Q. Does pain from SIBO discourage one from having sex?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 05, 2018

Hi doctor,

My wife was diagnosed with SIBO a few months back. We changed our diet to compensate and now she is on antibiotics. The pain in the gut is persistant. She does crossfit twice weekly and wall climbs at the gym. But says the pain discourages her from having sex. Any ideas?



Welcome to

So we need to consider partial response for the treatment. We should also rule out other causes for the abdominal pain. What is the exact site of pain? Is it upper abdomen, lower abdomen or generalized? Is there any vaginal discharge, burning and frequent urination or diarrhea?

I am keeping the possibility of simple gastritis, which is usually associated with upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in the throat or chest burning. If associated, she needs some antacids like Esomeprazole and Domperidone combination.

Other possibility is of pelvic inflammatory infection of genital tract which may cause pain in the lower abdomen and pain during sex. If it is not fitting in either, then antibiotics course needs to be repeated with another antibiotic.

Usually, Rifaximin is given but if inadequate relief is there, then she should be given a combination regimen of Metronidazole 500 mg three times per day along with Cephalexin 500 mg three or four times per day. She should also receive multivitamin supplements.

For immediate pain relief, she can have antispasmodic like tablet Dicyclomine 20 or Hyoscine 10 mg whenever needed upto three times a day. This should give her symptomatic relief.

Consult your specialist doctor, discuss with him/her and take the medicines with their consent.

Revert with more information to an internal medicine physician online -->

Thank you doctor,

But you did not answer the question. As she does crossfit twice weekly and is able to walk and climb 5.11’s, I am confused why sex has stopped? She is on a treatment plan.



Welcome back to

I got it. And yes, SIBO (small intestinal bacterial overgrowth) is not a probable reason for not having sex. Your doubt is appropriate. If someone is performing so much activities without much difficulties, then there should not be a problem for having sex. Now, you will have to find out the social reasons for this and discuss tactfully with her. SIBO does not appear to be related to this, considering the scenario.

However, in medical reasons, it is a dyspareunia. It is not uncommon for females to face pain during intercourse and this has got multiple reasons. It is possible that she may be attributing it to SIBO but it is actually dyspareunia.

The common cause is pelvic inflammatory disease, hormonal imbalance, and relationship stressors. So, you discuss with her and it is worthwhile to get examined by a gynecologist once.

For more information consult an internal medicine physician online -->

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