Endometriosis and Pain

The Most Common Symptom of Endometriosis is Pain

The most common symptoms of endometriosis are dysmenorrhea – or pain with periods, dyspareunia – or pain with intercourse, infertility, and pelvic pain in general. Although almost all women have some sort of cramping with their periods, dysmenorrhea is more than just your run of the mill cramps. It is pain that is frequently not completely relieved with the usual treatments of non-steroidal anti-inflammatories (like Advil, Aleve, ibuprofen, etc.). Many women with endometriosis say that their pain and cramping starts a couple of days before their menstrual flow and then it lessens or goes away once their flow really peaks. Other women describe pain that coincides with menstrual bleeding.

Dyspareunia means any type of pain with sexual intercourse.

There are two basic types of pain with sex

  • pain with entry
  • pain with deep penetration

Most women with endometriosis-related dyspareunia describe pain with deep vaginal penetration. This pain may be sharp or dull and it is frequently cyclic – being most severe near the end of the monthly cycle, just before or during menstrual bleeding. Sometimes the pain is also severe in the middle of the cycle, around the time of ovulation.

Oftentimes the pain is positional, and many women clearly recognize that certain sexual positions that they may have enjoyed in the past are now frequently problematic. Usually positions in which the woman can control the depth of vaginal penetration are the least bothersome whereas others may become “off limits”. Some women say that the pain is related to the angle of penetration – frequently being most severe with the penis is directed either anteriorly toward the bladder or posteriorly toward the rectum.

Endometriosis may also interfere with a woman’s ability to enjoy orgasm.

Part of the pleasurable sensation of an orgasm is mild contraction of the uterus that accompanies the orgasm itself. For many women with significant endometriosis, that uterine contraction is unbearable. This unfortunate condition can lead women to avoid sex altogether, leading to feelings of inadequacy and creating a strain on their marriage.

For all of these reasons, it is important to diagnose and treat endometriosis appropriately, as all of these symptoms are preventable and/or treatable. Over the course of the next several weeks, we’ll discuss many more aspects of endometriosis, so please keep checking our blog or call your TFC nurse with any questions that you may have.