Talking about women's sexuality remains a delicate subject, especially when it comes toendometriosis-related pain during intercourse. All too often, this difficult experience remains shrouded in silence or embarrassment. And yet, for many women, these symptoms invade the intimate sphere with great violence, profoundly altering the quality of their sexual life. In the face of these intimate problems, which are still taboo, there are therapeutic options, including surgery in cases of deep endometriosis. Awareness of the impact of this disease on sexuality is the first step towards greater understanding and more targeted treatment.
Why does endometriosis affect sexuality?
Endometriosis affects almost one in ten women, and for many it causes a series of aches and pains both during menstruation and outside it, particularly during intercourse. It is one of the main causes of dyspareunia, the medical term used to describe the pain experienced during intercourse. Several mechanisms are involved in the complex interaction between endometriosis and sexuality.
The presence of deep, inflammatory and sometimes fibrous lesions around the vagina, rectum or cervix modifies the architecture of the pelvic organs. During sexual intercourse, these particularly sensitive areas can be stimulated, triggering either sharp pain or a nagging sensation that spoils the experience. It's not just the physical sphere that suffers: the chronic muscular tension generated by pain sometimes accentuates the contraction of the perineum, creating a vicious circle of pain and anxiety around female sexuality.
What patients report: dyspareunia, reduced libido and persistent intimate problems
Many patients describe a strong psychological impact, as the pain often prevents spontaneity and the fear of pain ultimately erodes pleasure. The anxiety associated with the dreaded experience of painful intercourse frequently leads to a drop in libido. The women concerned then speak of feelings of failure or inability to satisfy their partner, creating an additional emotional distance.
Among the common testimonials emerge:
- Deep burning sensation during penetration, sometimes unbearable
- Intense pelvic pain several hours after the procedure
- Difficulty reaching orgasm due to constant fear of pain
- Reflex muscle tension making relaxation impossible
- Progressive refusal of intercourse for fear of persistent pain
This combination of problems often leads to lasting female sexual dysfunction, gradually undermining self-esteem and creating conflict within the couple.
How can surgery help improve women's sexuality?
In the case ofdeep-rooted endometriosis, medical treatments such as hormones alleviate the pain in many cases, but sometimes only surgical solutions provide significant relief, especially in the case of side effects to hormonal treatments. The aim is not to offer a miracle solution, but to envisage a concrete improvement in intimate daily life where other options have failed.
Endometriosis surgery involves removing lesions implanted around the genital, digestive or urinary organs. Modern techniques, such as minimally invasive surgery or the use of lasers, now make it possible to precisely target the destruction of diseased tissue, while preserving nerve and vascular structures as far as possible. In some cases, the results can be seen in a marked reduction in pain during intercourse and a release of associated muscular tension.
What are the expected benefits of adapted surgery?
After a well-performed operation, 90% of women experience a gradual reduction in deep-seated dyspareunia. The removal of painful sites not only allows women to regain a more serene sexuality, but also contributes to restoring confidence in their bodies. A better quality of sexual life often has a positive effect on mood, and reduces the occurrence of secondary intimate disorders linked to chronic frustration.
Other patients report a gradual resumption of sexual relations without major anxiety, even if some apprehension persists. Post-operative perineal re-education sessions play an essential complementary role in re-establishing the tone and elasticity required for fulfilling sexual activity.
What are the limits and risks of surgery?
It's important to remember that surgery offers no absolute guarantee of a complete cure for pain during intercourse, even if 90% of patients who undergo surgery do improve. Sometimes, tiny lesions remain, or the after-effects of old inflammation can lead to residual discomfort. Multidisciplinary support (gynaecologist, physiotherapist, psychologist) optimizes the chances of success, while avoiding disappointment in the face of unrealistic expectations.
Complications of endometriosis surgery also exist, varying according to the extent of the lesions removed. These include scarring difficulties, risk of infection and, more rarely, impaired fertility. Discussing objectives at length and sealing a personalized project with the healthcare team remains crucial for every patient faced with these complex, intimate problems.
Emotional impact and reconstruction after surgery
Endometriosis doesn't just leave its mark physically; its emotional impact is considerable. The distress experienced, the fear of pain and the change in sexual desire sometimes create a feeling of intense loneliness. After an operation, a period of reconstruction begins: this involves taming one's own intimacy once again and, if necessary, talking to a health professional trained in sexuality.
Openly communicating about your emotions, concerns and expectations can sometimes help to lift the immense taboo surrounding female sexual dysfunction. Daring to look for new points of reference, avoiding guilt and boosting self-esteem all contribute to a better quality of sexual life.
What reinforces expertise in the management of complex forms?
Cases ofdeep endometriosis, sometimes involving the vaginal-retro-cervical septum , call for precise surgical expertise. Specialized teams focus on the precise identification of endometriosis sites, choose the most appropriate tool, such as laser treatment of infiltrating lesions, and offer close follow-up focused on the whole person: physical pain, potential infertility and respect for sexuality and maternity plans.
Growing recognition of the psychological impact of endometriosis also helps to validate the trying journey of the women concerned. Ongoing dialogue between specialists and patients paves the way for a real - albeit slow - improvement in intimate life for all those living with the many facets of endometriosis.