Let’s talk about sex (and IBD)

Sexual dysfunction is common amongst inflammatory bowel disease (IBD) patients, particularly in the presence of active disease. The prevalence is very high, 45%–60% of women and 15%–25% of men1. Reflecting on my own practice, I do not routinely ask patients about how IBD may affect their sex life and vice versa. However, this aspect is clearly an important part of maintaining a good quality of life in the same way as compliance with medications or even psychological effects of IBD. How can we better help our patients with this?

Elford et al conducted an online cross-sectional survey to patients from Royal Melbourne Hospital and included all patients from 18-85 with a confirmed diagnosis of IBD. A summary of the responses can be seen below which are taken directly from the paper (figure 1). The results that struck me the most is that a significant proportion of patients had experienced some form of effect to their sex life. This was more commonly seen with those with a diagnosis of Crohn’s disease and those suffering with active disease. Alongside this, the authors found that the majority of patients would like to be linked to their sexual health services if this was available.

Figure 1: Likert scale answers on participant’s experience on sexual dysfunction and its relationship to IBD

These results should support us as clinicians to ask these questions in our consultations much more freely. We also should be looking at how sexual health services can be better integrated to provide holistic care for these patients as part of their IBD care. This is also supported by the fact that the authors found that only a minority of patients would seek this help themselves. This is intrinsically linked to psychological health and we have a responsibility to not only help keep their disease under control but to keep them well holistically. I have certainly reflected on this and need to ensure we ask these questions and help patients realise that sexual dysfunction is not normal just because they have inflammatory bowel disease. In the words of the authors: “sexual dysfunction is underserved”.

References

  1. Mikocka‐Walus A, Massuger W, Knowles SR, et al. Psychological distress is highly prevalent in inflammatory bowel disease: A survey of psychological needs and attitudes. JGH Open 2020;4:166–71. doi:10.1002/jgh3.12236

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