Inflammatory Bowel Disease (IBD) is often a debilitating condition which compromises and severely impacts on quality of life. Within the context of men’s health- chronic diarrhoea, abdominal bloating and rectal bleeding can have significant impact on partner intimacy, body image and sexual wellbeing.
A systematic review and meta-analysis of patients with IBD which was published in the Lancet, reported that up to a third of IBD patients were affected by symptoms of anxiety and a quarter affected by depression.
Additional research has also shown that clinicians can often have different priorities to patients who have IBD, therefore, understanding the lived experiences of men with IBD is important for health services to provide person-sensitive solutions.
What is Inflammatory Bowel Disease?
Inflammatory Bowel Disease describes two specific conditions- Crohn’s Disease and Ulcerative Colitis. Both of these diseases are usually diagnosed in the teenage and young adult period and are life-long conditions.
The cause of IBD remains unknown, however by 2030 nearly 2% of Australians will have received a diagnosis of IBD.
IBD & sexual wellbeing research
In a study published in the Journal of Clinical Nursing researchers conducted semi-structured interviews with 22 men to understand the sexual wellbeing of men with IBD.
The researchers noted that ‘within the broader IBD research literature, the sexual health needs of men have been similarly overlooked…with most studies focusing on women’s health due to the impact of the disease on fertility and pregnancy.’
IBD & male research participants
The demographic details of the 22 men included in this study were-
- Men were aged between 20-66 years of age.
- 21 participants were born male, and one identified as male (having undergone gender-affirming surgery).
- 19 were employed, 1 was a student, 1 was retired, and 1 was ‘unable to work’.
- 17 identified as heterosexual, 3 as bisexual and 2 as homosexual.
- 15 were diagnosed with Crohn’s Disease, 6 with Ulcerative Colitis & 1 diagnosed with Inflammatory Bowel Disease Unclassified.
- Relationship status: 9 were co-habiting, 7 were married, 3 were single, 1 divorced, 1 dating & 1 non-habiting.
- The median time since diagnosis was 6-years.
Following interviews with the 22 men in this research study, 3 distinct themes emerged which are discussed below. All quotes have been taken verbatim from the original manuscript.
Theme 1: IBD shapes intimate connections
The presence of a trusted partner was seen as crucial for supportive sexual wellbeing and engagement following diagnosis,
‘Brought us closer together, but at the same time it separates you’.
Some men articulated that meeting the sexual desires of their partners over their own sexual pleasures took precedence,
‘If you don’t engage in sexual acts with your partner for long enough, you can emotionally and mentally start to diverge’.
For men engaging with a new partner, disclosure of IBD could be a perceived barrier,
‘It’s a fear but they’ll find it quite disgusting, maybe think of me as a lesser person and be completely turned off.’
Men also spoke of bodily changes including fluctuations in weight and body muscle mass due to IBD. Changes in appearance affected how some men felt sexually,
‘I just didn’t feel like sex, cause I just felt really self-conscious about it and her having to see me that way. I just felt small you know, I didn’t think that she’d be able to see me as a sexual person, after seeing me like go through that and then like physicality’s of wound care and stuff. I guess, I just thought like how on earth is she ever going to see me that way again?’
Partners provided an important role in promoting acceptance of visual bodily changes,
‘She was absolutely fine with it (the stoma), like probably couldn’t be more supportive, was just like I’m not bothered if that’s part of you’.
Treatments for IBD often placed a priority on physical recovery over sexual intimacy,
‘When I had the stoma…it was only a period of 6 months, I don’t think from memory I was interested in anything romantic at all. I think because again, I was dealing with this thing’.
Theme 2: IBD thwarts sexual experiences
All the men interviewed spoke of the limiting impact IBD had on their sexual experiences to varying degrees,
‘One doesn’t feel sexy when one feels bloated or like you need the toilet and it’s a sensually, it’s a distracting feeling to have. So that had a big impact, that and being tired and low energy also impacted things, so even if I could get and maintain an erection doesn’t mean that I was particularly kind of energetic or in the mood’.
