In How I Have Sex, we bring you candid retellings of people’s sexual lives that explore the multidimensional nature of this human experience. In this installment, 34-year-old G. shares her story of experiencing sexual intimacy as someone living with ulcerative colitis.

I was diagnosed with ulcerative colitis about three years ago. It’s something that I have to keep in mind on a daily basis. Ulcerative colitis is essentially ulcers (lesions/open wounds inside the large intestine which can extend into the small intestine in some cases) that can bleed. A flare-up happens when either the ulcers are inflamed or bleed in severe cases. With the condition, absorption of nutrients is hindered, and if there is a bad flare-up, bleeding takes place intodigested food matter in the gut. When this exits the body as stool, it is bloody. Because the intestine, uterus, and vagina are locatedclose to each other, vaginal intercourse ends up causing discomfort when there are flare-ups. Flare-ups can be abdominal cramps, pain, bleeding stools, and repeated stools.

It has been four years since all these changes. Since the diagnosis, I’ve been on medications. Over time, I’ve been able to come to a highly manageable place with very few flare-ups. Now flare-ups are mostly abdominal cramps, rectal burning, and at worst, diarrhea – but luckily, I don’t experience bleeding now.

With sex, the physical effects of the flare-ups affect not onlymy ability to feel pleasure,but also my mood. But when the flare-ups are bad, the physical act can induce a bowel movement; I’ve had to go to the washroom mid-sex. It’s not fun experiencing this or explaining to someone else about it mid-pleasure. When there are no flare-ups, it’s totally fine except for an area on my left abdomen which is always sensitive; I’ve come to accept it. So if my partner touches or grazes it, it’s not pleasurable so I avoid that area.

It has been a journey over the last three years. My previous relationship did not have much space for this condition; my previous partner was more scared of the illness than I was. He had some reservations about my ability to live a healthy life, which affected our relationship’s health. I was with him when I first got diagnosed – when the condition was full-blown (as opposed to now, when it is highly controlled), which had a lot of side effects.

Sex was not comfortable at that time; I did not feel desirable in many instances, and I was still learning to comprehend my own illness and vocalize it. So at times, it was challenging to vocalize what I was and was uncomfortable with during sex. Alot of things were black and white — either we had sex or there was no sex. It’s less like that now; there are more grey areas in sex where I’ve learned there are many ways to experience rather than achieve pleasure.

Related on The Swaddle:

What It’s Like to Live With Ulcerative Colitis

There are still periods where I have flare-ups and have to refrain from sex or make do with no penetrative intimacy, but it’s much less frequent, and has becomea lot more comfortable to vocalize my needs accordingly. Back when I was first diagnosed, I was mainly dealing with the actual physical symptoms of the illness which were losing blood and developing skin problems. So in general I was not in a mind-frame to think about being sexually intimate. It was very hard to explain the illness to someone else as it’s to do with a part of the body that no one wants to talk about. So I would just do whatever suited me at the time; room for creativity or exploration in sex was very few, and I would stop whenever needed. I would not always be able to explain why I wanted to stop.

Now, however, I understand my body better and so I am able to ask for positions that are comfortable for me, depending on how my body feels. I am also okay with saying no to penetrative sex and only asking for oral sex or fingering. I have also realized that I also find pleasure in just giving pleasure, so I’ve also chosen that on times when I know my body needs rest. I am just able to listen to my body more and structure those thoughts into words. I also care less now about what guys think about the condition – if they can’t deal with it I move on instead of getting upset.

I don’t think I’ve been able to fully enjoy sex when I’ve had a flare-up. A part of my mind is always there so I’ve not come to that place yet where I am able to be in the moment completely during the flare-up. There was a lot of learning about communicating what feels good and what doesn’t. The language used also makes a difference in how desire is received. Being assertive yet compassionate is what I have been learning to do. This helped a lot with oral sex especially.

Interestingly, I usually do not finish through penetration and until now neither did my partner, however this time he did which was quite fulfilling for me too. This was a first in the current relationship. So far the sex has been good as it involved foreplay, penetration oral, a lot of touching, etc. I love foreplay and it’s the primary thing that keeps my drive going. My sex drive I feel has softened a bit as compared to before – maybe I’ve been more stressed the past two years.

Sexual kinks and pleasure centers are things I’m still identifying. I love bites and sucks on my neck, my abdomen is sensitive because of the colitis, but there’s an area on the abdomen that is highly pleasurable. I love back massages and they turn me on really quickly. Recently I’ve found that someone touching or kissing or massaging my feet also turns me on. I like a little soft aggression while having sex. I like dirty talk quite a bit. I also love it when I am pleasuring my guy and he moans or groans, it’s a huge turn-on. Vocal validation is a turn-on. Whenever I can freely moan without being concerned about who can hear me, those are my favorites — it’s a luxury.

I have found that I love doing all the things that I like to be done to me… Kiss the neck, nibble on the neck and the ears, kiss their eyes and cheeks, and nose, kiss, and lick everywhere basically. Also, play with their nipples, and caress their butt and thighs.

I do have some sexual fantasies. In a public toilet, on a dance floor, on the beach, under the stars, in a camping tent, on the kitchen table, against the wall, with the windows open, dancing leads to sex. There was a time I thought colitis will get in the way of me achieving my sexual fantasies. But not anymore; now I am feeling better and able to do whatever I want periodically.

It’s challenging to think about what makes me feel sexy about myself. Verbal validation from my partner matters, or when they moan. Both of us talking about our sexual experience with each other, affection and hugs, feeling physically strong, a bra and panty that fits well, clothes that fit well – they all add to the experience. Just appreciation from another and a show of their need for me is a major turn-on.

This interview has been edited and condensed for clarity.