"Mom, sometimes my vagina hurts after I poop. Is that normal?"
Yes, I actually asked my mother that when I was a teenager. The question made us both a little uncomfortable, which is why I didn't tell her exactly how much it hurt—that sometimes afterward, I curled into a fetal position near the toilet and hyperventilated until the pain died down. In any case, she had no idea what I was talking about and didn't know what to tell me.
A few years later, I started having sex. I expected some pain the first time, so I wasn't surprised when it hurt. But when the sex was still painful the second and third time, and every time after that, I started to think, "OK, how long does it take to break this thing in?" The pain and discomfort made vaginal sex impossible to enjoy, so I'd end up lying there waiting for it to be over. I didn't say anything about it to my partner and he never acknowledged my obvious non-enjoyment.
It was bad then, but it got worse later. I was 24 when I met Nigel*, and I hadn't had sex with anyone in years. After many dates and taking things very slowly, I decided to have sex and see if it still hurt. It did. Oh my gosh, it did—and worse than before. It was a terrible, ripping pain that I couldn't ignore, so I told him to stop. We ended up switching positions to something that didn't hurt as much, but it was still very uncomfortable. Once again, I found myself lying there waiting for the guy to finish. Afterward, I don't think he noticed that I was silently crying.
The next time I saw my mum, I tearfully told her about how painful the sex had been, and that I was afraid there was something irreparably wrong with me. This time, she had heard of this kind of thing before and thought she might know what it was. She told me to make an appointment at the same gynaecological practice she visited and assured me that we would figure out what was going on.
My diagnosis
At the appointment, I stared at the doctor meekly and made my confession: "I'm having pain during sex." She wanted more specifics. Did it hurt every time Nigel went in? Oh yeah. Did it ever feel like he was bumping into something in there? Yes, that's exactly how it felt.
The doctor told me that I probably had endometriosis, a condition in which uterine lining—or endometrium—grows outside of the uterus. This rogue endometrium sheds just like a woman's lining normally does during her period. But because there's nowhere for it to exit, it just gets stuck there, creating scar tissue and adhesions that bind together, causing pain and sometimes, infertility.
I was relieved that I might have an explanation for my pain, but I was dismayed to learn that the only way to confirm whether I had endometriosis was through a surgical procedure called a laparoscopy—an operation where a camera is inserted through small pelvic incisions and any endometriosis are removed. I wasn't worried about it hurting, but rather, that the doctor would open me up and find nothing there. Then I'd be back where I started, with no clue as to what was causing my pain. And even if it did turn out that I had endometriosis and the doctor removed the offending tissue during the laparoscopy, it could still grow back. This plagued my mind, too.
As I learned more about the disorder, I realised that I actually displayed a lot of its common symptoms. My irregular periods, constipation, backaches and pain during bowel movements were all, according to my doctor, "classic endo" symptoms. The condition can also cause intestinal pain, heavy periods, debilitating cramps and pain during urination. In some cases, endometrium can spread as far as a woman's lungs and diaphragm, causing shortness of breath.
Once I learned about what might be going on inside me, I began to talk more openly with Nigel about sex and the fact that I wasn't enjoying it. I told him about endometriosis and said that I was going to have surgery for it in the next couple of months. We made an effort to try different sexual positions; and when nothing felt right, we decided to only have non-vaginal sex until after the procedure. (This is an excellent way to get to know someone intimately and learn what he or she likes, by the way!)
My recovery
As soon as the anaesthesia wore off after my laparoscopy, I looked frantically at my mum and asked: "Did they get it out? Was there anything there?" "Yes," she reassured me. "They got it all out."
There had been some tissue around my ovaries and fallopian tubes, but most of it had been on my rectal canal. That explained why my bowel movements could be such a nightmare. It also explained some of the pain I experienced during sex.
Yet after Nigel and I started having vaginal sex again, I still found that I had some pain along the part of my vaginal wall near my rectal canal. My doctor told me that the pain could be from scar tissue caused by endometriosis that cannot be healed or removed. Fortunately, this didn't prevent Nigel and me from having great sex. Although some positions were still painful, the tissue removal allowed me to have pleasurable vaginal sex for the first time in my life. That means orgasms, people—which I never experienced before.
Since my diagnosis two and half years ago, I've learned that there is no cure for endometriosis, only ways to manage the pain and prevent it from progressing. Doctors still aren't sure what causes the condition, so there isn't one set way to treat it. I make exercise a priority because regular exercise can lower a woman's oestrogen levels. Endometriosis is an oestrogen-dependent disease; so lowering this hormone helps with my symptoms. I also take a progestin-only birth control pill called Norethindrone that's been helping.
I still have occasional pain from my endometriosis. I also know that in the future, I might have to try different treatments or have more surgery. And since I'm no longer with Nigel, I know that I'll eventually have to explain what endo is and what it means for sex to a new partner. Is this scary for me? Yes. But for now, I'm incredibly thankful to have a better understanding of my body and to know that sex (and pooping) don't have to be painful.
*Name has been changed.
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