Inflammatory Bowel Disease, which often shows up in a patient’s teens, 20s or 30s, can have a significant impact on sexuality and fertility.
Gastroenterologist Leonard Baidoo, MD talks with his patients about these issues to help them improve quality of life.
Dr. Baidoo also helps patients make sure their IBD is well-managed, allowing them to have healthy sex lives and make plans to start a family.
Inflammatory Bowel Disease (IBD) impacts many aspects of a patient’s life, and that includes sexuality and their plans for starting a family.
Leonard Baidoo, MD is a gastroenterologist at Regional One Health and a world-renowned expert in the treatment of IBD conditions like Crohn’s disease and ulcerative colitis. His goal for every patient is to manage their disease in a way that improves their quality of life.
“IBD is a disease of young people – it usually shows up when you’re a teenager or in your 20s or 30s,” Dr. Baidoo said. “That’s right when many people are starting to have sexual relationships or thinking about having a family.”
IBD can cause symptoms like abdominal pain, fatigue, diarrhea and incontinence. Some patients who require surgery and need a colostomy bag to collect fecal matter via an opening in the abdomen.
All of these issues can complicate a patient’s sex life. Dr. Baidoo talks to his patients about ways to overcome their concerns, including having open conversations with their partner, timing sex based on when their symptoms are less severe, and managing their symptoms consistently.
Dr. Baidoo also counsels patients on fertility issues.
For men, there are certain medications that can lower sperm count, so those should be avoided when the patient and his partner are trying to conceive.
For women, most IBD medications do not impact fertility negatively. And while the disease itself also does not stop a woman from getting pregnant, some of the symptoms – like pain and poor nutrition – can make it harder to conceive and carry a pregnancy to term.
“If you’re sick, it’s more difficult to conceive, so we often suggest patients don’t try to get pregnant while their disease is not well controlled,” Dr. Baidoo said. “But if you are in remission and doing well, there is no difference in fertility because you have the disease.”
A few IBD medications are not safe during pregnancy, and patients should stop taking those about six months before trying to conceive. However, “Most medicines we use are completely safe during pregnancy. And when you’re pregnant, you still need to treat the disease,” Dr. Baidoo said.
Pregnancy can impact a patient’s IBD symptoms, but the good news is the majority of women do not experience worsening symptoms. Dr. Baidoo said about a third of patients remain the same, a third report improved symptoms, and a third worsen if they conceive when their disease is under control
“You have a two out of three chance of not getting worse,” he said. “But even if your disease does get worse, we can still treat it.”
Dr. Baidoo also talks to women about the impact of IBD surgery, as it can cause scar tissue or damage to the fallopian tubes that can make it harder to conceive. In some cases, he advises patients to delay surgery until after they’ve completed their family.
Every patient’s situation is different, so it’s important for providers and patients to talk about sexuality and fertility. Unfortunately, Dr. Baidoo said, it’s a topic that is too often overlooked.
“It’s a big topic that people want to know about but don’t want to talk about,” he said. “It’s something people worry about, so we try to speak with our patients and answer their questions. Our goal is to improve their quality of life, and these topics are a big part of that.”