Author: Leng Jinhua (Peking Union Medical College Hospital)
About 50% of adults with endometriosis (endometriosis) and adenomyosis experience pain during intercourse. In addition, gynecological inflammation, postpartum injury, and vaginal dryness after women’s menopause are also important causes of painful intercourse.
Pain during intercourse seriously affects the quality of sexual life, self-confidence, and even the stability of marriage. Therefore, relieving intercourse pain and treating the primary disease are equally important.
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1. Will sex aggravate the disease?
There is currently no research evidence to suggest that the stimulation of sexual activity can exacerbate endometriosis/adenomyosis. In other words, patients can have normal sexual life under the premise of avoiding pain points [1].
But if it is a patient with acute gynecological inflammation, it is generally not recommended to have sex.
If sexual intercourse pain is caused by postpartum injury, please see a doctor in time, and the doctor will give specific advice according to your situation.
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Second, what methods can treat or relieve intercourse pain?
Different causes of intercourse pain can be treated or relieved in different ways.
Endometriosis/Adenomyosis
The primary goal should be to treat the primary disease. Common treatment methods include drug therapy and surgery. The doctor will also determine the tender spot according to the gynecological examination, the patient can avoid the pain point and choose the appropriate sexual intercourse position, which will help the smooth progress of sexual life.
Gynecological inflammation
If the pain during sexual intercourse is caused by gynecological inflammation such as vaginitis, the primary goal should be to eliminate the inflammation, and the related symptoms will also be relieved.
Decreased estrogen levels
In the case of vaginal dryness and pain during intercourse due to decreased estrogen levels, such as in menopausal women or in pseudomenopausal women using gonadotropin-releasing hormone agonists (GnRH-a) , consult a gynecologist, and if necessary, use related drugs to maintain hormone levels to relieve symptoms. Hormone test results should be consulted with a professional doctor.
Postpartum Injury
If the pain during intercourse is caused by pelvic floor muscle disorder caused by postpartum injury, pelvic floor rehabilitation training should be the main treatment.
The current mainstream pelvic floor rehabilitation training is the Kegel training method. There are many video tutorials on the Internet that you can follow. However, before training, you should go to the hospital for an examination to rule out traumatic or organic lesions before training and treatment.
It can also be combined with electrical stimulation combined with biofeedback therapy to relieve postpartum sexual pain[2][3].
Final reminder: According to the test results and diagnosis, the doctor will conduct drug and physical rehabilitation treatment for the primary disease, but the specific drug use and training need to be guided by the doctor Go ahead, don’t decide for yourself.
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References
[1] Li Donghong. Treatment of dyspareunia in patients with endometriosis [J]. Journal of Practical Obstetrics and Gynecology 2018,34:410-412.
[2] Huo Chiwen. Analysis of clinical efficacy of pelvic floor muscle electrical stimulation combined with biofeedback pelvic floor muscle training in the treatment of postpartum dyspareunia in women [J]. China Pharmacoeconomics 2017,12:95- 98.
[3] Liu Xia, Wang Xiangzhen, Zhang Dan. Evaluation of the efficacy of electrical stimulation combined with biofeedback therapy on postpartum sexual dysfunction in women [J]. China Maternal and Child Health Research 2018,29:906- 910.
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