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  • Writer's pictureLuise Müller

Let's talk about painful Sex

65% of all FemXX members suffer from pain during sex: pain during entry into the vagina, pain during penetration and pain after sex or orgasm.

Read about what can cause pain during sex and learn about strategies for a positive sexual experience with Endo.

What is dyspareunia?

Dyspareunia is when pain occurs in connection with consensual (!), vaginal intercourse. Many suffer from it, yet the term is still a foreign word.

There are many causes, including:

  • inflammatory diseases of the vulva or vagina

  • vaginal dryness

  • vaginal atrophy

  • decreased sexual arousal

  • vaginismus

  • scarring and adhesions

  • Endometriosis

Why does Endo cause painful sex?

Endometriosis patients report pain during entry or penetration, partly depending on the position, during orgasm and after intercourse. Pain is often described as "pulling", "stabbing" or "burning".

  • During sexual intercourse, pain may be caused depending on the location of the endometriosis lesions and/or associated adhesions.

  • A high number of nerve fibers in these endometriosis areas leads to high sensitivity to pain


Who is most affected?

Individuals with endometriosis close to the vagina (rectovaginal, Douglas, uterosacral ligaments) suffer more frequently and more severely from dyspareunia - as these areas are physically "bumped" during penetration.

  • There is no correlation with the stage of the disease (according to rASRM) - i.e. women with stage 1 can also be severely affected

  • Pain after orgasm is probably connected with the contraction of the uterus.

  • Due to our happiness hormones, the pain is often perceived with a delay.

What can help?

Sufferers report a wide variety of strategies, from avoiding sex to "putting up with it" - often associated with high emotional burdens such as feelings of shame and guilt towards partners.

In contrast, others were able to enjoy their sexuality despite dyspareunia by finding alternative positions or sexual satisfaction without vaginal penetration.

The "pill" has also been shown to have an effect on dyspareunia.


We are many

It is extremely difficult to talk about pain during sex. Sufferers often feel alone and guilty.

You are not alone - and you are not to blame

Break the silence

There is hardly a topic that is so difficult to discuss even with the closest of friends. However, unfortunately, naming your pain is the first step in dealing with it.

Have a look at our Instagram Interview with Sex-Coach and Endometriosis-fighter Naila.

Dyspareunia & Endo Research:

The Clinical Anatomy of Dyspareunia: A Review

"Dyspareunia can be described as continuous unremitting or intermittent pain associated with intercourse. It can be classified based on the location of the pain –entry or deep dyspareunia, or based on when the pain was first experienced –primary or secondary dyspareunia. There are different causes of dyspareunia and some of the most important causes include the following: vulvodynia, postpartum dyspareunia, endometriosis, inadequate vaginal lubrication or arousal, and other anogenital causes such as hemorrhoids and anal fissures. In this review, our objective is to apply the anatomical knowledge of dyspareunia to patient care, increase awareness among clinicians about the diverse etiology of dyspareunia and ensure that the whole patient, not just the pain of dyspareunia is being treated as the causes of dyspareunia can be due to various pathologies."

Alimi et al. 2018

The Subjective Experience of Dyspareunia in Women with Endometriosis: A Systematic Review with Narrative Synthesis of Qualitative Research

"This systematic review of qualitative research aimed to provide an in-depth exploration of women’s lived experience of dyspareunia (i.e., how they perceive and describe their pain, how they deal with it, how it affects their psychological health and intimate relationships). A total of 17 published articles were included. Our findings, derived from thematic analysis, highlighted that endometriosis-related dyspareunia manifests itself in multiple forms (deep, introital, and/or positional dyspareunia, at orgasm, during and/or after intercourse). Women use a variety of coping strategies to deal with sexual pain, such as interrupting or avoiding intercourse, enduring pain to seek pregnancy, and/or finding alternative ways to enjoy sexuality. Dyspareunia impairs women’s psychological health, especially in terms of poor self-esteem and sense of femininity and has negative consequences on intimate relationships."

Facchin et al. 2021


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