Relationships and Sexuality
Many people with new ostomies are concerned with returning to work or school activities. "Will I smell? Will there be noises? Will they see it? What if someone asks?", are commonly expressed concerns. You need to be reassured that there should be no odour as the appliances are designed for stool, however, deodorant drops or room aerosols for the bathroom can be used to add confidence and comfort.
Noises are often muffled by clothing and can be further muffled by placing an arm across the stoma site. The appliance itself should not be visible — the key point to remember is that as a person, you have not changed, but rather, have undergone a surface change giving you back your health.
The decision to share with others that you have an ostomy is very personal. Disclosure will occur only if you want it to.
Sexuality and Intimacy
Life with an ostomy should not limit or curtail your sexual activity. Often, the return to health and well-being, and the associated improvement in energy and strength, will encourage a return to sexual relations. Hesitancy or worry at the beginning is normal. Most individuals are concerned with perceived changes in their desirability and attractiveness to their partner, and are worried about how to manage the appliance during intercourse. Communication is key. Be open with your partner and share concerns and worries. Comfort and confidence will come with time.
There are some things that you can do that may make your experience easier. If you are using a two-piece system, a mini-pouch or stoma cap is available to make the appliance more discreet. You can switch to it prior to engaging in sexual activity. Remember that smaller pouches and caps have a limited capacity and should not be worn for extended periods of time.
When wearing your regular pouch, try to empty it before beginning relations. Some people like to secure the pouch against their skin to minimize its movement and lessen any "rustling" noises. This can be done simply with tape, or more creatively with things like cummerbunds, crotchless underwear, a half-slip, or a tube top stretched over the appliance. Try different positions, as some may be more comfortable than others. Sexual activity will not hurt your stoma. While being sensitive to your personal needs and that of your partner's, maintaining a sense of humor throughout will help with the transition.
If you are entering into a new relationship and it is progressing towards intimacy, then disclosure well in advance of sexual activity is helpful. While the amount of information you may want to share about your illness is a personal choice, you may want to start the conversation with: "I had an illness that required surgery on my bowel. I needed to have my bowel diverted to the outside and now I have an ostomy. That surgery allowed me to feel healthy again."