Lack of Sex Drive With IBD

People with Crohn's and colitis may experience a lack of libido

Since a diagnosis of inflammatory bowel disease (IBD), is it true that sex isn't what it used to be? It's not uncommon for adults with IBD to experience a change in their sex drive. This side effect can be frustrating for both the person with IBD and for their partner. The good news is that there are ways to cope with this problem. With some patience, couples can work towards having the intimate moments that they want. Couples who find that the problems are too much to conquer alone, don't hesitate to ask a gastroenterologist or another medical professional for help. In some cases, a few visits with a mental health professional can improve the situation immensely.

Woman sitting up in bed holding stomach with man in bed in the background
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What Can Cause a Lack of Sex Drive?

The causes are varied, and in many cases, several causes may be contributing to the problems with intimacy. 

  • Exhaustion: Sheer fatigue is a major factor. Dealing with a chronic illness is downright exhausting. Getting up in the middle of the night to use the toilet, repeated bouts of diarrhea or vomiting, malabsorption or loss of nutrients, and chronic pain all make for a tired person.
  • Medication: Another culprit can be the medications that people with IBD take to squelch a flare-up or to prevent a new one. Prednisone can affect the sex drive, too, in addition to all its other charming side effects.
  • Complications: More common in Crohn's disease than ulcerative colitis, fistulas can be a major block to romance. Fistulas, particularly recto-vaginal ones in women, could make sex messy and painful.
  • Self-image: For some, the last and most complex reason is a poor self-image. Let's face it, spending a lot of your time in the toilet is not going to help you feel like having sex.

How to Deal With a Lack of Sex Drive

Addressing nutritional issues can be an answer for some people who find their libido has changed. Low levels of iron, folic acid, and vitamin B12, in particular, can lead to anemia and leave a person feeling quite tired. With proper supplements, either by mouth or through injection, iron and vitamin B12 levels can be raised to combat the anemia.

Prednisone is a fact of life for some people living with IBD. Patients often work toward reducing the use of prednisone as soon as possible because it can play havoc with so many body functions. With dosage decreases as small as 1 mg, tapering down from 40 mg to 5 mg or 10 mg a day can be a long process. The good news is that once the drug is stopped, many of prednisone's side effects (including an altered sex drive) are usually reversed.

Until fistulas are treated effectively through medication or surgery, they can affect sexual desire. A personal lubricant may help in some instances of recto-vaginal fistulas that are causing discomfort. It's important here to try to avoid activities or positions that cause discomfort. It may be necessary to avoid penetrating sex but instead to enjoy oral sex or mutual masturbation at times when a fistula is flaring up.

A more time-consuming issue is one of body image. Open communication can go a long way to helping problems in the bedroom. The well partner can be assured that the lack of sex is not a personal rejection; the lack of interest really is due to the disease. The partner with IBD needs reassurance that he or she is still attractive and that the well partner is committed to seeing the health problems through to a solution. Remembering that this is a temporary bump in the road, and all relationships have many, can help put the situation in perspective.

A Word From Verywell

Keep in mind that healthy adult relationships have more nuance and depth to them than sexual gratification. There are also the benefits of companionship, trust, and friendship. Finding a way to work through this hurdle of intimacy, as couples go through all the others that IBD put in their path, will bring increased closeness as a couple. Communication is key and couples who find that challenging shouldn't hesitate to seek out further help. Strengthening the relationship is always going to be worth the work.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Jedel S, Hood MM, Keshavarzian A. Getting personal: a review of sexual functioning, body image, and their impact on quality of life in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2015;21(4):923-38. doi:10.1097/MIB.0000000000000257

  2. Christensen B. Inflammatory bowel disease and sexual dysfunction. Gastroenterol Hepatol (N Y). 2014;10(1):53-5.

  3. Nikzad Z, Iravani M, Abedi P, Shahbazian N, Saki A. The relationship between iron deficiency anemia and sexual function and satisfaction among reproductive-aged Iranian women. PLoS ONE. 2018;13(12):e0208485. doi:10.1371/journal.pone.0208485

Additional Reading

By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.