Women with irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) frequently report sexual dysfunction, according to new research presented at Digestive Disease Week 2026, which evaluated psychosocial factors and anorectal manometry (ARM) findings in a large female patient cohort.

The study found that reduced sexual interest was strongly associated with older age and depression, while objective pelvic floor dysfunction measures did not fully explain symptoms.

Study Findings

Researchers analyzed 349 sequential female patients referred for ARM between August 2023 and October 2025 for CIC or IBS-C evaluation. Participants completed several validated questionnaires assessing sexual function, bowel symptoms, fecal incontinence, gastrointestinal-specific anxiety, depression, and quality of life.

The cohort had a mean age of 47.9 years, and most participants were White. Nearly 60% had CIC, while 40.1% had IBS-C. More than 58% of patients reported below-average interest in sexual activity during the prior month.

Compared with women reporting average or above-average sexual interest, those with reduced interest were significantly older (51.7 vs 42.3 years; P=0.01). They also demonstrated higher levels of anxiety, depression, and gastrointestinal-specific anxiety, all reaching statistical significance (P<0.01).

Unexpectedly, women with lower sexual interest reported less vaginal and vulvar discomfort than women with normal sexual interest. Investigators noted that this finding suggests sexual dysfunction in constipation disorders may not primarily stem from pelvic pain or genital discomfort.

ARM testing also revealed lower maximum resting anal pressures and lower squeeze pressures among patients with below-average sexual interest (P<0.01 for both). Concurrent fecal incontinence was nearly twice as common in this group.

In multivariable logistic regression analyses, age (odds ratio [OR], 1.02; 95% CI, 1.01-1.04; P=0.01) and depression (OR, 1.22; 95% CI, 1.09-1.38; P<0.01) were independently associated with reduced interest in sexual activity. Difficulty with vaginal lubrication was paradoxically associated with normal sexual interest (OR, 0.10; 95% CI, 0.05-0.20; P<0.01).

Clinical Implications

The findings highlight the complex relationship between chronic constipation disorders and female sexual dysfunction. Although pelvic floor abnormalities are often considered a potential contributor, the study suggests psychosocial factors—particularly depression and anxiety—may play a larger role in diminished sexual interest.

For gastroenterologists, colorectal specialists, pelvic floor clinicians, and primary care physicians, the data underscore the importance of screening for sexual dysfunction and mental health symptoms in women with CIC and IBS-C. Reduced sexual interest may coexist with fecal incontinence and impaired quality of life even when classic pelvic floor hypertonicity is absent.

The results also challenge assumptions that sexual dysfunction in constipation-related disorders is directly tied to vaginal pain or increased pelvic floor tone. Clinicians may need a broader multidisciplinary approach that incorporates behavioral health evaluation alongside gastrointestinal and pelvic floor assessment.

Sexual dysfunction appears highly prevalent among women with IBS-C and CIC, with depression and age emerging as major associated factors. The study suggests that sexual health concerns in constipation disorders are multifactorial and may not be explained solely by pelvic floor dysfunction, highlighting the need for integrated patient care strategies.

Reference:

Silvernale C, Beck V, Dorff EM, Staller K. Sexual dysfunction is not related to objective measures of pelvic floor dysfunction in a cohort of women with chronic constipation or irritable bowel syndrome with constipation. Presented at: Digestive Disease Week, May 2-5, 2026. Chicago, Illinois.