A female with an inflammatory bowel disease (IBD, Crohn's disease, ulcerative colitis) may develop infertility or sexual dysfunction.


Active inflammatory bowel disease is associated with:

(1) decreased fertility

(2) an increased risk of miscarriage


Intestinal manifestations of the IBD that may interfere with sexual behavior:

(1) abdominal pain

(2) diarrhea

(3) perianal fistula

(4) enterocutaneous fistula


Complications of medications:

(1) high dose corticosteroids

(2) drugs with teratogenic effects


Complications of intestinal surgery, including restorative proctocolectomy with ileoanal pouch anastomosis (IPAA):

(1) adhesions around the ovaries and/or fallopian tubes

(2) stoma

(3) dyspareunia


Extra-intestinal manifestations:

(1) ankylosing spondylitis

(2) skin lesions in the genital area

(3) significant oral involvement


Psychological barriers to a sexual relationship:

(1) poor self-image

(2) depression

(3) fear of intimacy


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