You may have heard of the term 'dyspareunia', this is the medical word for pain with sex. Pain during or after sex is a common symptom of endometriosis with many reporting either symptom or both. Sex should be an intimate and pleasurable experience and when pain is the outcome, it’s not surprising that it can lead to a negative response both physically and psychologically. It’s common for those who experience pain with sex to have a drop in libido (sexual desire). If something causes pain the body will want to avoid it, this is a protective mechanism.
Why is sex painful?
The tissues within the pelvis and the vagina can become more inflamed with endometriosis, this can make the tissues more sensitive and responsive to pain. What we also see with endometriosis is that tissues can become tethered (stuck together) by fibrosis/scar tissue. Mobility and expansion of the vagina can cause pain, as these tissues are not freely mobile, instead they can pull and stretch the tissues affected by endometriosis within the pelvis.
It's not just pain…
Pain isn’t the only factor affecting sex and intimacy for couples. Other factors associated with endometriosis can include bleeding during or after sex; fatigue; feeling unwell; low mood; loss of body confidence; the stress of trying to get pregnant; and medication side effects such as, vaginal dryness and reduced libido.
The impact to relationships…
Pain, bleeding, low libido, and fertility problems can be difficult and distressing for both partners. It’s important to speak to your partner about your feelings and symptoms, your partner may also be worried and have feelings of helplessness and guilt. Supporting each other and finding ways to build intimacy is fundamental. Remember, sex isn’t just penetration, there are many other ways to achieve intimacy and pleasure. Supportive communication and finding your own ways together as a couple can help to strengthen relationships.
For more information, our recent webinar on how endometriosis can affect sex and how it can be managed by physiotherapy may be helpful: endometriosis-uk.org/webinar/endometriosis-and-sex
For further information on managing symptoms of endometriosis related pain, including painful sex, please download our Pain Management for Endometriosis Information Booklet
