Sexual Health

Sexual Health Challenges in Individuals With and Without Inflammatory Bowel Disease: A Population-Based Study in Denmark.

TL;DR

Individuals with ulcerative colitis as well as patients with IBD experiencing active disease, stoma, or perianal involvement faced more sexual challenges than those without IBD, highlighting the need for gastroenterologists to proactively address sexual health and provide tailored support.

Key Findings

Men with ulcerative colitis had significantly higher odds of hypoactive sexual desire disorder compared to individuals without IBD.

  • Adjusted odds ratio for hypoactive sexual desire disorder in men with UC: aOR 2.18 (95% CI, 1.13–4.19)
  • Study used logistic regression controlling for relevant covariates
  • UC group consisted of 437 individuals identified from the Danish National Patient Register
  • Comparison group was drawn from 62,675 participants in the Project SEXUS cohort

Women with ulcerative colitis had significantly higher odds of hypoactive sexual desire disorder compared to women without IBD.

  • Adjusted odds ratio for hypoactive sexual desire disorder in women with UC: aOR 1.66 (95% CI, 1.04–2.66)
  • This finding was statistically significant as the CI does not cross 1.0
  • The 6-item Female Sexual Function Index (FSFI-6) was used to assess female sexual dysfunction
  • Results were part of a population-based cross-sectional study design

Women with ulcerative colitis had significantly higher odds of genital pain dysfunction compared to women without IBD.

  • Adjusted odds ratio for genital pain dysfunction in women with UC: aOR 2.30 (95% CI, 1.26–4.19)
  • Genital pain dysfunction was assessed using the FSFI-6
  • This was one of the more pronounced associations observed in the overall IBD population
  • No equivalent statistically significant finding for genital pain was reported for men with UC or for individuals with Crohn's disease in the overall analysis

Overall sex life satisfaction and relationship quality were similar between individuals with IBD and those without IBD.

  • This finding applied to both ulcerative colitis and Crohn's disease groups
  • The study used study-specific measures in addition to validated instruments (IIEF-5 and FSFI-6)
  • 218 individuals with Crohn's disease and 437 with ulcerative colitis were compared to non-IBD controls
  • Similar overall satisfaction was observed despite elevated odds of specific sexual dysfunctions in UC

Overall IIEF-5 and FSFI-6 scores did not indicate an excess of sexual dysfunction in the general UC and CD populations.

  • The 5-item International Index of Erectile Function (IIEF-5) was used for men and the 6-item Female Sexual Function Index (FSFI-6) for women
  • No statistically significant excess of dysfunction was detected on these standardized scales at the overall IBD population level
  • Specific subdomains (desire, pain) showed elevated odds even when composite scores did not
  • This suggests composite scoring tools may miss specific sexual health challenges in IBD populations

Patients with IBD who had active disease, a stoma, or perianal involvement had particularly elevated odds of sexual dysfunctions compared to non-IBD controls.

  • Subgroup analyses were conducted for active disease, stoma, and perianal involvement
  • These subgroups showed higher odds of sexual dysfunction than both the general IBD group and non-IBD controls
  • Perianal involvement and stoma are known to affect body image and physical function, which may mediate these associations
  • Results were reported as adjusted odds ratios with 95% confidence intervals

The study identified 655 individuals with IBD from a large Danish population-based cohort using registry linkage.

  • 62,675 participants from the Project SEXUS cohort were linked to the Danish National Patient Register
  • IBD diagnoses were identified between 1996 and 2017
  • 437 individuals were diagnosed with ulcerative colitis and 218 with Crohn's disease
  • Cross-sectional design was used with logistic regression as the primary analytic method

The authors concluded that gastroenterologists should proactively address sexual health and provide tailored support for patients with IBD.

  • Clinical recommendation was based on findings of elevated sexual dysfunction in UC and in IBD subgroups with complicated disease
  • The authors noted that people living with UC or complicated IBD are more likely to face sexual problems than those without IBD
  • The study highlights sexual health as an area requiring increased clinical attention in IBD care
  • Both disease-specific factors (active disease, stoma, perianal involvement) and sexual health domains (desire, pain) were identified as targets for clinical inquiry

What This Means

This research suggests that people living with inflammatory bowel disease (IBD)—particularly ulcerative colitis (UC)—face specific sexual health challenges that are more common than in people without IBD. Using data from over 62,000 Danish adults, researchers found that men and women with UC were roughly twice as likely to report low sexual desire, and women with UC were about twice as likely to experience genital pain during sex. Importantly, these differences were even more pronounced among people with IBD who had currently active disease, a stoma (a surgically created opening in the abdomen for waste), or disease affecting the area around the anus. Despite these specific challenges, people with IBD reported similar overall satisfaction with their sex lives and relationships compared to those without IBD. Standardized sexual function questionnaires also did not flag a broad excess of dysfunction across the whole IBD group, suggesting these tools may miss targeted problems like pain or low desire that are more common in this population. This research suggests that the sexual health impacts of IBD are real but often specific and may go unaddressed in routine medical care. Doctors treating IBD patients—especially those with active or complicated disease—may benefit from routinely asking about sexual health and offering appropriate support or referrals, rather than waiting for patients to raise these concerns themselves.

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Citation

Larimore C, Albaek Jacobsen H, Graugaard C, Andersson M, Larsen L, Frisch M. (2026). Sexual Health Challenges in Individuals With and Without Inflammatory Bowel Disease: A Population-Based Study in Denmark.. Inflammatory bowel diseases. https://doi.org/10.1093/ibd/izaf234