Today, we embark on a journey to delve into the underlying reasons behind this distressing issue. We will explore the myriad of causes contributing to dyspareunia while shedding light on its close association with endometriosis.
Intimate togetherness is a topic that has become more openly discussed in recent times, encompassing aspects such as favorite positions and sex toys. However, one aspect that remains largely taboo is the occurrence of pain during sexual intercourse. The fear of facing this issue alone can be overwhelming. Yet, studies indicate that dyspareunia, as it is medically known, is far more common than previously thought.
In an enlightening American study, researchers analyzed data from 1,738 women and men collected through the 2012 National Survey of Sexual Health Behavior – a comprehensive Internet-based survey representative of Americans.
The result: The findings revealed that approximately 30% of women reported experiencing pain during vaginal intercourse. In most instances, these pains were mild and of short duration [1]. However, for some individuals, pain during intercourse can be a persistent companion. The German Professional Association of Gynecologists (BVF) estimates that about 10% of women endure pain during sexual activity [2].
Sex, an act that should ideally be pleasurable and delightful, can sometimes be accompanied by pain due to various reasons. To gain a better understanding, we can differentiate between superficial and deep-seated pain.
Have you ever heard of the “Bartholin’s glands”? These are two glands located in the vaginal vestibule responsible for secreting that provides lubrication during sexual arousal. Insufficient foreplay can result in inadequate vaginal moistening, leading to discomfort during intercourse. Vaginal dryness may also be caused by declining estrogen levels, such as during menopause or pregnancy.
Apart from insufficient lubrication, superficial pain may also be caused by:
If persistent pain is experienced, it is important to discuss the issue with a doctor to explore possible causes and treatment options.
Deep-seated pain during intercourse may originate further inside the body. Women with endometriosis often describe this type of pain, particularly during deep penetrations. Studies suggest that between 10 and 50% of endometriosis experience this issue [3].
It is crucial that individuals experiencing persistent pain discuss their symptoms with a doctor promptly.
In endometriosis, a condition where endometrial tissue settles outside the uterus, various distressing symptoms can manifest. Among the leading symptoms is dyspareunia, which refers to pain during sexual intercourse.[4]
The pain experienced during intercourse in endometriosis may result from pressure applied to the endometriosis lesions. Additionally, adhesions to sensitive organs can trigger discomfort. Moreover, women often exhibit increased tension in the pelvic floor muscles, which can also contribute to pain during intercourse, and in some cases, even during or after orgasm. In such situations, seeking the expertise of a physiotherapist is recommended.
Dyspareunia in endometriosis is frequently associated with specific findings, including:
Research suggests that pain during sexual intercourse is more prevalent in individuals experiencing chronic lower abdominal pain and increased pain sensitivity (hyperalgesia) [5].
Experiencing pain during or after sexual intercourse warrants a visit to your gynecologist, who can provide valuable insight and guidance. During your appointment, your medical history will be thoroughly discussed. Your doctor will inquire about the intensity and nature of the pain, such as whether it feels like burning or cramping.
Discovering any pre-existing medical conditions or past surgeries is crucial in the diagnostic process. Besides assessing physical symptoms and overall health, your doctor will also consider psychological and social factors.
Variables like stress levels, relationship dynamics, and emotional well-being play significant roles in understanding the issue. Engaging in a trusting and informative conversation with your medical professional will aid in exploring potential causes for the pain.
Following the discussion, a physical examination will be conducted. If necessary, the doctor may take samples for laboratory analysis, such as a smear test, to rule out any infectious diseases.
Please note: It is essential to note that not all endometriosis lesions can be detected through ultrasound alone. In cases where additional information is required, your doctor may recommend an abdominal endoscopy for a more comprehensive evaluation.
Firstly, it is essential to know that you do not have to endure pain during sexual intercourse. There are numerous therapies available that take into account your overall health and potential causes of the discomfort. Depending on the underlying physical condition, medications such as antibiotics or hormone preparations might be considered. In certain cases, surgical interventions may also be necessary, based on the diagnosis. For individuals diagnosed with endometriosis, the gynecologist will provide detailed advice on the most suitable treatment approach. Often, the removal of endometriosis lesions can help alleviate the symptoms.
Endometriosis can significantly impact one’s sex life, as it involves a multi-faceted togetherness that extends beyond mere functionality. Research indicates an interplay between sexual dysfunction and pain intensity. Moreover, partner satisfaction is frequently cited as the primary motivation for engaging in sexual intercourse. [6] The fact that endometriosis can negatively affect the quality of the sexual relationship was also evidenced by another study [3],
The Problem: Women rarely receive counseling to maintain a fulfilling sex life after their endometriosis diagnosis [6, 7].
Potential Solutions: A multidisciplinary approach may offer a way forward, involving sexologists, physiotherapists, psychologists, or psychotherapists in addition to gynecologists. This team can provide support in communication with partners, addressing individual complaints, and exploring needs. Open communication with partners can lead to identifying pleasurable activities in the sexual realm and can help not only to reduce pain during intercourse but also to enhance the overall sexual experience for endometriosis patients [1].
In addition, exploring one’s sexuality in a relaxed manner through masturbation can be helpful in discovering what is pleasurable and what may cause discomfort.
Living with endometriosis does not mean sacrificing a satisfying love life. By following a few tips, you can help prevent pain during sexual intercourse and foster a positive intimate experience:
Important: If you experience persistent or severe pain during sexual intercourse, we strongly advise you to make an appointment with your gynecologist immediately.
Sexuality is a fundamental aspect of our lives, but pain during sexual intercourse can hinder the pleasure it brings. Various factors can contribute to this discomfort, such as infections, allergic reactions, or scarring. For women with endometriosis, pain during sex is a common concern, affecting up to 50% of those with endometriosis lesions. To identify the reasons for painful intercourse, your doctor will inquire about physical symptoms and consider psychological factors, like past trauma or relationship dynamics.
After a thorough consultation, a physical examination and diagnostic tests, such as ultrasound or lab tests, may be conducted to reach a specific diagnosis. If diagnosed with endometriosis, hormone therapy or surgery may be recommended, and for many women, the removal of endometriosis lesions can significantly improve symptoms.
Regular communication with your partner is vital in finding ways to prevent pain during intercourse, such as exploring suitable positions or engaging in extensive foreplay. Seeking sex counseling can also offer valuable insights for a fulfilling and enjoyable sex life despite endometriosis-related challenges.
Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
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