"I was diagnosed with endometriosis five years ago and I suffer a lot during sex. I hear a lot about vaginismus, although my doctor only attributes my pain to endometriosis. Can you have vaginismus and endometriosis?"
What is endometriosis?
Briefly, endometriosis occurs when the mucous membrane in the uterus migrates outside the uterus, for example into the fallopian tubes or the abdomen. Among other things, this migration leads to severe pain during menstruation and an increased chance of infertility. Endometriosis can also be characterised by the formation of cysts in the vagina that become extremely painful for the woman concerned, or by the adhesion of the walls, which also leads to increased sensitivity. Because it only affects people with a uterus, endometriosis is a little-known disease, which is diagnosed late and for which there is little or no treatment.
Endometriosis can therefore already cause pain during sexual intercourse. These pains are often located at the bottom of the vagina and not at the entrance itself, as is the case with vaginal women. But does this mean that there is no connection? No.
Endo and primary vaginismus.
There is nothing to prevent women with endometriosis from developing vaginismus in childhood or adolescence, and that vaginismus is superimposed on endometriosis. In this case, they have what is called primary vaginismus, which occurs before any sexual intercourse. It is difficult to diagnose because most health care personnel consider pain during sexual intercourse to be normal, and even more so when there is endometriosis.
Endo and secondary vaginismus.
But women with endometriosis can also develop secondary vaginismus as a result of the disease, and this is even more common than you might think.
If you have endometriosis, you may have experienced severe pain during sexual intercourse or even during medical consultations (e.g. with catheters). Your subconscious has associated the intrusion of something into your vagina with danger. Your body has prepared itself for the pain by tensing up during sex, and this tensing up has reinforced the pain: it is a vicious circle that leads to vaginismus. When the association is made between sexual intercourse and pain, it is very difficult to get rid of it naturally. It is therefore important to identify this association and to put a word to it - vaginismus - in order to be able to break free from it. Pain during sexual intercourse is not inevitable, even for people with endometriosis.
Psychological construct.
In addition to this rather simple pain association, women with endometriosis may develop vaginismus as a result of their disease due to more complex psychological factors.
The first, and fairly obvious, factor is detestation of one's vagina/uterus. People with endo may see their vagina as a burden in their lives, a source of pain. They therefore distance themselves from it, which can lead to vaginismus. This distancing is reinforced by the multitude of medical examinations they have to undergo, but also by taking heavy treatment, such as the pill, which completely disconnects the woman from her uterus. They are faced with a part of their body that they do not know, do not control and have only a conflicting relationship with it.
The second, more hidden factor is related to pregnancy. Women with endometriosis are warned almost from the first consultation that they are or will be at risk of infertility. This risk is an enormous pressure on these women who, for some of them, want to become pregnant or at least have the choice of becoming pregnant. For fear of infertility, women with endo may close themselves off to sex, resulting in vaginismus. This is a way for them to deny the reality of their potential infertility, and it is a form of unconscious protection.
To answer your question, women with endo can have vaginismus, both primary and secondary, and it is actually quite logical. It is important to keep in mind that pain is not normal and should not be considered definitive. Identifying your vaginismus when you have endo is therefore an essential act to get out of it. Good luck to you, if this is your case, and we'll see you in a fortnight.
Maelle Sable Bizet
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