Inflammatory Bowel Disease, Self-Esteem and Sexual Well-Being

This research explored associations between self-esteem, satisfaction with physical appearance, sexual satisfaction and physical and mental health among women living with inflammatory bowel disease in Australia.

Inflammatory bowel disease which includes Crohn's disease and ulcerative colitis is a chronic autoimmune disease. Its relapsing, remitting nature has deleterious impacts on self-esteem and sexual well-being.

The study employed a cross-sectional design with secondary exploratory analyses and used an online survey to collect data from Australian women between March and November 2024.

Responses from 64 women revealed a nuanced but complex interrelationship between self-esteem and biopsychosocial factors which impact on sexual well-being. Self-esteem scores for all women sat at the low end of normal, and none of the women reported any level higher than average. Women with lower self-esteem reported more dissatisfaction with their physical appearance, poorer mental health and lower sexual satisfaction.

Having a high self-esteem is a protective factor in adaptation to life events. The chronic nature of inflammatory bowel disease highlights that adaptation and self-realignment are ongoing processes of which clinicians must be cognisant because chronic illness can have negative effects on self-esteem.

Sexual well-being is influenced by multiple intersecting biopsychosocial factors. Routinely incorporating discussions which relate to mental health, self-esteem and body image into assessments for people living with inflammatory bowel disease is critical in holistic care.

The findings provide justification for integrated teams of psychologists, sexual health nurses and potentially body-image specialists which could be coordinated by registered nurses.

Women-specific care pathways which acknowledge reproductive life stages, relationship health, sexual well-being, hormonal variation, menstrual impacts and sociocultural gender pressures are required. Introducing regular screening, which includes adding registries on digital platforms, may assist with ensuring equitable holistic healthcare.