What is dyspareunia in women with endometriosis?

Dyspareunia, or pain during sex, is one of the common symptoms endometriosisIt is associated with, among other things, chronic inflammation and the presence of endometrial foci or adhesions. Unfortunately, it has a significant negative impact on the quality of life of endometriotic patients. Sexuality is an integral part of well-being, and problems in this area can have further consequences, both health-related and emotional. In this article, you will find the most important information about dyspareunia in endometriosis and how to reduce it.

What is dyspareunia?

Dyspareunia is a sexual disorder. It involves pain in the genital area before, during, or immediately after sexual intercourse. The duration and intensity of pain vary greatly. Each woman with dyspareunia may also experience pain in a slightly different location. It can occur at the vaginal opening, in the vulva, or in deeper structures of the reproductive organs. It is worth emphasizing that dyspareunia itself is not a disease, but a dysfunction and symptom. It can occur in the course of various gynecological conditions. It is also related to our emotional well-being and mental condition. Unfortunately, this is a problem that can affect up to 18% of women worldwide. However, this percentage is significantly higher among patients with endometriosis, and pain during intercourse may affect up to 80% of endometriosis patients. 

Dyspareunia as a symptom of endometriosis

Pain during intercourse is one of the first and main symptoms of endometriosis. Unfortunately, it is still often downplayed, both by patients and some specialists. If you regularly experience pain during intercourse, I want you to remember one important thing from this article – it's not your beauty and sex should never hurtDon't ignore these symptoms and seek help from a gynecologist, urogynecological physiotherapist, or sexologist. Nowadays, medicine offers many options to support you in dealing with this problem. You don't have to face it alone, and well-chosen treatment can yield truly remarkable results.

Where does dyspareunia in endometriosis come from? Endometriosis lesions in the pelvic area cause inflammation and adhesions, which can reduce uterine mobility and cause pain during sex and orgasm. endometrium They can also implant in the ligaments between the vagina and rectum, causing pain during penetration. Systemic inflammation is also a factor, as it can increase pain in the vulva and pelvic area. The impact of endometriosis on dyspareunia is complex and multifaceted, so treatment is best approached holistically. 

Endometriosis and pain during intercourse – how to recognize it?

There's no single test that can definitively confirm dyspareunia. A fundamental element of the diagnostic process is a detailed interview with the doctor and a urogynecological physical therapist. Unfortunately, the lack of clear standards and guidelines leads to some patients being ignored. Therefore, if you're struggling with dyspareunia, don't let anyone tell you you're exaggerating, that it's not that bad and that you just need to relax. I know it's frustrating, but seek out specialists who won't dismiss your symptoms and will address your health seriously and comprehensively. 

You can find a list of recommended specialists here: https://endome.pl/leczenie-i-diagnoza-endometriozy/?srsltid=AfmBOorn8MTI_wEFU22YsQbHxGcjOcNLZ7udEobNRKHb9IDHeB584s3r 

Before your first visit, it's worth answering a few questions for yourself. Consider:

• • How often do you feel pain during sex? Does it appear every time or in specific situations?
  • Where is the pain located? At the entrance to the vagina or deeper?

• Does the pain occur only during penetration, or also before or after?

• Are there positions that cause you the most pain?

• In addition to dyspareunia, do you also struggle with painful periods, pain during bowel movements or urination?

Such self-observation is a great introduction to diagnostics – Ultimately, it is what you feel, how you feel it, where and when you feel it that is most important. 

How to deal with dyspareunia in endometriosis?

Treatment Dyspareunia is a process that requires patience, commitment from specialists, the patient, and the partner, and a very holistic approach. Each woman may find slightly different methods helpful, so remember not to compare yourself to anyone else and to listen only to your body, because it speaks to you daily. What are the available treatments for dyspareunia in endometriosis?

Dyspareunia in endometriosis: home remedies

You can partially manage your comfort during intercourse at home. Here are the most important things:

• Good hydration – Vaginal dryness unfortunately increases pain during penetration. You can use lubricants during intercourse and use vaginal suppositories with hyaluronic acid daily. Also, remember to wear cotton, breathable underwear to avoid mechanical irritation.
• Relaxation techniques Sexual dysfunctions negatively impact our well-being. Stress, in turn, negatively impacts our comfort and sexual satisfaction. I know that the "don't stress" recommendation won't bring anything to your life. But as much as you can, try to avoid overstimulation, fatigue, and stressful situations that don't require your presence and involvement. Try to find at least 5-10 minutes for yourself every day. You can devote this time to breathing exercises, guided meditation, or simply a moment of mindfulness. You'll find a lot of helpful content in our free supporting materials.
• Experiment in bed – I know that when you're in pain, it's probably the last thing on your mind. But remember, not all sex has to involve penetration. Explore (together!) new positions and activities that are comfortable and enjoyable for both of you. 
• Use vibrators Vibrators and other vibrating sex toys not only spice up foreplay but are also a great way to relax your muscles. Try them alone or with a partner. If you're unsure how to approach this, talk to a urogynecological physiotherapist. Self-massage is a truly fantastic way to release tension. 

Dyspareunia in endometriosis: urogynecological physiotherapy

Cooperation with a urologic physiotherapist is almost irreplaceable in the case of painful intercourse in the course of endometriosis. In-office therapy and individual exercises help release muscle tension and better understand your body. Your physiotherapist will also be your primary source of knowledge on how to care for your pelvic floor health. She will show you which habits are worth cultivating and which ones require work to avoid excessive tension, intimate problems, and pain.

Dyspareunia in endometriosis: pharmacological treatment

Unfortunately, there are no medications that specifically address dyspareunia itself, but hormonal medications used to treat endometriosis may reduce the symptoms. symptoms this disease, including painful intercourse. Pharmacotherapy should be individually selected by a doctor, tailored to your health condition, lifestyle, and reproductive plans. 

Dyspareunia in endometriosis: surgical treatment

Surgical treatment and the surgical removal of endometriosis lesions and adhesions are effective methods of treating endometriosis. A doctor always determines eligibility for surgery, as not every patient will benefit from it. Many women experience relief from painful periods and intercourse after the procedure. 

Summary

Dyspareunia, or pain during sexual intercourse, is a common sexual disorder in women with endometriosis. It occurs up to four times more often in women with endometriosis than in women without the condition. Pain during intercourse is most likely related to chronic inflammation and the presence of adhesions characteristic of endometriosis. Treatment of the disease can significantly improve the quality of sexual life of patients with this condition, but it requires time, patience, and the involvement of many specialists. Fortunately, today's medicine and physiotherapy offer great chances of success and effective help for endocrine patients.

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