How to relieve painful sex associated with endometriosis?

Painful sex or dyspareunia is one of the major symptoms of endometriosis. However, current medications for relieving pain during menstrual period associated with endometriosis may not work for relieving sexual pain. The hormonal therapy drugs for treating endometriosis can even cause sexual dysfunction because it causes vaginal dryness and atrophy.

Here we introduce a natural alternative method for relieving painful sex or dyspareunia in women with endometriosis.

What is endometriosis?

Endometriosis is a disease caused by misplacement of the lining tissue normally inside of the uterus to grow outside the uterus. Common locations include ovaries, fallopian tubes and the lining of the pelvis. Occasionally, the intestines and urinary tract may also be involved.

When the ovary is involved, the blood released from the endometriosis lesion can fill the ovary to form an ovarian cyst.

For more information about endometriosis, you can visit the Endometriosis Foundation website.

Endometriosis – the lining tissue grows outside the uterus

How many women get endometriosis?

Endometriosis affects 10–15% of all women of reproductive age and 70% of women with chronic pelvic pain. Unfortunately, for many of these women there is often a delay in diagnosis of endometriosis resulting in unnecessary suffering and reduced quality of life.

Endometriosis is common

What are the symptoms?

During menstruation, the misplaced endometrial tissues may also swell, breaks down, and bleed to cause painful period.

However, since the bleeding from these misplaced tissues does not have an exit, the blood is trapped, causing irritation, inflammation, and eventually scars and adhesions to their surrounding tissues.

Endometrial scar tissue or adhesions can cause the uterus to stick in a backward position, almost like gluing it in place, causing retroverted uterus.

Symptoms include chronic pelvic pain and sometime severe pain in the pelvis. Pain increases during menstrual periods, bowel movement, or sexual intercourse. Fertility may also reduce.

Due to severe pain in the pelvic floor, sometimes endometriosis may be misdiagnosed as pelvic organ prolapse, interstitial cystitis, pelvic inflammatory disease, or irritable bowel syndrome.

To achieve a precise diagnosis, researchers are developing a smart tampon. Once developed, it will hopefully be able to diagnose endometriosis from menstrual fluid extracts.


How is endometriosis pain managed?

For severe endometriosis, the lesions can be removed by surgery, like hysterectomy and laparoscopic surgery, but most women with a mild case manage the condition by non-surgical means. For endometriosis pain management, your doctor may recommend or prescribe medications as follows

1) Painkillers

  • Over-the-counter painkillers (like ibuprofen, acetaminophen, naproxen)
  • Prescription strength painkillers (like ibuprofen, naproxen)
  • If the pain is not controllable by above medications, opioids may be prescribed (like hydrocodone with acetaminophen).

2) Hormonal therapy

  • Hormonal birth control (like pills, injection, implant, IUD)
  • Gonadotropin-releasing hormone antagonists (like Orilissa)
  • Androgenic hormones (like danazol)
  • Aromatase inhibitors: Arimidex (chemical name: anastrozole), Aromasin (chemical name: exemestane), and Femara (chemical name: letrozole).
Painkillers may not work well for painful sex.

These medications can reduce endometriosis pain by anti-inflammation or by suppressing estrogen production. They may work well for pain associated with menstrual period, but they do not work for painful sexual intercourse. Conversely, the treatment of endometriosis with hysterectomy or hormonal therapy cause vaginal dryness and atrophy, which may result in painful sex, loss of libido, and female sex dysfunction.

Painful sexual intercourse associated with endometriosis

Endometriosis can grow in different places around the uterus, fallopian tubes, and/or the back of the vagina. Therefore, women may experience sexual pain differently.

Endometriosis may cause painful sex

If the endometriosis is behind the vagina in the lower uterus, sex may be most painful (deep dyspareunia). Sometimes endometriosis can grow between the vagina and rectum, causing scars or adhesion of the two tissues. Penetration can pull and stretch the adhered scar tissues, causing pain.

