Part 3 of the Women's Health Series

Bloating, gas, urgency, abdominal pain, and that relentless “what if something happens?” loop can turn sex from a close connection into stress fast. 

Digestive symptoms can quietly impact some of the most vulnerable parts of our lives...including intimacy, relationships, and self-esteem. And often, the shame surrounding those experiences feels heavier than the symptoms themselves. If you’ve ever pulled away from connection because your gut felt unpredictable, this conversation is for you. In this episode, we’re opening up an honest and empowering discussion about gut health, confidence, and reclaiming intimacy without fear or embarrassment.

We dive into this topic with our expert guest, Dr. Alyse Bedell, GI psychologist and Certified Sex Therapist, covering: 
• Why digestive functions feel taboo in sexual relationships 
• How IBS and IBD symptoms can impact desire, relaxation, and satisfaction 
• Myth-busting the idea that sex must be spontaneous to be pleasurable 
• Scripts and “reset” strategies for handling symptoms in the moment 
• Redefining intimacy so closeness does not always imply intercourse 
• Flexible planning around meals, energy, triggers, and symptom patterns 
• Partner support that reassures without becoming patronizing 
• The circular sexual response cycle and starting from sexual neutrality 
• Rebuilding sexual self-esteem with stigma work and acting with "as if” confidence 

This episode has been sponsored by Ardelyx. 

References: 

Ballou S, McMahon C, Lee HN, et al. Effects of Irritable Bowel Syndrome on Daily Activities Vary Among Subtypes Based on Results From the IBS in America Survey. Clin Gastroenterol Hepatol. 2019 Nov;17(12):2471-2478.e3. 

Fretz KM, Hunker KE, Tripp DA. The Impact of Inflammatory Bowel Disease on Intimacy: A Multimethod Examination of Patients' Sexual Lives and Associated Healthcare Experiences. Inflamm Bowel Dis. 2024 Mar 1;30(3):382-394. doi: 10.1093/ibd/izad106. PMID: 38206426; PMCID: PMC10906359.

Wang J, Varma MG, Creasman JM, et al. Pelvic floor disorders and quality of life in women with self-reported irritable bowel syndrome. Aliment Pharmacol Ther. 2010;31(3):424-431. doi:10.1111/j.1365-2036.2009.04180.x

Dubinsky MC, Potts Bleakman A, Schreiber S, et al.. Impact of moderate-to-severe ulcerative colitis and Crohn's disease on sexual activity: United States and European patient perspectives from the communicating needs and features of IBD experiences (CONFIDE) survey. Curr Med Res Opin. 2025 Jun;41(6):1017-1030. doi: 10.1080/03007995.2025.2530736. Epub 2025 Jul 17. PMID: 40635574.

Come As You Are: Revised and Updated: The Surprising New Science That Will Transform Your Sex Life by Emily Nagoski Ph.D.  

Becoming Cliterate: Why Orgasm Equality Matters--And How to Get It by Laurie Mintz

The American Association of Sexuality Educators, Counselors and Therapists (AASECT) (great resources as well as a place to find a certified sex therapist)

Give us a follow us on social media @TheGutHealthPodcast, where we'd love for you to share your thoughts, questions, and experiences. 

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.  

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment.  Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.