dyspareunia

"Not Tonight, Honey...I Have Endometriosis!"

Let's be frank: Endometriosis combined with sex does not always bode well for the ultimate intimate experience. Make no mistake - Endometriosis is a disease that affects more than just the woman. It affects her partner almost as much, and dealing with it as a couple is crucial.

Let's first address why some patients with Endometriosis experience dyspareunia (painful intercourse): the lesions may obstruct, bind or invade tissues and organs; it can secrete inflammatory substances known as prostaglandins and histamines that irritate surrounding tissue; it can cause scarring which can restrict blood vessels; and it can make our pain receptors much more sensitive. Cul-de-sac (the membranous wall between the rectum and the vagina) Endo is a well known culprit for causing painful intercourse, particularly upon deep penetration. Take these physical aspects of the disease and combine them with treatments that kill our libido, throw our hormones into overdrive, and in some cases, make us gain weight so we can have a whole new set of body-concious issues to deal with, and you've got a recipe guaranteed to have "Not Tonight, Honey..." coming soon to a bedroom near you.

Further, let us not forget that infertility also factors into the mix for some. When we're having sex because our dreams of fertility depend on it, we sometimes forget in the process that sex can and should also be an intimate sharing between partners...and frankly, fun.

That said, here are some coping tips that might help:

You Must Work Together With Your Partner
This is the cardinal rule. Two-person problems are never resolved by one-person efforts. Work together to find what seems best for you as a couple. This includes having your partner join you at doctor visits and encouraging them to ask questions of their own. Don't be afraid to ask for help - if the problem becomes bigger than both of you, seek the assistance of a qualified therapist who understands the disease. Blame, doubt, fear, anger, sadness and even shame - of self and of each other - can appear in the bedroom when Endometriosis is a factor. There is nothing wrong with getting professional guidance, and it is not the same as saying "it's in your head" or "you're imagining the pain."

Treat the Disease
Research proves that thorough eradication of Endometriosis from all affected areas can leave a patient symptom-free in many cases, and if desired, even improve fertility. Finding a doctor who is skilled in the treatment of the disease can be your first step in feeling better overall. See http://groups.yahoo.com/group/EndoDocs for help finding someone near you.

Timing is Everything
For example, a lot of women feel physically best before ovulation. Determine what your "good" time is and plan accordingly. Call it "scheduled spontaneity"!

Lubricate, Lubricate, Lubricate
Then lubricate some more. GnRH therapy and other medications can cause vaginal dryness, as can certain surgeries. There are numerous products available to compensate for this, such as KY jelly, Astroglide and Gyne-Moistrin. Please note: if you are attempting to conceive, certain lubricants such as KY jelly can decrease sperm motility or destroy sperm altogether. Similarly, if you are using a barrier form of birth control such as condoms, vaseline-based products can deteriorate the latex. Ask your gynecologist for a few safe suggestions that might work for your situation.

Stop the Pain Before it Starts
If you need to, take your pain medication beforehand - but don't overdo it!

Remember that Intercourse Does not Necessarily Equal Intimacy
Intimacy can be established through numerous other means: hugging, holding, kissing, etc. You can heighten these experiences through candlelight, music, sharing a bath or whatever makes you feel good. Best of all, these activities can be done even when you're not feeling great, so you can both still share intimacy. There are also other activities that can be done in lieu of intercourse...use your imagination.

Communicate
Establish a signal with your partner that indicates when you feel ready for penetration. Take it slow and most importantly, be gentle. Talk about what works for you both - and what doesn't. Find ways to work around the things that hurt [no pun intended].

It is Even Possible to Have Fun!
Experiment with positions that are enjoyable for you both. Female dominant and side by side are very popular with Endo ladies, but find ones that work for you. If penetration is still too painful, consider oral intimacy.

Endometriosis does not have to mean a death sentence to your relationship. In fact, it can bring you closer together as a couple as you battle the disease together. In the beginning, it may highlight a greater need for real honesty and communication between you and your partner, but establishing both of these things can make for a happier partnership both in and out of the bedroom in the long run. It's not an overnight process; learn what works for you both - but learn together.

Men should not feel left out of the Endometriosis support experience! For more information, support, ideas and experience exchanges on all aspects of Endo, please visit this invaluable website. It is the first organization formed for "Men Who Love Women With Endo." See MENDO at: http://groups.yahoo.com/group/mendomen