If the endometriosis is in other places, such as on the ovaries, you may not have pain or feel less pain during sex. But if endometriosis is in multiple pelvic organs and the uterus, sex may be more painful.

Some women use hysterectomy or hormone therapy to treat their endometriosis. But these treatments reduce the level of estrogen, which often leads to vaginal dryness and atrophy, making sex painful or uncomfortable.

Endometriosis treatments may not work for relieving painful sex

When a woman has endometriosis, she may experience painful sex due to inflamed endometriosis tissue. For this condition, anti-inflammatory painkiller may work.

However, more commonly, painful sex may be caused by stretching old scars or tissue adhesions caused by previous endometriosis tissue damages. Anti-inflammatory painkillers may not work on reducing pain caused by pulling old scars or tissue adhesions that have no current inflammation.

Additionally, treating endometriosis with the hormone therapy or hysterectomy may cause vaginal dryness and atrophy. Estrogen can be used to reverse vaginal dryness and atrophy, but this will increase the severity of endometriosis. Therefore, estrogen cannot be used to relieve painful sex in women with endometriosis.

Drugs may not ease painful sex in women with endometriosis.

Relieve painful sex naturally for women with endometriosis

When estrogen cannot be used, you may try natural alternatives.

NeuEve is a natural alternative to the female hormone estrogen. It works by nutritional supplement to nourish the atrophied vaginal tissue. It also provide natural anti-inflammatory agents for pain relief.

To date, more than 100,000 women with severe vaginal atrophy including many women with endometriosis have found relief from painful sex by using NeuEve cream and suppositories.

For women with vaginal atrophy, deep pain in the pelvic floor, and pain associated with penetration, adding dilation exercise can speed up the healing process. The reason is that dilation stretches the atrophied tissue and resorption of the scar tissue. It promotes the regeneration of the vaginal lining skin.

Many of our customers reported excellent results using NeuEve together with a vaginal dilator.

We recommend the VuVa Smooth Set of Five Dilators, for sale for $49.98, and the VuVa Neodymium Magnetic Set, for sale for $229.00. These are higher in price, but you’re really getting what you pay for. They are worth it!

These dilators are not our products. They are sold by VuvaTech. For convenience of our customers, we list the product links below:

Buy Non-Magnetic Pelvic Dilators

Buy Magnetic Pelvic Dilator

Tips about using dilators:

1) Avoid overstretching. It is understandable that one may wish to move up the sizes quickly to get a more rapid recovery. However, this can be counterproductive. The recovery of vaginal atrophy is a slow process. Moving up the dilator sizes too quickly or skipping sizes can cause overstretching, which in turn can tear the atrophied tissue to cause injuries. Please do not skip the sizes and try the largest dilator first. Please be patient and do the exercise with a stepwise increment to avoid possible injuries due to overstretching. Please give one size dilator at least 3-4 weeks to allow tissue to catch up the growth before moving up to the next size.

2) Preventing UTI. Physically, dilation exercise is like sexual intercourse. The penetration movement can mobilize bacteria normally on the skin into the bladder to cause UTI. You will need to pee immediately after each exercise to prevent UTI. Urination can flush out any bacteria that entered the bladder during the dilation exercise. Therefore, drinking a lot of water before exercise helps build up the urinating flushing pressure and prevent UTI.

Disclaimer: This article is for information purposes only. It is about natural products, nutrients, and/or methods for managing vaginal discomfort (not a true infection or disease). It is not medical advice for the treatment of any diseases.

About the author

Dr. Renjie Chang's medical and pharmaceutical experience:
- OB-GYN in the Peking Union Hospital in China
- a faculty member of OB-GYN at University of Oklahoma Health Sciences Center
- drug developer at the Abbott Laboratories in Chicago
- Founder of Lavax, Inc, where she developed an innovative vaginal microbicide for preventing sexually transmitted disease with grants from NIH and Gates Foundation
- Founder of NeuEve, an all-natural women's health company

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