Chronic illness, including endometriosis, may impact on your sexuality.
For many, being unwell can completely change your sexuality and therefore have an impact on your general health and wellbeing, which can extend into other parts of life. It may have an impact on your body image, self‐esteem, and intimate relationships. For many sex is not an easy topic to discuss and yes even health professionals can find issues relating to sex difficult to discuss. Even if you feel embarrassed or uneasy, it is important that you seek assistance for your sexual health concerns.
The following suggestions may help.
1. Chronic illness
can change your life but remember that you are still a sexual person. Sure you may not feel sexual when you are in pain or you feel like your body is a walking medical experiment. You are still a gorgeous, sexual person.
2. It is important to remember that sex drive and sexuality fluctuate across the lifespan - for everyone.
No one is always turned on and ready for sex, we do not live in a porn movie. It is healthy and important for everyone to explore new ways of enjoying pleasure as we grow and change.
3. What is your definition of sex?
Do you instantly think of intercourse? Sex is so much more than that, think kissing, massage, hugging, oral sex, masturbation, and the list goes on. Focus on pleasure and intimacy rather than the end result or performance.
4. Educate yourself about your illness, treatments, and medications, including how it affects your sexuality.
Talk to your doctor about common sexual issues for people with your condition. If they can’t help, research to find someone that can ask for referrals, look at the option of seeing a sexologist. Learn about your medications and any effects they may have on sexual function and desire. If you are concerned speak to your doctor about the options that you may have.
5. Communicate with your partner,
If you have one, about your fears, desires, and boundaries and listen to theirs.
For some this will be the first time you have ever had a conversation with your sexual partner about ‘sex’ and may be difficult at first, do it with an open mind and without laying blame.
6. For many partners of people living with chronic illness,
it is not actually the no sex that causes the most hurt it is the feelings of disconnection, rejection and thinking that they are not wanted anymore.
Communicating with your partner lets them know that your relationship and your sex life are important to you and something you want to work with them on.
7. Plan for sex
so you can conserve energy, manage symptoms and create space and time for both you and your partner to enjoy intimacy.
8. Remember that sex does not have to equal intercourse.
Explore both of you and your partner's definitions of sex. You may have to redefine what sex and intimacy mean to you, it is important to remember that there are so many pleasurable and satisfying ways to be intimate and sexual with your partner that do not involve intercourse.
9. As women we ignore painful sex, we ignore symptoms for fear of being judged or ignored.
To be honest that is often with good reason, with gynecological conditions typically taking 7 plus years to be correctly diagnosed it is no wonder women ignore what they are being told is just a part of being a woman. Women can get it wrong too and not recognize there is anything wrong, that may be because of social, media or cultural messages.
10. Pelvic floor dysfunction can result from being in chronic pain, painful sexual experiences or endometriosis treatments.
Pelvic floor exercises can be important exercises but they can also cause more discomfort and pain if not done correctly or suited to our specific needs. As with any exercise program, it is important to have health checks prior to commencing and pelvic floor exercises are no different. See your pelvic floor physiotherapist for an assessment before you begin pelvic floor exercises and ensure you get proper instruction on how to do the correct exercises for your body. For this, you should see your pelvic floor physio or an exercise physiologist that specializes in women’s health.
11. Use a quality lubricant that is suitable for the activity you are going to enjoy.
Vaginal dryness can cause, friction and pain with intercourse. Vaginal dryness may be a side effect of medication, treatments, reduced hormone levels, not taking enough time to build up to intercourse.
12. Pain during sex is a common symptom of endometriosis.
Movements and positions used for intercourse may stretch or put pressure on areas affected by endometriosis. There are alternatives and options available. Intercourse and other sexual activity after excision surgery should be in accordance with your doctor's instructions.
13. Explore and be adventurous.
Try new positions to work with changes in your body, to manage fatigue and pain. Read an erotic story to get your head in the right space. Try toys such as vibrators. Try intimate wearables such as The Ohnut. Explore individual and mutual masturbation. Increase the amount of touch in your relationship and that is touch without intercourse.
14. Your journey with endometriosis is unique to you.
No one list will cover everything. This is a starting point for you to explore your sexuality and if you need more help to speak to your doctor, health professional or sexologist.