How to Have Better Sex With IBS If Your Symptoms Always Hit at the Worst Time
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Like an annoying third wheel, an irritable bowel syndrome (IBS) flare-up can show up just in time to ruin a moment. Content creator Jenna Jean Davis would know—she tells me she’s spent countless nights at a new fling’s house panicking about having to poop. “It shouldn’t be that big of a deal…. It’s a bodily function,” she says. But these are not your average craps. The volume! The sounds! The smells! “It’s not something you want to do at someone else’s [much less, a lover’s] house,” she says, because there’s no buzzkill quite like explosive diarrhea, if you ask, well, anybody.
As many as 10 to 15% of adults in the United States have IBS, a condition that’s characterized by a bunch of different gastrointestinal symptoms, like constipation, diarrhea, bloating, and abdominal pain. One common thread that weaves them together? A degree of unpredictability.
“We don’t really know why some people will get an IBS attack today and not tomorrow,” Andrew Boxer, MD, a board-certified internist and gastroenterologist at Gastroenterology Associates of New Jersey, tells SELF. The number of IBS triggers—like certain foods, some medications, and stress, among others—is vast, which doesn’t bode well for any sexy moment that’s spontaneous.
Short of causing a beeline to the bathroom, IBS symptoms like cramping, bloating, or feeling super gassy don’t exactly make you feel sexy, either, whether you’re about to hook up with someone new or a partner of 15 years. So it’s no wonder more than one in four people with IBS report having a low sex drive, and roughly the same number of women with IBS say that GI symptoms directly keep them from having sex. Here, experts explain why IBS can really zap your sex life—even when you’re not in the middle of a flare-up—and how to avoid this shitty situation.
Let’s talk about why IBS can do a number on your sex life.
While any sort of pain can put sex out of mind, the type of GI discomfort that’s common with IBS—and where symptoms manifest in your body—can make it especially tough to get into the mood.
There’s also the potential impact on your body image to contend with. Being gassy can cause your abdomen to become “distended,” Dr. Boxer says, or puffed outward, which might leave you feeling self-conscious or uncomfortable in an intimate situation. Certain positions—like any involving direct pressure on your belly—could also worsen stomach pain or nausea, especially if you’re dealing with constipation, Dr. Boxer adds.
But even when you don’t have any physical symptoms of IBS, you could be left ruminating on whether they may show up unannounced. “Things that are unpredictable [like IBS flare-ups] breed anxiety,” Megan Riehl, PsyD, clinical director of the Michigan Medicine GI Behavioral Health Program and co-author of Mind Your Gut, tells SELF. And this “anticipatory anxiety” can kick off what she calls the “GI stress cycle,” wherein the connection between your brain and gut leads to mental and physical symptoms. Basically, when you worry about an IBS episode, it triggers the physiological effects of anxiety, which can include spasms in your gut that lead to (drumroll, please) diarrhea or constipation. And either one can leave you stressing over when it’ll end—hence the vicious cycle.
Even when you’re hooking up with a long-term partner who’s aware of your condition (and fewer things are up to chance), you might be a little in your head about all of this. J.R., the Toronto-based founder of the IBS Patient Support Group, who asked SELF to omit his full name, often fears that he’ll have to run to the bathroom during or right after getting busy with his spouse. It’s not exactly a great headspace for sex—much less, good sex, which hinges on being present.
How to have a better sex life with IBS
1. Cut down on FODMAPs ahead of sexy time.
Experts aren’t entirely sure what causes IBS (and your personal triggers may feel equally like a mystery to you)—but one thing they do know is that foods high in certain types of carbohydrates, called fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), tend to make symptoms worse for a lot of folks with GI-related conditions. “FODMAPs pull water into the gut, which can cause or worsen diarrhea,” Kate Scarlata, RDN, MPH, a Boston-based registered dietitian who specializes in digestive health conditions and co-author of Mind Your Gut, tells SELF.
The tricky thing is that FODMAPs are found in a ton of different foods, including wheat and dairy products, as well as a variety of fruits and vegetables, like onions, garlic, asparagus, apples, pears, and cherries, for starters. Of course, these foods are nutritious (and delicious!) so it’s tough to nix them all the time—and that may not be necessary to manage your symptoms—but on days when you’re really looking to set yourself up for success in bed, following a low-FODMAP diet is a good idea, as long as your health care provider gives you the green light.
2. Go easy on the alcohol.
Similar to FODMAPs, booze is a well-established gut enemy; it generally spawns liquidy poops, even for people who don’t have IBS. You’ll also want to avoid getting sloshed for the simple reason of holding onto as much control over your mind and body as you can in a situation that may feel otherwise unpredictable, Dr. Riehl says. You’re going to feel more capable of coping with a potential IBS flare-up and communicating with a partner (more on that below) if you have all your wits about you, she says.
If you really want to sip on a boozy something, say, during a drinks date and you’re planning to bang later, go for a single glass of dry white wine or one vodka- or gin-tonic, Scarlata suggests, all of which are low-FODMAP (meaning, gentler on the tum).
3. Get strategic about timing.
Even if your IBS episodes can come out of nowhere, you might have a general idea of when in the day symptoms tend to hit you. J.R., for instance, knows that his diarrhea-predominant IBS often rears its head right when he wakes up—so mornings are pretty much off the table sex-wise, and he and his spouse aim for evenings instead.
Planning to get busy around a particular time also allows you to prepare, Dr. Boxer says, which can leave you feeling more confident. For example, if you have some warning, you could use the bathroom beforehand or sip a stomach-soothing peppermint tea.
