Sex and Endo

By Sexologist, Jodie Dunne

What does sex mean to you? Do you have a definition that pops into your head, maybe an image? Is it influenced by Hollywood or porn industry, do you think of intercourse and simultaneous orgasms? Generally, when people think of sex they think intercourse. Sex is so more than that, so, so much more. Think of sex as a smorgasbord with a multitude of options that you can choose from. Any consensual act that involves the vulva, clitoris, breasts, vagina, anus, penis, testicles for the purpose of sexual pleasure falls could fall into a definition of sex. Hold on what about things that are sexual pleasurable that don’t include those body parts? Things like phone sex, sexting, online sex, masturbation, kissing, heavy petting through clothes, intimate touching and massage and the list is only limited by your pleasure. Notice that the definition doesn’t have to include intercourse, orgasm or reproduction. There is no one ‘correct’ definition of sex, no one personal definition is more real or better than another. It is about you and what you find pleasure in and it is important to be safe and consensual.

Depending on the study you read the statistics on women with Dyspareunia (painful sex) varies from between 30 – 70%. I have read statistics that say women with endometriosis are 4, 5 or even 9 times more likely to suffer with dyspareunia than women who do not have endometriosis. Then research goes into the location of the endometriosis in relation to the pain, where the pain is felt or if it is related to deep infiltrating endometriosis or not (it is important to note that painful sex can be caused by things other than endometriosis and they may be physical or psychological and it can have wider impacts on both a woman psychological health and her relationships). If sex is painful and I am not talking Mr Grey spanking painful, I mean if sex hurts and the intention is not pain for consensual pleasure, whether it hurts a little or a lot, whether it is deep pain or superficial pain it doesn’t matter, if it hurts it hurts and it is pain that should not be ignored.

There is no magic wand that is going to make it better for everyone. For some having a specialist in excision surgery for endometriosis operate can reduce symptoms and for others this may not be successful or long term. Your care should be holistic. Seek help from a variety of professionals that can work together, including your endometriosis specialist, women’s health physiotherapist or sexologist.

This is a brief list of things you can try; positions in which you control the depth and speed of penetration or positions that don’t involve vaginal penetration (and no that is not only referring to anal); masturbation; mutual masturbation; clitoral stimulation; oral sex; picking a time of the month that you know your symptoms are less then scheduling time and conserving energy for those times; use lube; assessment with women’s health physiotherapist to assess for any pelvic floor dysfunction; counselling for the psychological impact that can go along with pain during sex; talking to your partner about your pain; do not ignore it.

Our definition of sex is influenced by socialisation, family, religious eye beliefs. To know what works for you do you can communicate it with your partner you need to ask what your definition of sex is? Does it include intimacy, foreplay, etc? Or does your definition of sex revolve around intercourse and reproduction? How can you redefine your definition of sex and work out what feels pleasurable to you? You can then communicate it to your partner and work out what will work for you both.

No one can tell you the answer to these questions. Your definition of sex is as individual as any other aspect of your behaviour and values. Here are some questions you can take time to answer for yourself and if your partner can as well;

• What is your definition of sex?

• Does it include any of these? Intercourse, masturbation, mutual masturbation, oral sex, caressing or playing with other sensitive body parts, intimacy – cuddling, massage, doing things you enjoy together, sex toys and lube, Communication and not just about house or work stuff (unless that gets you going), What else would you include?

• How do you typically orgasm? Clitoral? Vaginal?

• Do you need to orgasm to have pleasurable sex? How important is that to you?

• How important is sex to you? Has that changed?

• How important is intimacy to you? Has that changed?

• What other parts of your body give you pleasure when touched? Eg nipples, neck, ears, inside of your leg, feet etc.

• Do you enjoy getting or giving massages?

• Do you include your other sense in your sex play?

• Do you enjoy giving or receiving oral sex? Is it a regular part of your play or is it something you avoid?

• Sex toys? Do you have a favourite? Do you use them alone or with your partner?

• What positions have you tried for intercourse, oral, sex toy play? What hurts and what doesn’t? Do you switch positions up or have you always done it the same way?

• What has influenced your ideas around sex? Family, social or religious values?

Remember there is no wrong or right answers here, it is about exploring what sex is to you and starting to think about what you are happy with or what you would change. Also this is not an exhaustive list, it is a starting point. Your ideas around sex, your sexuality and what gets you excited and brings you pleasure is not static, it changes throughout your lifespan. Just as you reassess what you want from your career, finances, relationships and travel you can reassess what you want from your sex life.

Masturbation is an excellent way to explore what you find pleasurable and is a form of self care I bet you hadn’t considered. How can you tell or show your partner what brings you pleasure if you don't work it out for yourself first. Masturbation gives you a chance to work out what brings you pleasure without feeling any pressure to have intercourse. Experiment with techniques, positions, rhythm, depth, visual or brain stimulating content (erotic stories) and what works and what doesn’t depending on the time of month. Think of it as creating a map, a map of your body, once you have worked out how to bring yourself pleasure you can share the map with your partner.

This is not a one off exercise ladies it is something you will just have to experiment with more than once. Enjoy! You are welcome. You may choose to include your partner in some of your pleasure experiments, you may not.

Of course this is only one way to explore your definition of sex. A sexologist can work through other ways with you. Once you have redefined what sex means to you, what brings you pleasure you can talk to your partner about it. You can involve them in this process if you like or you can go to them with a happy starting point.

Upcoming blogs will have some tips on how to talk to your partner about sex and what works for you, positions and other things you can try and tips on how to talk to your health professional about sex.

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