"It feels like an uppercut to the uterus" : exploring the impact painful sex has on women's sexuality due to endometriosis : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science (by thesis) in Psychology at Massey University, Albany, New Zealand

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Massey University
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130,000 women have endometriosis in New Zealand, with an estimated 70% of these women experiencing pain during or after sex (Adamson et al., 2010). There is limited research in New Zealand exploring women with endometriosis experiences of painful intercourse and its impact on them as a woman and their sexuality. Research has focused predominantly on the medical factors that affect women with endometriosis sexuality rather than taking a holistic approach. It is critical to explore the impacts painful intercourse have on women with endometriosis to better support them. This study aimed to explore women living with endometriosis experiences of painful intercourse and the impact this has on their sense of femininity and sexuality taking a feminist approach which privileges the women's voices and stories. Ten women with endometriosis took part in two semi-structured interviews and created a timeline of painful menstruation and sexual intercourse. In the first interview, participants discussed their endometriosis journey and created a timeline. In the second interview, participants discussed their experiences of painful intercourse, the impact, and the ways they cope. A structural narrative analysis was used to explore how the women storied their endometriosis journey alongside their experiences of painful intercourse. It was essential to capture the women's diverse and unique experiences and make meaning of their narratives. The analysis revealed the following narrative points, which consist of narrative subthemes. 1) something isn't right - pain, normalisation of pain and the turning point, 2) who am I as a woman living with endometriosis and painful intercourse? - sexual function, sexual relationships, fear and anxiety towards future sexual interactions and impact on their sense of femininity and, 3) what does this mean for their sexuality and them as a woman? The findings indicate that painful intercourse associated with endometriosis impacts women's sexual relationships, self-worth, femininity, feminine roles, and sexuality. However, there was less impact on women's sexual function. These findings are essential for future research methods and intervention strategies to support women living with endometriosis.