For men who were homosexual or bisexual, a lack of understanding by health professionals was sometimes observed,
‘He was like; I mean with your condition why are you like this and I’m just simply like; I like what I like and I have to make it work’.
For other men, the need to maintain cleaning and hygiene rituals affected sexual spontaneity,
‘We’ve had a nice evening, are we likely to have sex tonight, I need to have a shower beforehand and prepare myself there’s so many things I am trying to prepare, mentally prepare for all possible options in my head which is very taxing’.
Theme 3: IBD disrupts male gender norms
The male participants in this study had varying views on how IBD affected masculine norms. Returning to prior physical strength and fitness was prioritised by many,
‘I used to be in decent shape before it happened. I had decent muscle on me and would be happy to walk around with my top off…we went on holiday and I had a lot of anxiety about walking around with my top off.’
The researchers observed that the need to be stoic and resilient (a traditional masculine norm) was evident in conversations with some of the men,
‘I think being a man is just, get on with it.’
IBD & men study conclusion
The researchers concluded their study of sexual health and wellbeing in men with IBD by noting that, ‘the narratives presented in this study bring to light the disease-specific issues faced by men and the urgent need for improved understanding, assessment and care of the wider sexual health and well-being issues faced by men with IBD, beyond erectile function’.
Expert Opinion: Justan Singh – Crohn’s Educator
Let Your Symptoms Be Your Guide, Not a Wall
I used to think that my Crohn’s disease was something I needed to hide. You know, downplay the symptoms, avoid situations where it might come up, just try to keep it in the background. But after living with it for a while, I realized that wasn’t helping me—it was actually making things harder. What if instead of hiding from our symptoms, we let them be the filter for who’s really worth having in our lives?
My Story: From Hiding to Embracing Crohn’s
There was a time when I thought my symptoms would stop me from living fully, especially in terms of how I saw myself sexually. I worried that having a colostomy bag would turn people off, but in this day and age, people are so much more accepting and forgiving than we give them credit for. That’s when I decided to challenge my own beliefs about my body and sexuality.
Over 10 years ago, I stepped on stage as the world’s first stripper with a colostomy bag. I didn’t know what to expect, but from the moment I saw a room full of young women cheering me on, all those limiting beliefs I had just shattered. I never looked back. That experience taught me that I didn’t have to hide or feel ashamed—people saw me for who I am, not for my condition.
Why We Hold Back
As men, we’re often told to be tough, keep things to ourselves, and never show weakness. So, when you’re dealing with something like IBD, it feels natural to try to keep it under wraps, afraid that others will see you differently. But the truth is, hiding takes more energy and isolates us even more. It’s exhausting pretending to be something we’re not, especially when our reality is tied to a chronic condition.
What Changed for Me
When I stopped hiding and embraced my symptoms as part of who I am, I found freedom. My IBD and colostomy bag became a way to filter the people in my life—those who couldn’t handle it weren’t worth my time, but those who stuck by me saw my real value. That day on stage taught me something: I don’t need to be ashamed of any part of myself. My Crohn’s is part of my story, and it’s made me stronger.
It’s Like Letting the Waves Roll In
It’s like standing at the shore watching waves crash in—you can’t stop the ocean, but you can decide how to face it. IBD is like those waves—it’s there, and we can’t control it, but we don’t have to fight it either. When we learn to go with the flow and accept that it’s part of our life, we stop wasting energy trying to hold back the tide. And when we embrace it, life becomes a lot less exhausting.
How I Found Peace with It
Here’s what I realized: the right people, the ones who really matter, won’t be scared off by Crohn’s or a colostomy bag. The more I owned my truth, the more I found people who respected me for it. That day on stage didn’t just change how others saw me—it changed how I saw myself. Now, I live my life without apologies.
The Wisdom I’d Pass On
I get it—opening up and showing this side of yourself can feel terrifying. But hiding only pulls you further from the connection and understanding you need. By embracing who you are, symptoms and all, you’ll attract people who truly care. Closing off does the opposite of what we want. The real strength comes from being open, honest, and unapologetic about what you’re going through.
