Painful sex. It’s not a rags-to-riches topic… but the truth is: sex isn’t 100% perfect, all the time. Sometimes, the anticipation of the future act can inspire more anxiety than excitement. As a group that spends all day talking about orgasms, condom size, and yeast infections, we figure the more everyone talks about the uncomfortable, “embarrassing” bits, the less uncomfortable they feel. Bingo, it’s easier than ever to deal with the hot and heavy stuff.
Last month, we tackled the silence and shame surrounding the more common than you think vaginal health condition by putting billboards across the UK, creating a simple digital guide to communicate about the situation and hosted an in-person meeting to liven up the conversation. When we heard how much you wanted to see its visibility but conditions that are also stigmatized, we caught up with ours Co-Founder Dr Sarah Welsh. In her time as an NHS doctor and in sexual health clinics, she heard from many patients with endometriosis. Here’s her take on why it can take a toll on sex – and how to achieve pleasure while managing the pain…
What is endometriosis – and why does it affect sex?
Endometriosis is a condition where cells similar to those in your uterus appear elsewhere in the body. Just like those in the lining of the uterus (womb), they build up, break down and bleed every month. However, there is nowhere for this blood to go – unlike in the womb (a period). An often misunderstood condition, endo can cause painful periods, bowel conditions such as IBS, pelvic inflammatory disease, fatigue and affect fertility. One topic that isn’t talked about as much is painful sex. Penetrative sex can be painful, thanks to the pressure or pulling of the endometrial tissue and the dryness of the vagina. For some, it is quite mild, for others, however, the pain can be severe and can occur either/both during sex or after. This can have a real impact on your enjoyment of sex and negatively impact your pursuit of pleasure – and even cause relationship problems when partners don’t understand what you’re both into.
Why is the impact of endo not talked about openly?
About 1.5 million of us with wombs in the UK currently living with endometriosis… So why isn’t it being taken seriously? doCultural distress around menstruation has something to do with it, making it harder to talk to your partner(s), family, friends or your doctor if your periods are too heavy or just not ‘normal’ . Likewise, it’s not the easiest thing to get other endo symptoms like painful bowel movements, so body taboos actually make it less likely for people to seek help for the condition, period.
Props to the names in the audience who have spoken about their experiences, including the wildlife expert Biddy Irwin who recently revealed she was told by a doctor that IV pain was “just something you deal with as a woman”. Shocking, and not an isolated incident, as many have experienced misunderstanding by the medical profession. In fact, a study by period care professionals Yopi showed that you could travel to the moon 456 times before being diagnosed with endometriosis. From our community, we’ve heard from those whose extreme pelvic pain was dismissed as “just” aches and pains, and unpleasantly, more than one person was advised to have painful sex with a glass of wine. (Footnote: please do not do that).
Ultimately, a combination of lack of awareness, symptoms that vary from person to person and look like other conditions, dare we say it, gender stereotypes of pain (Especially for Black women), all make it difficult to get much-needed treatment. In upbeat news, a groundbreaking clinical trial led by the University of Edinburgh is to explore a potential new treatment that could improve the daily lives of people with endometriosis. Watch this space…
How to support your pleasure when you have endo
Living with endometriosis doesn’t have to mean a sexless future. Whether you plan to indulge with partners or go it alone, here’s how to approach it:
- Use plenty of lube. Lubricant is an excellent sexual enhancer, especially for penetrative vaginal sex and if you suffer from pain from conditions such as endometriosis. Be sure to check your lube’s ingredient list: gentle, pH-balanced, glycerin-free formulas are ideal. MAll the major brands use unnecessary chemicals that can cause yeast infections like thrush or bacterial vaginosis. Our top tip: go for a water-based lube, as oil-based lube can trap bacteria creating the perfect environment for infections…
- Don’t focus solely on penetration, especially if it makes you uncomfortable. Clitoral stimulation, using lots of lube and sex toys, sensual massage, and focusing on foreplay can be great ways to enjoy sex without focusing on PIV pleasure.
- Be experimental with positions. Depending on where your endometrium is located web is, you may find that some sex positions are much better than others. Try different methods, positions, rates and levels of penetration. This can be with your hand, a toy or a penis.
- Talk to your partner(s) about what feels good and don’t be afraid to direct the action and take control during sex. You are an active participant in your own pleasure!
- I’m looking for help. If you have endometriosis, it’s important to talk to your doctor about the problems you’re experiencing and make sure you have an effective pain management plan. This may include pain medication, which you can schedule to take before/after sex. Some people report that taking a warm bath or practicing relaxation techniques before and after sex can be helpful. If you have previously been dismissed by your GP or feel that your pain has been underestimated, know that you can get a second opinion from another doctor. Endometriosis UK has more information about advocating for yourself and them Support network it also has a helpline and local support groups.
- Endo can also cause more intense period pains, so it’s time to give yourself a hand. Masturbation releases endorphins that can help with period pain, aches and cramps, as these hormones relieve pain, promote relaxation and reduce stress. Take it slow, focus on enjoying the senses without the pressure of orgasm as the endpoint. Try it Erica Lustof moral porn, or Four Chambersaesthetic and conceptual exploration of the erotic.
- Invest time in yourself and your sexual well-being. It’s important to own your body and your medical journey, especially if you have endometriosis. Science-based audio guide Fairly is designed to help you be more present during sex and explore intimacy in a non-intimidating way through expert advice, hands-on physical contact and recordings from trusted therapists.
- Talk about it with your partner(s). Communication is sex is key, with or without endometriosis. However, endometriosis can put a strain on sexual relationships, so being open and honest with the person(s) you’re intimate with is more important than ever. Some people really benefit from talking to a specialist such as a sex counselor to support this and improve your sex life.
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