2018, Responses from: Hannah Blakely
“I would like to approach my partner about the pain that I sometimes experience when having sex due to my endo. I’ve already discussed this with my doctor but how do you suggest I approach the subject with my partner so that he understands?”
Hannah Blakely: That’s a really important question. Endometriosis may affect couples not just the individual in a relationship – particularly in the context of intimacy and sex.
Some things to cope with this and consider are:
Communication and education are key; sometimes the person with endometriosis is the only one given information about pain associated with the condition and how this develops from disease progression or after some surgeries. When this occurs it can be painful during sex. Having a discussion with your partner about how endometriosis may ‘behave’ can be useful to reduce personalising the pain experience from, for example: ‘when we have sex you make me sore’… to … ‘sometimes when we have sex it hurts because of endometriosis’. Following examination and advice from your doctor, letting your partner know sex is not causing physical damage can be important as your partner may fear hurting you which can cause conflict and does little for desire and arousal.
Sometimes when our brain recognises repeated pain signals associated with fear and anxiety, outside of physical harm, it can continue to interpret future sexual interactions as dangerous thus increasing the intensity of the pain experienced. That means for some women when sex is painful due to endometriosis this is recorded by their brain. The next time painful sex occurs the brain remembers this and sends pain signals that are more intense. For these women the response to reduce and avoid pain is to avoid sex which can have an impact on their relationship. When sex is painful either partner may experience emotions such as anxiety, guilt, frustration and sadness.
Recognising these behaviours and emotional responses is important. Validating your partner by letting them know it’s difficult sometimes and is about endometriosis and not personalised to them can be useful to keep the channels of connectedness and communication open.
Psychological treatment can help with endometriosis education, pain management, anxiety and relationship communication together with medical specialists managing aspects through a multidisciplinary approach.