How to Overcome Pain During Intercourse

Letter #2

Dear Dr. Harley,

My wife and I have been married for about 2 1/2 years. Before our marriage, and for a short time afterward, our sexual relationship was fantastic. 2-3 months after we got married, she was diagnosed with endometriosis and went into the hospital for a laparoscopy to remove the endometriosis. She was still having quite a bit of pain a couple of months after the surgery and the doctor put her on Zolodex (a drug that makes the women go through a "temporary" menopause while she is on it). She was on the Zolodex for about 5 months, and our sex life has never been the same. We rarely had sex while she was on the Zolodex, and it has continued on since then.

She has spoken to her doctor who put her on the medication, he says it's all in her head (which of course did not hit home very well at all). She has told me that she is still very attracted to me, but she just can't raise those emotions anymore.

So here lies the problem, it has now gone on for well over 2 years and I am really getting frustrated about not being able to resolve this. My greatest desire is to get our sexual relationship to the point it was when we got married. She wanted me as bad as I wanted her. I am willing to do whatever it takes to get us back to where our relationship was and build on that, but her response is "If I don't have any desire, how can I fix the problem?"

At this stage of the endometriosis, she does not have pain during intercourse (though at the beginning of this fiasco she did). We are now at a point where we are fighting a battle over desire. She is very willing to do what it takes to solve the problem, so if I can find any possible solutions, she is willing to try them. She thinks it's a hormonal problem, but she's already asked her doctor and he doesn't agree with her.

What started from a small outpatient surgical routine, has turned into a full blown problem which has led to some very stressful evenings and conversations (mostly on my part). I am more than willing to do anything you might suggest to get to the bottom of this, I would love to have the girl I married back.

She has this fear that everyone we talk to about this is going to tell her she has a mental problem, and that bothers her. This may be a reason why she hasn't pursued a solution to this herself. She wants this to be a physical thing, such as a low estrogen level, but her doctor assures her it's something else. Is there anything I can do, or anyone I can talk to who would have more knowledge about circumstances such as these? I am almost at my wits end, I love my wife very much, but I want us to be happy and enthusiastic as we once were.


Dear M.H.,

From what you have told me, I would agree with your wife's doctor that the problem is not physical, but rather emotional. She is probably now as physically capable of passionate sex as she ever was. Her loss of desire can be explained by the experiences she had with you while she endured the symptoms of endometriosis. Those experiences not only included painful intercourse, but could have also included insensitivity on your part to her predicament. Since then, you apparently have been arguing with her about it, perhaps being disrespectful and demanding. Those Love Busters really do a number on sexual desire!

Sexual desire for most women is considerably more fragile than for most men. For men, physiological factors (testosterone) tend to dominate, while for women, emotional attachment and past sexual encounters have more influence.

I would imagine that her endometriosis turned her terrific sexual experience with you into a nightmare; she came to view lovemaking as a very unpleasant necessity. For a while she would have endured the pain just to please you, but eventually she could not bear it any longer. She may have even been brought to tears while making love to you.

To compound the problem, your sex drive may have made you insensitive to her pain. Knowing that she was suffering, you may have charged ahead to meet your need. She would have seen you in an entirely new light, a man who cared more about sex than about her. Then, when the endometriosis was discovered and treated, your months of celibacy may have made you less affectionate and thoughtful.

In the beginning of your marriage, you were meeting your wife's emotional needs and avoiding Love Busters. She wanted to make love to the man who loved and cared for her, and each sexual experience was a treat. She was emotionally connected to you and she had memories of many enjoyable sexual experiences. That's why she had sexual desire -- she expected each sexual experience with you to be terrific because every past experience had been that way.

When your wife developed endometriosis, it may have marked the beginning of a downward slide in your relationship. Perhaps a few Love Busters were unleashed, and perhaps you were not as thoughtful or affectionate as you had been in the past. By the time the disease was under control, she couldn't even remember what it had been like to enjoy sex, and she was no longer emotionally connected to you. The result was no sexual desire.

You and your wife are at a point in your marriage where you can recreate the enjoyable experience you once had. But to do it, you will need to begin at the beginning.

First, I recommend that you make sure that your wife re-connects with you emotionally. Have you eliminated Love Busters that may have been created during her months of endometriosis? Are you meeting the emotional needs you once met? You may want to encourage her to complete my Love Busters Questionnaire and Emotional Needs Questionnaire to help identify the obstacles to your relationship.

Then, if she still gets a knot in her stomach whenever she thinks about having sex, I suggest that she follow the advice I offer in my Q&A column, "How to Overcome a Sexual Aversion." These procedures may seem to be long and technical, but they work. Once you have a willing sex partner again, you will appreciate what you have even more than before, and you will know how to protect it so that you don't lose your passion for each other again.

Your wife went through sexual hell when she had endometriosis, so it's no surprise that she just doesn't feel the same about sex. If you treat her with the love and thoughtfulness she deserves, and she learns to overcome the aversive reactions she has developed, those bad experiences will be replaced with good experiences, and sexual desire will return to her.

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