Approximately two-thirds of women having endometriosis in the world report different sexual problems. These complications include but are not limited to dyspareunia or pain during sex.

 

Of course, women are different. Others will report pains during sex, while some report them after or during sexual intercourse. Also, women report the degree of pains differently, ranging from mild to severe pains.

 

These pains may take only hours to resolve, while others will last for months. Read through this article for information about the condition and how you can have sex while having endometriosis.

What is endometriosis?

Endometriosis is a female reproductive disorder where tissues similar to the uterine lining tissues grow out of the uterus cavity. The uterus lining is called the endometrium. These fake tissues act in a similar way as normal tissues during periods; they will break and start bleeding at the end of a cycle.

 

However, this blood has nowhere to flow to and stays in the uterus. This may make the nearby areas swollen or inflamed, and you may get tissue lesions and scars. Though the condition can occur in different areas around the uterus, it is more common in the ovaries. And this is the primary reason women experience and describe endometriosis pains differently.

 

The condition can be more painful if it occurs behind the vagina towards the lower uterus. Other times it can stick to the vagina close to the rectum.

 

Any push or penetration can stretch or contract the irritated tissues and cause pains.

 

If it occurs in the ovaries, you may experience no pain at all or have mild pain during sex. However, if endometriosis is in multiple places, you will get hurt, regardless of anything, making it harder to have sex while having endometriosis.

Causes of endometriosis.

The body removes the uterus lining during the normal menstrual cycle to allow the menstrual blood to flow through the cervix to the vaginal opening. The actual cause of this condition is still not known, but there are various studies about its cause though none has been proven scientifically.

 

Among the ancient theories shows that endometriosis is caused by a process known as retrograde menstruation. This is a condition that causes the blood to flow backward through the fallopian tube into the pelvic cavity instead of the vaginal opening.

 

Another research also states that the hormones transform cells on the outer side of the uterus into the normal uterine cells, called endometrial cells.

 

While it is unknown why it happens, other people believe that it may be due to a small area of the abdomen converting into endometrial cells. This may be true because most tissues in the abdomen grow from embryonic cells.  These tissues can transform and act like uterine tissues.

 

Once they are displaced from the uterus, these cells may stay on the pelvic walls and the surfaces around the pelvic organs like ovaries, bladder, or rectum. They grow and thicken continuously and start bleeding throughout your menstrual period as a response to your hormonal changes.

 

Another unconfirmed theory is that uterine cells are displaced from the uterus via the lymphatic system. Another one also claims that it may result from a poor immune system that fails to destroy errant tissues after menstruation.

 

Other studies believe that the condition may begin in the fetal stage with a displaced cell that starts to respond to puberty hormones. This theory is known as the Mullerian theory.

Stages of endometriosis.

There are four types or stages of endometriosis depending on different factors such as location, size, number, or depth of the endometrial implants.

  • Stage 1. Minimal stage; in this stage, minor wounds, shallow endometrial tissues, and lesions start appearing on the ovaries. You may also experience inflammation around or in the ovaries.
  • Stage 2. Mild; though it might look similar to stage one, the lesions and implants on this phase are a little bit pronounced.
  • Stage 3. Moderate; moderate endometriosis features deep implants on the pelvic lining and the ovaries. There are also more lesions around the pelvic area.
  • Stage 4. Severe endometriosis; the most severe stage of this condition, has deep implants in the pelvic walls and lesions on the fallopian tubes and the ovaries.

Diagnosis of endometriosis.

Your health provider might recommend different diagnostic procedures based on individual symptoms. However, mostly, endometriosis may show similar signs to other health conditions such as pelvic inflammatory diseases or ovarian cyst.

 

Below are some of the tests the doctor may recommend based on your symptoms and stage of the condition.

  • Physical and oral examination. Your doctors will examine your symptoms and inquire about your personal or family endometriosis history. They will manually feel the abdomen for scars or lesions at the lower uterus.  Also, they can perform a general body assessment to identify if there are any potential signs of long-term effects.
  • Ultrasound. Depending on how you describe your pain when engaging in sex while having endometriosis, your doctor may recommend an abdominal or transvaginal ultrasound. In the former process, a transducer is inserted through the vagina.  However, both of these ultrasound processes provide pictures of your reproductive organs. And while they can help the physician identify cysts related to endometriosis, they are not quite effective in separating the disease.
  • Laparoscopy. The only sure way of identifying endometriosis is by looking at it directly. And this can be achieved by a minor operation known as laparoscopy. If detected, the tissues can be removed by a similar procedure.

Endometriosis complications.

Fertility problems are among the most severe complications of endometriosis. However, women with milder forms of the condition can conceive and carry the pregnancy to term. About 30-40% of those who have it have difficulty conceiving.

 

Medications do not improve fertility when you have the condition. However, some women have managed to conceive after getting the endometrial cells removed surgically.

