Oct. 13, 2022 — If you live with inflammatory bowel disease, chronic liver disease, or irritable bowel syndrome and it’s affecting your sex life, you’re not alone. 

These GI conditions are the ones most associated with sexual issues, including erectile dysfunction and loss of libido in men and pain during intercourse for women. 

The good news: Treatments can help. The bad news: Few doctors or patients bring up these intimate challenges during a doctor visit, a new survey finds. Only 4% of patients and 29% of gastroenterologists start a conversation about sexual dysfunction, for  instance. 

Of the 426 doctors surveyed, 80% said lack of knowledge was the main reason. Another 58% said they don’t have enough experience in this area, 44% said they don’t have enough time, and 30% said they are embarrassed.

"While patients with gastrointestinal disorders often experience sexual dysfunction, discussions around the matter are not routine in gastroenterological care," Marco Romano, MD, from the University of Campania "Luigi Vanvitelli," in Naples, Italy, said at this year’s United European Gastroenterology (UEG) 2022 meeting in Vienna. 

Doctors recognize

 this is a quality-of-life issue for their patients, Romano says. Most doctors would welcome more education and training in this area during medical school, residency, or as experienced doctors. 

And many doctors surveyed think patients would welcome a doctor respectfully asking if their GI disorder interferes with their intimate relationships. This discussion "is often considered a relief to patients who find that the gastrointestinal problem and the sexual dysfunction are interlinked," Romano said. 

GI and other medications could be partly to blame, like certain drugs to help control acid reflux. Nearly 15% of clinicians said that prokinetic agents played a role in patients’ sexual dysfunction, and 18% cited proton pump inhibitors. Both drug classes are considered responsible for sexual troubles.

The pros and cons of different medications should be discussed with patients, said Asma Fikree, MD, PhD, from the Royal London Hospital, Barts Health NHS Trust in London.

The survey also stresses the importance of asking patients about sexual dysfunction, Fikree said. 

“We might do it in men and ask about erectile dysfunction, but we are very poor about asking in women," said Fikree, who moderated the session at UEG. "Some patients might not be very bothered by sexual dysfunction, but others might consider it very important.”

"We should be considering this as part of their treatment and care."

Show Sources

SOURCES:

United European Gastroenterology (UEG) 2022, Oct. 9, 2022.

Marco Romano, MD, University of Campania.

Asma Fikree, MD, PhD,  the Royal London Hospital.

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