Reproductive and sexual health concerns in gastrointestinal illness: a narrative review

Gastrointestinal (GI) disorders, including inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), can have a profound and widespread impact on quality of life, including on reproductive and sexual functioning. However, reproductive and sexual concerns are rarely addressed in GI appointments and patients desire more information and guidance related to these important aspects of quality of life. The purpose of this review is to provide a resource for providers seeing GI patients with these issues and to provide suggestions of resources and strategies to address these concerns.

We conducted a non-systematic, narrative review of databases including PubMed and Google Scholar to identify English language research on reproductive and fertility concerns and sexual dysfunction (SD) in the setting of GI illness. We applied a biopsychosocial lens to highlight the complex, multifactorial nature of illness experience and quality of life.

GI illnesses, including IBD and IBS, contribute unique biopsychosocial risk factors to disruptions in reproductive and sexual functioning. GI patients have unique counseling needs that may shift throughout the reproductive lifespan. Research indicates that psychosocial outcomes improve when patients receive education and counseling, yet providers rarely address these topics.

Multidisciplinary providers working with GI patients should routinely assess for reproductive and sexual concerns, and share accurate education with patients to reduce misinformation, shame, untreated symptoms, and emotional distress. Future research should continue to address these topics, as evidence remains inconclusive in several biopsychosocial domains of GI reproductive and sexual health.