 

But in case you don't get pregnant after a surgical procedure, you might want to think of fertility medications or in vitro fertilization to boost your chances of getting a baby.

 

You may want to have sex while having endometriosis or consider having babies sooner rather than later, but your symptoms may deteriorate with time and make it difficult for you to get pregnant.

 

Nevertheless, you'll be examined by a doctor before and during your pregnancy period for any complications. So, remember to reach out to doctors for more ideas on having sex while having endometriosis and conceiving.

 

Even if conceiving is not a problem, managing chronic endometriosis can be challenging. Anxiety, depression, and other mental issues are very common. Besides talking to a doctor about handling these side effects, joining a support group of people with a similar condition can offer as much help.

Endometriosis Treatment.

Obviously, you want faster relief from the symptoms and pain of endometriosis. If left untreated, this condition can severely interfere with your life. Though it has no cure, its symptoms can be managed.

 

Various surgical and medical options can be applied to reduce symptoms and prevent any potential problems relating to the condition. Doctors may first recommend conservative treatments but later book you for the surgical process if the former method doesn't improve the situation.

 

People respond differently to these treatment options, so you'll have to discuss with a gynecologist before and during treatment to help you identify the best management plan for you and check how you react to it.

 

Getting early diagnosis and treatment options for this condition can be frustrating. And together with pain, fertility issues, and the fear that there is no cure, this disease can cause mental disruptions. As mentioned before, you need to consider joining a support group to help you manage mental issues.

 

Below are some of the treatment options for endometriosis.

 

  • Hormonal therapy

 

Using supplemental hormones can help reduce pains and prevent the development of endometrial tissues outside the uterus. Hormonal therapy helps the body control the monthly changes promoting the growth of cells that occur when you get endometriosis.

 

  • Pain medications.

 

Though these are not effective in some cases, taking over-the-counter medications like Ibuprofen can help relieve pains based on the stage of your condition.

 

  • Gonadotropin-releasing hormone agonist and antagonists.

 

Women are required to take what are known as gonadotropin-releasing hormone agonists and antagonists to prevent the release of estrogen, responsible for stimulating the ovaries. Estrogen is the female hormone that is primarily responsible for the development of reproductive features in women.

 

Stopping estrogen production prevents menstruation, hence creating artificial menopause. This form of therapy shows side effects like hot flashes and vaginal dryness. So it is advised that you take small doses of progesterone and estrogen alongside this treatment method to limit or reduce these side effects.

 

  • Hormonal contraceptives.

 

This type of contraceptive reduces fertility by preventing monthly buildup and growth of endometrial tissues. Vaginal rings, birth control pills, and patches can reduce or completely eliminate pains in less severe endometriosis.

 

The Depo-prover injection is another effective option in stopping menstruation by stopping the development of endometrial tissue implants. It can be used to reduce pains and most of the symptoms.

 

However, this should not be your first choice medication due to the risks of weight gain, decreased bone production, and increased occurrence of depression in some instances.

 

  • Danazol.

 

This is also another effective medication used to prevent menstruation and reduce symptoms. When taking this drug, the disease may continue to grow.

 

Danazol can cause side effects like hirsutism and acne. The former is abnormal hair growth on the face and the body.

 

  • Conservative surgery.

 

Conservative surgery is a treatment procedure done to those who are not responsive to hormonal treatment but want to get pregnant or undergo severe pains. The aim of this operation is to thwart the growth of endometrial tissues without interfering with reproductive organs.

 

A minimally invasive operation called laparoscopy is used to visualize and diagnose endometriosis and remove the endometrial tissues. Surgeons make minor cuts in the abdomen to surgically remove the cells, vaporize, or burn them. Currently, lasers are often used for destroying errant endometrial tissues.

 

  • Final-solution surgery, or hysterectomy.

 

Suppose your condition doesn't improve from the above treatment options. In that case, your doctor will call for a rare operation called a total hysterectomy as the final option. During this operation, the doctor will remove the uterus and cervix.

 

Also, they will remove ovaries because they are the organs responsible for estrogen production, and estrogen fosters the growth of unwanted endometrial cells. Additionally, they will remove the visible implants.

 

Remember, hysterectomy is not considered a treatment or cure for endometriosis, and you won't be able to conceive after undergoing one. So, you need to have an alternative solution apart from surgery if you want to start a family.

Tips for having sex while having endometriosis.

Although women experience pain during sex while having endometriosis differently, there are several things you can do to minimize these pains. Let's discuss more in the following section.

 

  1. Track your menstrual cycle and try sex at different times of the month.

 

While pains in most women with endometriosis are constant, the feeling can become more painful during your periods or even during ovulation. When you track your cycle effectively, you’ll also be able to track the symptoms of the condition.

 

This information will enable you to identify times of the month you are likely to have pains and when you are pain-free. You can keep track of the cycle by creating a period calendar or downloading free mobile apps such as Flo Period Tracker or Clue to help you log your cycle.

