A chronic illness such as Crohn’s disease can affect your sexual identity. Crohn’s disease not only alters your body, it also may change how you feel about your body. As someone with Crohn’s disease, sexuality may feel especially important because it affirms feeling normal and capable—two senses of the self that can feel threatened as you work to control your symptoms.

Of course everyone has insecurities, but Crohn’s disease may amplify the normal insecurities you have. It may make you more susceptible to feelings of depression and anxiety, both of which can affect sexual health and well-being. When your Crohn’s is active, pain and fatigue also may interfere with your sexual desire and function. What’s more, Crohn’s disease can affect your partner, who may also be struggling with fears, fatigue, or managing the new role of caregiver.

But there are ways to manage all of these issues. You are not doomed to a life of celibacy, or even a life of bad sex! Here are some helpful ideas to keep in mind:

As a person living with Crohn’s disease

The first step is to work to understand how Crohn’s disease affects your sexuality. The next step is to find ways to manage any problems. Regular exercise is a tremendous boon to your sexual self overall. Local or online support groups are also a great source of validation and comfort, as they offer an opportunity to discuss your worries with others who understand. Finally, always remember that your partner and your physician are both there to help you. Communicating with them is a vital part of finding a solution to any sexual issue.

Talking to your partner

Your sexual desire may ebb and flow according to the progress of your healing. That’s why it’s important to let your partner know that you’re still open to nonsexual physical affection. When you aren’t feeling well, this affection may help support you and your partner. And it can be an opportunity to cultivate and deepen the emotional intimacy within your relationship.

Talking to your physician

Your physician doesn’t have to be an expert in sex therapy to help you address these issues. Often just having another person to listen is an enormous help. Many of us simply need reassurance that it’s normal to worry about sexuality in the face of Crohn’s disease. Because these topics are difficult to discuss, it would be helpful if physicians took the first step; however, asking patients about sexual concerns is rarely part of a regular evaluation.

By starting the conversation yourself, you can open a collaborative discussion of these sensitive concerns. Even if you don’t have any worries at the moment, once you’ve broached the subject, you can feel more comfortable mentioning any issues in the future.

Sexuality: Feel good about it

Sexuality reminds us that we are healthy and alive. Sexuality also reinforces confidence and makes us feel attractive. And for those of us with Crohn’s, it gives us pleasure when pleasures in general may be missing. Don’t shy away from talking about sexuality, so you can start enjoying it.