Sexuality and cystic fibrosis

Q: How can cystic fibrosis affect my sexual relationships?

A: In general, cystic fibrosis (CF) does not prevent you from having normal and satisfying sexual relationships. It does not affect desire, performance, or development in any way. However, certain particularities must be considered in order to promote and optimize sexuality. CF affects several body systems and could therefore influence sexual activity. Reproductive system

Fertility issue: The vast majority of men with CF are infertile (not to be confused with infertile) due to the absence or blockage of the vas deferens. In women, the viscosity of vaginal and cervical secretions may make fertilization more difficult, but not impossible. It is therefore important to discuss an effective contraceptive method with your CF team. In addition, the practice of safe sexual relationships is essential to prevent sexually transmitted infections.

Women with CF are more likely to develop vaginal infections. This is in part due to the frequent use of antibiotics, which alters the normal vaginal bacterial flora. The most common symptoms are itching and thick vaginal discharge, which can cause discomfort during sex. It is therefore important to communicate with your CF team in order to receive adequate treatment.

For men, the high salt content of perspiration could cause irritation of the genitals and discomfort for their partner during sexual intercourse. Good hygiene is recommended and sometimes the use of lubricant can be helpful.

Respiratory system

Coughing is often accentuated during physical exercise. It is therefore possible that coughing fits are triggered during the sexual act. Performing respiratory physiotherapy before sex could thus reduce the frequency of cough induced by effort.

The strength of cough in CF sometimes leads to urinary incontinence in women. At the wrong time, it can be embarrassing. Some exercises promote the strengthening of pelvic floor muscles, such as Kegel exercises.

Depending on the severity of the lung injury, some people may experience shortness of breath. The use of a bronchodilator (about 15 to 30 minutes before sex) can relieve effort-related shortness of breath. Certain positions may also be preferred: those that release the rib cage so as not to interfere with optimal lung expansion and those that require less energy. For those who need oxygen, it can be increased significantly during the act, in the same way as during physical exercise.

Self-image is an important component of sexual development. It may be altered during the course of the disease. The installation of a subcutaneous catheter (Port-O-Cath®) or a gastrostomy, weight loss, barreled chest, finger deformity (clubbing), oxygen supply are examples of situations that can discourage self-image. An open and candid discussion with your partner allows you to verbalize your fears and improve your understanding of CF. Discussing it with your FK team allows you to explore possible solutions and to be directed to resources offering support if necessary.

To conclude, despite the fact that there are some aspects related to CF that can influence sexual life, it is still possible to make the most of them by adapting to them.

Dr Michel Ruel

Joanie Bernier Inc., B.SC.

Cystic Fibrosis Clinic at the McGill University Health Center (MUHC)

Montreal (Quebec) Canada

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