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Many patients with endometriosis confront with pain during intercourse. The causes might be different from case to case: multiple adhesions, an endometriosic nodule, an endometrioma, bowel endometriosis, pelvic floor dysfunction which is very common in endometriosis etc.

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If you also face pain during sex below you have 10 recommendations that might be useful in your case.

Painful intercourse – what are the other causes?

Besides endometriosis and its manifestations, pain during intercourse, also called dyspareunia, can appear in some other cases too.
-    Hormonal changes when taking some medications such as birth control pills or antidepressants, after childbirth and during breast feeding, after menopause etc.
-    Trauma after pelvic surgery or a cut during childbirth.
-    Infections or skin problems in the genital area.
-    Pelvic inflammatory disease or pelvic floor dysfunction (both very common in endometriosis too).
-    Uterine fibroids
-    A psychological problem

Painful intercourse due to Endometriosis – 11 recommendations you might try

DISCLAIMER: The above advice does not replace medical consult (as the first point states). Besides, in many cases, pain during sex can be dimished after surgery if your case requires this kind of approach. Yet, no matter if you choose the surgical path or not, the below recommendations might be very useful.

1). Go to a medical check-up with an endometriosis specialized doctor

Before proceeding, keep in mind each body is different and, of course, you first need to ask your doctor about this problem. You need to know what is causing your pain: an ovarian cyst, the adhesions, nodules, myomas etc. – you need a specialised opinion.

Then, your doctor might prescribe you something for a better lubrication, a cream for this that has beneficial effects on dyspareunia too.

For example, my doctor recommends Gleitgelen, a German product, so you might find it in this country but also in my country, Romania. For the rest of you, the whole list of ingredients is: glycerine, hydroxyethylcellulose, perfumed oil, purified water, chlorhexidine dihydrochloride.

2). Talk to your partner!

These kinds of things have to be discussed in intimacy, with your partner. He surely knows your endometriosis history so remind him of this symptom too and try to see together what you can do in order to feel less pain and to feel comfortable when being intimate.

Read also "Spotting and Heavy Bleeding - What Can Be Done"

3). Try Pelvic Floor Therapy or the so-called "intern massage"

On one of the Facebook groups I was several years ago I read a lot about the so called Pelvic Floor Therapy. In Romania there are not so many specialists in this kind of therapy/massage, but it would worth a try looking for more about this topic. As far as I know, Pelvic Floor Therapy is very popular in the United States of America so at least there you can surely find a specialist.

Pelvic Floor Therapy is a type of massage that aims to reposition the pelvic area organs in the appropriate place, and also relaxes the area and weakens the adhesions.

4). Wait a little bit longer after surgery

If you have been through an endometriosis surgery lately, the pelvic muscles might relax harder so it would be better to wait a little bit longer till you have sex again. Of course, when it will happen take into considerations things like foreplay, context, position, lubrification etc.

5). Read books that might help you!

Books that connect with your feminity, but also about sexual problems might be helpful here.

On groups, girls have mentioned most often Wild Feminine: Finding Power, Spirit & Joy in the Female Body de Tami Lynn Kent.

Even if it does not have as a main topic painful intercourse, Lara Briden's book: Period Repair Manual is also great as it helps you balancing your hormones and, this way, eliminating this cause that might also give painful sex.

6). Do sport and practice yoga!

Sport is good for endometriosis, no matter the symptoms. Yet, for this particular type of pain, the most efficient would be Kegel exercises. They strengthen your abdominal muscles and help you in having a better control over them.

Yoga is another type of physical movement recommended in endometriosis and pain during intercourse. Here, try to work with a specialist or to choose yoga exercises that focus on the pelvic area.

On Melissa Turner's group (which is closed now, unfortunately), many girls mentioned Dru Yoga and its benefits for pain during sex. Therefore, if you practice Yoga with a specialist, ask him about this particular type of Yoga.

7). You need a very good lubricant

As I said above, my doctor recommends Gleitengel, but other doctors could have other recommendations.

The idea is to ask, not to be ashamed. I remember one of my acquaintances had this problem, pain during intercourse, and when she finally had the courage to tell the doctor, he explained her that when there are lesions on the ovaries, the risk of this kind of pains is highe and the use of a good lubricant is a must. Besides, she was taking birth control pills which aggravated the problem even more.

Therefore, talk to your doctor and take what he prescribes you.

If you don't go to an endometriosis specialised doctor or if he doesn't know what to recommend you in this regard, I would advise you to consult yourself with a well-trained pharmacist.

Read also "10 Dietary Supplements Beneficial in Endometriosis & Other Diet Tips"

8). Constantly work on your adhesions

Some says there's nothing we can do about the adhesions. I don't agree with that. Ok, I don't know if we can "eliminate" them, but I do think we can prevent their formation or we can loosen them up a bit.

Daily massage, castor oil packs, yoga, sport, some essential oils, Omega 3 - all can be efficient for this.

When we work on the adhesions, there's a chance we can diminish the pain during intercourse too.

Below you have some of the methods I tried for loosen up adhesions but also some of the recipes I found online (so I cannot guarantee for them, but still, I wanted to have them here).

a). Coconut oil as a career oil + some drops of Frankincense oil + some drops of Helichrysum oil + some drops of Copaiba oil.

Here I wrote more about these oils but also about some other that I do not recommend in endometriosis (based on studies). Regarding the above recipe, you can use all three oils (besides  the career oil) or just 1 or 2.

b). Mix 20 drops of Helichrysum oil +  10 drops of Myrrh oil + 5 drops Copaiba Oil + 5 drops Sandalwood oil + 1 drop Rose oil.

This is a recipe I found online, I think you should also use a career oil.

c). Mix 150 ml coconut oil, 15 drops Frankincense oil + 15 drops Rose Damascene oil + 15 drops Myrrh oil + 15 drops Helichrysum oil + 10 drops Jasmine oil (this recipe I found on Melissa's group and many of the patients said this mixture is great also for adenomiosis).

d). Omega 3 Oil Triple Strength from Solgar - I use this, 2 caps a day and I feel very well, it diminished my ovary pain and I truly believe it is beneficial for adhesions too. I got operated the second time in 2016 and ever since my doctor never told me at the ultra sound that I have adhesions as he said to other patients.

9). Change your diet!

Many endometriosis patients say their wellbeing and health state improved with a healthy diet, and here we can also include diminishing pain during intercourse.
You can try eliminating sugar, coffee, gluten, fizzy drinks, dairy, alcohol. I know it is hard but when you confront with pain during sex it is worthwhile to try all the solutions you may have.

10). Try to eliminate as much as you can inflammation!

This is correlated with the above topic.

A healthy person might be able to eat or drink things like dairy, sugar, alcohol without developing any symptoms, but the body of someone with endometriosis functions a little bit different. Our detox pathways might not function properly so we cannot rid of the estrogen excess, we might have some gene mutation that could promote inflammation etc.
When inflammation occurs, we might have problems with the bladder, constipation, gastro intestinal problems, pain all over the pelvic area - and not only - all these can also give or worsen pain during sex.

Some patients reported not eating 2 hours before sex helps them in lowering this kind of pain.

11). Try Clear Passage Physical Therapy

This is a therapy I haven't tried, just read about it. This is very popular especially in the USA but many girls reported they had great success in eliminating pain during intercourse (and not only in terms of endometriosis symptoms) after Clear Passage Physical Therapy.

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I don’t know if there are Clear Passage Physical Therapy specialists in Europe but you should certainly give it a try if you live in America.

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