 

The Center for Young Women’s Health provides a printable sheet known as My Pain and Symptoms Tracker, allowing you to map out the discomfort and pains you feel. Regardless of the method you'll choose, remember to rate the pain you feel to enable you to track the time of the month when the pains are worst.

 

  1. Take pain-relieving medications an hour before sex.

 

You can reduce pain and discomfort during sex when you take OTC pain relievers such as Ibuprofen or aspirin one hour before engaging in sex. Also, you can take pain relievers, if necessary, after sex.

 

  1. Apply lubrication.

 

A lubricant should always be your best bedroom friend if you have endometriosis. Most women experience pain during sex while having endometriosis because of lack of lubrication or vaginal dryness.

 

However, using silicone or water-based lubricants during sex can help minimize discomforts. You are required to use as much lube as possible to keep you wet and use it again after sex if you feel your vagina is getting dry.

 

Do not shy away from using lube even if you think you don’t want it. Use more lubes if you are experiencing endometriosis and you want to have sex.

 

  1. Try different sex positions.

 

If you engage in sex while having endometriosis, you’ll find that some sex positions are causing more pain than others. For instance, the missionary position is the most painful sex style due to deep penetration and tilted uterus.

 

Trying different positions with your partner can help you find out which ones bring a lot of pains and you should avoid at all costs and ones you use for more comfortable sex.

 

Although the best position varies from person to person, styles with shallow penetration are the most recommended. You can also consider spooning, modified doggy style, face-to-face, raised hips, or girl on top. For more comfort and pleasure, make sex a game, and it can be real fun.

 

  1. Control the right rhythm.

 

Quick thrusting and deep penetration can increase pain for most women with endometriosis. Getting the right rhythm can help you reduce discomfort during intercourse.

 

Talk to your partner about slow and shallow penetration where you don't experience too much pain. Also, you can change positions from time to time to enable you to take control of thrusting and penetration depth where you are more comfortable.

 

  1. Prepare for potential bleeding.

 

Post-coital bleeding or bleeding after sex is a common characteristic of endometriosis. It can happen due to deep penetration, which makes the uterine tissue to get inflamed and irritated. Though the experience can be frustrating, there are various ways you can plan for potential bleeding. Have a look.

  • Lay a cotton cloth or towel before engaging in sex.
  • Use positions that do not cause excess pains.
  • Keep wipes close for quick and easy clean-up.

 

You also need to inform your partner beforehand to avoid getting them off guard, wondering what might have happened during sex. To make this conversation easier;

  • Create some time when you can have a discussion with your partner without interruptions.
  • Explain to him what endometriosis is. You can start by defining what it is and inform them what it does to your body.
  • If it is comfortable with you, tell them how this condition makes you feel emotionally and physically.
  • Provide information as much as you are comfortable with.
  • If possible, let your partner accompany you to the doctor's appointment to allow them to ask questions and feel part of the support system.

 

​Make enough time for foreplay.

 

Instead of getting straight into intercourse-which you not be prepared or in the mood for, start intimacy by engaging in a satisfying foreplay. Acts like kissing, cuddling, and erotic chats can make you more connected to the partner and become more aroused before sex.

 

  1. Engage in pelvic floor therapy and professional counseling.

 

Most of the time, if you have endometriosis, the pelvic area and related muscles become misaligned, which causes pain during sex. Your doctor may refer you to a professional physical therapist who is an expert in performing pelvic floor therapy.

 

This specialist will take you through pelvic exercises that will help ease the discomfort during intercourse. Also, the doctor may recommend a qualified sex counselor to teach you the best positions for your condition and communication skills for better discussion with your partner.

 

 

  1. Explore other sex alternatives.

 

Sex doesn't have to be about intercourse; there are other satisfying alternatives you can get to for a more satisfying sexual experience. Kissing, foreplay, mutual masturbation and fondling, and other penetration options can get you attached to your partner without invoking the symptoms.

 

Talk with your partner about things that turns you on and sample all the factors that can give you pleasure. Allow yourself to savor different levels of intimacy without pain and discomfort.

Conclusion.

Endometriosis is a severe health condition that happens to women across the world. It is caused by abnormal growth of endometrial tissues outside the uterus or on other female reproductive organs like ovaries, fallopian tubes, or cervix.

 

These errant tissues respond to the natural menstrual cycle and burst like uterine tissues and bleeding. Once it bursts, the blood has nowhere to go and leads to painful complications such as pain and discomfort when having sex.

 

However, women need to understand they don’t have to live with pain when engaging in sex while having endometriosis. There is hope and remedy to help you get intimate. Talk to your partner about the condition, use lubes during sex, try different positions, choose your rhythm or explore alternative sexual activities.

 

While these will help ease your pains, it is much more important to consult a gynecologist to guide and advise you on the best ways you can keep your condition in check.

Contributor: admin