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Sexual relationships and intimacy are important parts of life. Having an ostomy does not change this, but might require some adjustment.  

You can take steps to make yourself and your partner more comfortable with the changes in your body caused by your ostomy.

Talk with your partner about your intimacy and sexual concerns

Having a stoma changes how you look and feel about yourself. Your partner is likely also anxious about sex and may be afraid of hurting your stoma or dislodging your pouch or tracheostomy. Let your partner know that sex is not likely to harm the stoma. Try to be patient with each other.

After getting an abdominal ostomy, sexual function may or may not change. Women might have some discomfort during sex. Men may have trouble getting and keeping an erection. But these problems usually get better with time.

Prepare for intimate contact

Sex is safe and most often will not hurt your stoma. There are ways to reduce the effect of an ostomy on your sex life.

If you have a colostomy, ileostomy, or urostomy

• Make sure your pouch system fits well.
• Check the seal and empty your pouch before sex. This will reduce the chance of a leak.
• To reduce rubbing against the appliance, choose sexual positions that keep your partner’s weight off the ostomy.
• Consider wearing a cover made for ostomy pouches to decrease rubbing on you or your partner’s skin. Specialty undergarments are also available to help hide your pouch. And some people like to wear intimate clothing that covers their pouch.

If you have a tracheostomy

• If you have a tracheostomy, you may want to clear secretions from your tracheostomy tube or stoma before having intimate contact.
• Your partner may be startled at first by breath that hits at a strange spot. If you or your partner find this distracting, a scarf, necklace, or turtleneck can help hide your stoma cover.
• If you are concerned about food odors coming from your stoma, it might help to avoid garlic or spicy foods and wear perfume or cologne.
• If you can’t speak or speak clearly, it might be hard to communicate during sex. If you learn to speak using your esophagus, this can make talking during sex less of an issue. A speech aid or electronic voice box built into the stoma might also work well.

Pregnancy with an ostomy

Having an ostomy is not a reason to avoid pregnancy. But before you plan to get pregnant, you should talk with your doctor. If you are healthy, the risk during childbirth appears to be no greater than for other mothers.

Of course, any other health problems must be considered and discussed with your doctor. People who have been treated for cancer might have issues with fertility.