skin. If you usually wear a transparent bag, the cover hides the contents. Some choose to wear silky or cotton vestlike tops that cover the bags and the top half of their bodies. 

If your anus has been removed, the position of being on top of your partner may be uncomfortable for vaginal sex. One option is to enter the vagina from behind. 

A finger, a penis or a sex toy should not be pushed into a stoma because this could damage the stoma. 

If you have faecal oozing, use plugs designed for rectal use. Plan to have a spare stoma bag, toilet tissues or wet wipes on hand in case an accident does occur. 

Plan for intercourse – wait at least two or three hours after a meal and empty the bowel or bladder before you have sex. Place an absorbent pad/draw sheet on the bed if you are concerned about wetting.