Pain during or after sexual intercourse
can be a common symptom of endometriosis. Unfortunately,
all too often it causes couples immense emotional
pain and turmoil. Some of this can be avoided with
an understanding of the problem, better communication,
and a little experimentation.
The pain of painful intercourse has been described
as sharp, stabbing, jabbing or a deep ache. 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.
Causes
Painful intercourse is usually caused by stretching
and pulling of endometrial implants and nodules located
behind the vagina and lower uterus. Sometimes, it
is caused by vaginal dryness as a result of hormonal
treatment or a hysterectomy in which the ovaries have
been removed.
Dealing with pain during intercourse
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.
Communicate
You need to explain the nature of your pain, and how
it affects you, physically and emotionally. You also
need to talk about such things as your need to love
and be loved, your fear of intercourse, your fear
of intimacy that may lead to intercourse, your guilt
about not being able to have intercourse, your guilt
about letting your partner down, your fear of losing
the relationship to someone else, and your fear that
your unwillingness to have intercourse will be interpreted
as a sign of rejection.
Your partner needs to talk about such things as his
need to love and be loved, his frustrations at not
being able to have intercourse with you, his fear
of hurting you, his frustration at your emotional
withdrawal during times of intimacy, and his fear
that he is being rejected.
Once you have discussed and resolved some of these
issues, you will have the foundations for moving on
and finding ways of resolving the problem.
Sex therapists may also be able to help you with
this.
Experiment
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 are able to 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.
Communicate
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. In the long term,
it may lead to hesitancy 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.
Find alternatives
Even with the most patient and sensitive
experimentation, some women will not be able to experience
pain-free intercourse because of their endometriosis.
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 mutual masturbation
can be as just pleasurable as intercourse if you want
it to be.
© 2003 Ellen T Johnson
Reprinted with permission
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