Dear Dr.Eve – 17 May 2021

“Dear Dr. Eve


I’ve always experienced sexual pain. I am now 41 years old and really
long for a healthy sexual life with my husband. He is so patient with me We can seldom have penetration as it is just too painful for me.
I’m on quite a lot of medication as I have a few problems with my
health. I have endometriosis, which causes me a lot of pain. I have pain with periods, even bowel movements. In addition, I am always bloated and experience a lot of fatigue.
I’m not sure if this is relevant but I have had a lot of stress in my life as
my mother was an alcoholic and my father was hardly around. And they fought a lot. You say you work with “intimacy trauma “ so I wonder if my endometriosis has anything to do with this.

Lucy.”

Dr.Eve Answers:

Hello Lucy
Sexual pain is complex and, like all pain, impacts sexuality and
mental well-being. The sexual pain that you speak of is diagnosed as a Sexual Dysfunction, known as “genito-pelvic-pain disorder/penetration disorder”. This means that women like you have recurrent or persistent

difficulties with either vaginal penetration during intercourse,
vulvovaginal or pelvic pain during vaginal intercourse or attempts at
penetration, or fear or anxiety of the pain in anticipation of or during or
anticipated vaginal penetration.
There are treatments for this and going to an accredited sexual medicine therapist will give you some good results.

The piece that is most interesting to me as a sex therapist and intimacy trauma therapist, is your endometriosis. Endometriosis
https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
as you know only too well, is the cause of sexual pain. Endometriosis is complex, hard to diagnose, and difficult to treat. And one fact that is
known about it is that it can be caused by an immune disorder.

You may be wondering what this has to do with your sexual pain. Let’s
explore this a little more. Believe it or not, there is robust evidence to
show that trauma or intense stress ups your odds of developing immune disorders… like endometriosis. Other disorders of the immune system that are related to trauma include rheumatoid arthritis, psoriasis, Crohn’s disease. We can also add in depression, anxiety, addictions.

Trauma and its resulting stress harm us through physiological changes to the body and brain, and those harms can persist throughout life. Excess stress can predispose us to everything from diabetes to heart disease, maybe even cancer.

So Lucy, whilst you will benefit from treatment via sex therapy, the piece that will be as beneficial to you is working with the trauma you survived as a neglected and abandoned child. In this way, you are working with the pain that your body carries due to your childhood abuse.

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