For a lot of women with endometriosis and pelvic pain, sexual intercourse is not the erotic, passionate and pleasurable experience that we all wish it to be. Painful sex (also known as dyspareunia) is very common for women that have pelvic pain.
The pain can be different for everyone. Most describe it as sharp, stabbing, jabbing or a deep ache and it ranges in intensity from mild to excruciating. It may be felt during intercourse, for up to 24–48 hours after intercourse, or both. Some women experience pain with any form of intercourse, but others experience it only with deep penetration. Some women feel pain only at certain times of the month, such as around the time of the period, while others feel it throughout the month.
There are lots of possible causes but with some help, you and your doctor can usually work out what the problem is. Common causes of pain with intercourse include sensitive skin at the opening of the vagina (called provoked vesibulodynia), painful pelvic muscles, a painful bladder, a painful uterus or endometriosis. Learn more about the causes and treatments for painful sex here.
Experiencing pain with sex not only influences your body, state of mind, and libido, but can also lead to difficulties in expression of sexuality as an individual and as a couple. Endometriosis.org has got some great advice that may be helpful for you and your partner:
See a Professional. If you are experiencing pain during sex, speak to your doctor or gynecologist about possible treatments.
Communicate. Dealing with painful intercourse can be a difficult and emotional task. It needs open and honest communication between you and your partner. It also needs both of you to be patient and understanding towards each other. In particular, you need to develop an awareness of each other’s predicament and feelings. Without these efforts, dealing with the problem can quickly degenerate into an emotional battlefield. Sex therapists may also be able to help you with this as well if you are having trouble working it out between yourselves.
Keep talking. If you experience pain during intercourse, it is important to tell your partner immediately, so he can stop. Trying to conceal the pain will usually result in you unconsciously withdrawing from him, which may be perceived as rejection, even though it isn’t. In the long term, it may lead to hesitation on your part regarding any intercourse, which will place unnecessary stress on the relationship. It is better to be open and honest at the time, so you and your partner can learn which situations create pain. That way you can learn which situations to avoid, so you can both have pleasurable and satisfying intimacy together.
Experiment – and check out the time of the month. With a little experimenting, you may be able to find ways or times when you can have intercourse. If appropriate, try experimenting with different positions. Some women can enjoy intercourse if it is shallow, or if slow and gentle penetration is used. You may like to try experimenting with foreplay and artificial lubricants. Some women are able have pleasurable intercourse if there is plenty of foreplay to stimulate the natural lubricants in the vagina or if a lubricant such as KY Jelly is used. Similarly, it may be appropriate to try experimenting with the timing of intercourse. Some women find that intercourse is pleasurable at certain times of the month, such as in the week after ovulating or in the two weeks after having a period. If you can identify the times when intercourse is pain-free, make that time of the month a special time to enjoy intimacy together.
Find Alternatives. Even with the most patient and sensitive experimentation, some women will not be able to experience pain-free intercourse because of their pelvic pain. If this is the case, you need to experiment to find other ways of sharing intimacy and lovemaking — after all, intercourse is not the only way of being intimate! Lying in bed together, kissing, hugging, holding, stroking, massaging, and mutually masturbating can be as just pleasurable as intercourse if you want it to be.
What works best for you and your partner?