Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) of the large intestine (colon) that affects the lining of the colon causing inflammation as a result of an overactive response by the immune system. This inflammation can result in tiny open sores or ulcers that develop along the surface of the colon causing pain and discomfort. Crohn’s disease is also an IBD but with an important difference between it and UC. Crohn’s disease can affect any part of the digestive tract from the mouth to the anus whereas UC is limited to the large intestine and the rectum.
In general, IBD affects men and women equally. However, most North American studies show that UC is more common in men than in women. In addition, men are more likely than women to be diagnosed with ulcerative colitis in their 50’s and 60’s.
Besides UC’s affect on the colon, it also can have an unexpected contribution to sexual dysfunction of erectile dysfunction (ED). ED is very prevalent among men with IBD including both UC and Crohn’s disease. All men with either UC or Crohn’s should automatically be screened for ED too.
Erectile dysfunction and ulcerative colitis
There are a variety of reasons why men with UC unfortunately are more likely to suffer from ED. Many of the symptoms of UC likely lead to men to have less sexual desire and increased sexual functioning. When in an active phase, symptoms can include diarrhea, abdominal pain, rectal bleeding, urgent need to move bowels, and a sensation of incomplete evacuation of bowel movements.
Autoimmune diseases such as UC can also carry a psychological toll on men’s mental health. A 2017 meta-analysis found that men with UC experiencing depression along with anxiety, stress, and poor social and emotional functioning, were all predictors of sexual problems that followed. Even if these men took antidepressants to deal with issues, antidepressant medication in and of itself, can lead to reduced sexual functioning as well.
Helping men with ulcerative colitis and erectile dysfunction
A first step in helping men with ED and UC is for either their doctor or the patient themselves, to begin the discussion. Ideally, all gastroenterologists should ask their male UC patients if they are experiencing ED. But, if that is not happening, a man should tell their doctor about this problem in order to get help.
Once this conversation has begun, it sets the stage in motion for seeking solutions. Depending on each man, some may benefit significantly from a referral to a urologist or sex therapist. Other men may benefit most from prescription medications such as phosphodiesterase type-5 inhibitors, the class of drugs marketed for ED including Viagra and Cialis.
Regular follow-ups is also recommended keeping tabs on their sexual health and what suggestions or medications are working or not. This helps men be more open discussing ED with their doctor helping them feel heard and acknowledged about their health concern.