And if it’s a dating situation where you can’t exactly schedule sex? Perhaps you plan to meet up around an optimal time for you, stomach-wise, and avoid food entirely, Scarlata suggests, so that digestion is less of a variable. That might mean an afternoon trip to a museum or a botanical garden…followed by a daytime romp in the sheets. (Hot!)
4. Take a pre-sex (post-meal) stroll.
If you regularly deal with stomach cramps or pain, that’s a sign your GI system struggles to move food and gas through your body—a common scenario with IBS. But you can give it an assist by moving yourself, Dr. Riehl says. Mild physical activity has been shown to ease constipation, pass gas through the gut, and alleviate bloating. In fact, a 2021 study found that a short post-meal walk can bring about as much—or more—relief from bloating than the drug domperidone, which helps treat various stomach issues. Hence, the beauty of the after-dinner fart walk.
But you don’t even have to make it about anything digestive. “It could be a lovely stroll [with a partner] that feels intimate and like you’re building toward whatever the next move is,” Dr. Riehl says. Not to mention, she adds, some movement before you’re about to have sex “can also reduce levels of adrenaline in the body and just help calm your system down.”
5. Do some big belly breaths in the heat of the moment.
Remember how stress and anxiety can send your intestines into a tizzy? The opposite is true too: Releasing some tension and relaxing your mind can calm your digestive system. Of course, that’s easier said than done if your brain is spiraling about whether your stomach will let out a gurgle or a fart might escape mid-thrust.
That’s where deep diaphragmatic breathing comes into play: It’s a way of using your breath to reverse-engineer a chilled-out mental state. “It also massages the intestinal organs in a way that you don’t get when you have that short, shallow, anxious breath,” Dr. Riehl says.
To try it yourself, start with a four-second inhale through your nose, followed by a six-second exhale through your mouth, focusing on relaxing your shoulders down from your ears and releasing your jaw muscles. And you can do it wherever, whenever—whether you’re trying to ease your nerves mid-date or stay present in the lead-up to (or during) sex.
6. Tell your partner about what’s going on with your bowels.
Bottling up concerns you have about sex with IBS is kinda like holding in a fart: The more you do it, the higher the chance it eventually comes out in the least comfortable way. Sure, you don’t have to tell a new fling about the texture of your poops or the stench of your farts—but sharing that you deal with a sensitive stomach upfront can help alleviate some fears about symptoms happening in front of them.
It also may not land with as much of a thud as you’re expecting: After all, up to 45 million Americans have IBS, “and that’s probably an underestimate given that not everyone participates in research or surveys,” Dr. Riehl says. So there’s always a chance this person either deals with some form of IBS too or knows someone who does.
Plus if they’re into you, they’ll be glad you told them because they should want you to feel as comfortable as possible, Dr. Riehl says. (Good sex is a product of everyone involved enjoying themselves!)
7. Fight a buzzkill with humor.
Take it from someone who publicly shares her struggles with IBS on the internet and tells me she has a great sex life: Making light of symptoms with a partner is a better coping strategy than trying to hide them, Davis says.
For example, she recalls a time when her date ordered cheesy pasta for the two of them to share, and rather than interrupt the moment with a discussion of her IBS, she simply acquiesced to eating it, even though she knew it would trigger her symptoms. Lo and behold: She fully pooped her pants—without a doubt, the worst-case outcome.
These days, she makes a joke about any food order that she knows won’t agree with her: “I’ll be like, ‘I can’t eat that because I’m literally going to shit my pants. I’ve actually already done it once, so let’s get something else unless you want to experience that.’”
8. Adjust your angles.
Sometimes partnered sex might just seem infeasible with IBS symptoms, particularly if it involves putting pressure on your abdomen—in which case, it’s worth considering how you might switch up your positions.
There isn’t necessarily an ideal one to go for, because where and how you’re feeling discomfort can change, Jessica O’Reilly, PhD, sex and relationships expert at Womanizer and host of the Sex With Dr. Jess podcast, tells SELF. “You might find that one day, being on top feels better; another day, spooning feels better; and another day, standing feels better.” Your best bet is to consider positions that don’t squish your belly into your bed or partner, as Dr. Boxer noted.
If you’re the receiving partner, Dr. O’Reilly suggests exploring a position where your partner sits on the edge of the bed, and you’re in a slight squat over their lap. She says this can help alleviate tension you may be holding in your pelvic floor—which is both common in folks with IBS and can make penetrative sex less comfortable.
9. Get into solo play.
It may be easier to adjust your sex life around your IBS symptoms when you take a partner out of the picture: You can do it whenever your gut is in a good mood (and stop if things take a turn for the gurgly without having to share that with anyone).
Masturbating can also help you get to know what turns you on and boost your body image, Dr. Riehl says, which can be a helpful baseline for sex with a partner. (Not sure where to start? Allow us to suggest some of the best sex toys.) The more confident and comfortable you are in your body, the better you’ll be at communicating how you’re feeling in bed.
10. Remember that pleasure doesn’t have to involve actual sex.
Maybe any glimmer of gas or flicker of a stomach cramp leaves you 0% interested in sex. Or perhaps a bathroom explosion sucked your libido dry. Whatever the case, there are bound to be times when your IBS makes sex unattainable—and that’s okay. Simply lying on the couch and cuddling with your partner, or making out (and not going any further) can feel just as intimate, Dr. Riehl says.
Now, when Davis is on a date and her IBS flares up, she’s learned to let the person know how she feels and sees if they might lie down with her. “I’ve asked guys to just put their hand on my tummy or tickle my stomach when I’ve felt sick,” she says, “and it’s so intimate because it establishes that they care about me.” At a basic level, it feels good in the moment—which is really what sex is all about.
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Originally Appeared on SELF
