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

Abstract

AIM: 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. INTRODUCTION: 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. METHODS: 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. RESULTS: 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. DISCUSSION: 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. CONCLUSION: 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. IMPLICATIONS FOR NURSING: The findings provide justification for integrated teams of psychologists, sexual health nurses and potentially body-image specialists which could be coordinated by registered nurses. IMPLICATIONS FOR HEALTH POLICY: 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.