hurts so good...wait, not good

November 11, 2009 6:20 AM

Sex, ouch. Endometriosis? What kind of pain?

I know, I know, I should ask my doctor. I have asked my doctor, and I will ask again. Maybe I should have asked anonymously (do any real life people know teragram? show yourselves!)...but, here goes.

24 year old female here. Been on the pill/the ring for about 5 years, with two or three short breaks. I have been having minor but interfering pain during sex, probably for a month or so. Inside my vagina, but closer to the outside than deep inside, if that makes sense. We tried more lube and more wine, we tried no sex for 10 days, but it still hurts. Not terrible pain, but enough that we have to stop. I am having my period now, and it is uncomfortable to remove a tampon, never had that trouble before. It's sort of an "ooo this hurts, better remove quickly like a bandaid" kind of thing. It also hurts when I remove or insert the NuvaRing, which is new pain.

Unfortunately, the timing is such that it seems to be coinciding with a general need for slower sex anyway: been with my (wonderful) boyfriend for about 8 months, which is around the time when arousal requires more than a kiss or a look. So, we have to slightly change the way we are having sex anyway, complicating the issue. Could be that's all it is.

The problem with pain during sex, other than the fact that SEX HURTS, is that it is a very stressful pain. And you wonder if it's in your head, and you think that maybe the boyfriend or doctor thinks it's in your head. But, the tampon/NuvaRing pain has convinced me that I'm not making this up.

I knew that I was conceived on fertility drugs, but I just found out today that the cause for my mother's infertility was caused by endometriosis and polycystic ovarian syndrome. I did go to the doctor, she had a look and said she didn't see anything that looked strange. I didn't mention my family history of endometriosis, because I didn't know about it at the time. She said if the pain persisted, she would have me see a GYN.

My plan is to monitor this for a few more weeks, and then ask for are referral to a GYN. I know there are a lot of questions about pain during sex and about endometriosis in particular. I have perused them, but as always I feel my question is a special special snowflake. Please point me to other questions if you feel I missed something that would be helpful.

My question is, for those of you who have endometriosis or perhaps have a partner with it, what sort of pain during sex do you have? How does it hurt? I definitely welcome any suggestions, either on the pain front, or the endometriosis/pain front? I guess I am just stressed out and want some information sooner than I can get a doctor appointment. Thanks!

posted by teragram to health & fitness (11 comments total)

What you're describing sounds more like vestibulitis and/or vulvodynia. Endometriosis tends to be pelvic/abdominal, not vulvar - it's generally in the same location you would have cramps, or may even present as intestinal pain or suspected appendicitis.

You would really need to see a GYN for vestibulitis, if there's no observable infection or deformity.
posted by Lyn Never at 6:44 AM on November 11 [1 favorite]

Get thee to a gynecologist!
Do not wait a few more weeks.
You should not have pain so bad you can't continue sex and it really doesn't sound good that it was painful to take out a tampon.
Seriously, that is not cool.
I don't know anything about endometriosis, but it could be so many other things, and really, WHY WAIT?
posted by smartypantz at 6:50 AM on November 11 [1 favorite]

(IANAD.) I know you said you went to the doctor so perhaps s/he did dismiss this possibility already, but for vaginal pain (which, as Lyn Never said, is not usually what endometriosis has to do with), the first thing to eliminate would surely be just a yeast infection? They can be fairly asymptomatic, and the irritation/pain only noticeable when there's contact (as during sex or inserting/removing tampons). New partner/frequent sex (8 months is pretty new) is a pretty easy time to get yeast infections. A trip to the GYN is definitely a good idea -- why should you wait with unexplained pain that's interfering with your life? Even if it did go away, that doesn't mean nothing was wrong!
posted by lysimache at 6:55 AM on November 11 [1 favorite]

Perhaps fibroid--ultrasound will determine that. Endo can't be determined unless you get endoscoped. Sorry you're in pain.

I have a fibroid and it's a fullness, heavy, bloated pain. I'm also tipped so hitting the wrong spot is a jabbing pain. And I most likely have endo (lovely tube wrapped around my uterus and adhered. Super) but I was never scoped. They're only guessing due to the physical findings.

And don't overly worry about fertility (in case it crossed your mind). I was told by an OB there would be no way I would conceive without IVF. Went to a wonderful infertility doc and he said well since your HSG is all clear, let's have a whirl. Clomid + trigger shot + IUI= my beautiful son.

Take care and good luck. Go to the OB and discuss all possibilities. It really doesn't sound like endo but endo can spread to all sorts of places beyond the uterus.
posted by stormpooper at 7:29 AM on November 11

Painful sex is a sign of endometriosis - I had it too, and now I am sans uterus. It is not something to mess around with.

According to webmd (link above) these are some of the symptoms of endometriosis:

* Abdominal cramps or back pain during menstruation.
* Very painful menstrual cramps.
* Painful bowel movements.
* Painful urination, especially during menstruation.
* Abnormal or heavy bleeding during periods.
* Painful sex.
* Difficulty becoming pregnant.

Even if you don't have any of the rest. I would get to the GYN as quickly as possible, and don't let them blow you off. Painful sex is usually a sign that something is wrong.
posted by patheral at 7:35 AM on November 11

Of course see a doctor. But sex was painful for me when I was using the ring (but not the pill). After 9 months on the ring, it was unbearable and I threw the rest away. It's been quite some time, and I used the ring when it was very new, but I do remember reading a few forums where other women said the same thing.

It just dried me out like crazy, and I remember reading that the hormones being local to the vagina can thin the tissues, I think? Again, see a doctor, but if you could go back to the pill and ditch the ring easily, you might try that.
posted by peep at 8:34 AM on November 11

My sister had an exposed nerve in her vagina which made sex painful in a similar way. A doc prescribed her some numbing cream, I believe.
posted by emilyd22222 at 11:33 AM on November 11

Get to a gynecologist asap.

You can get a pap smear while you're there or something, and if there's nothing going on it won't be a total waste.
posted by kathrineg at 2:04 PM on November 11

Have you noticed pain with a speculum? (No, seriously, and no, don't need to answer here). I ask because I had that problem --- though no pain during sex --- and it turned out that I had myofascial pain of the pelvic floor, which is basically when the mucscles don't know how to unclench. A physical therapist helped with this.

But since you have a family history of endometriosis, it could be endometriosis. But for some odd reason, the people I know who have endometriosis also have myofascial pain, though not vice-versa.

So, I'd go back to the gyno, update your history, and get another exam done. It might be a good idea to ask for a referral to one who is known for treating pelvic pain.
posted by zizzle at 4:11 PM on November 11

Vulvar vestibulitis FTW! Licocaine 5x/day, and, we'll see how it goes. Thanks.
posted by teragram at 7:05 PM on December 1

Hey there, thanks for the follow up and I hope that helps. If it doesn't, keep considering endometriosis. It is underdiagnosed (in my opinion!) because it's not really easy for a doctor to "feel" during an exam, even if it's there. It can definitely cause pain during sex for various reasons (scar tissue, adhesions, random other stuff), not just bowel/abdominal pain.

So if things don't get better, keep endometriosis in mind, and get a second (or third, or fourth) opinion if you need to!
posted by kathrineg at 7:22 PM on December 1