Wife frequently suffers abdominal pain during sex

My wife is in her late twenties and we have been together for 9 years. She has often experienced abdominal pain during sex, but a number of factors have recently combined to worsen the situation and I’m seeking some advice in case anyone has experienced a similar problem.

My wife has had stomach/digestive issues in the past. Many years ago she became gluten intolerant for a few months, however that passed and she now has no adverse reactions to any food. She is frequently ‘gassy’ despite eating well. She is a healthy weight. She often experiences kidney pain (although how she localises it to her kidneys, I don’t know. I’ve never experienced abdominal pain which I could identify that specifically). She suspected that she had endometriosis a couple of years ago, but the doctors identified nothing on a scan and told her they could only proceed with further diagnostics if she took the pill for something like 6-8 months first, which she has no intention of doing as she suffered bad side effects when she took it in the past. She experiences wildly unpredictable period pain: sometimes many months can pass without her even noticing her periods (she has an IUD), but occasionally they will be very bad. She suffered crippling period pain when she was a teenager (days off school, etc.) but it’s never been that bad since we met. She has never climaxed through penetration, although she says she thinks we’ve gotten close on a few rare occasions.

Penetrative sex usually causes her dull lower abdominal pain. Sometimes it produces a sudden need to urinate. Sometimes she needs to lie on one side for 10-20 minutes waiting for gas to pass before it is tolerable for her. Sometimes all penetration causes her discomfort (usually shortly after a meal); sometimes only very deep penetration or sex at a specific angle or in specific positions causes pain. There is no correlation to whether an IUD is in or not, nor to how excited she is. The most turned-on I have ever seen her was the last night of our honeymoon after dinner and drinks, but this didn’t result in sex because she ended up curled up with bloating pains on the sofa. Food and alcohol in particular seem to make things much worse. More vigourous sex tends to be worse, but when it’s painful, it’s still painful no matter how slow/gentle I am. Sometimes passing gas during sex immediately makes it better, but not always.

From my perspective it seems that she has very unusually sensitive innards, especially as I haven’t found any useful information online about this, but honestly I have no idea how common this sort of problem is. Endometriosis seems to cause all kinds of different pains in different people, so I suppose it could be that; but apparently if she has it it’s at least mild enough that it can’t be detected on a scan.

The reason I’m posting this now is that I’ve finally decided that enough is enough, and I want to do something about it. We have been to doctors, we have tried activated charcoal, we have tried only having sex in a certain position. We have tried making sure she has toileted and thoroughly passed gas before sex. This has been going on for years and nothing has worked. Over time I have seen my wife gradually losing all interest in making love. My wife no longer cares about fixing the problem anymore as it seems to have destroyed her sex drive completely. She just accepts that sex is usually painful in one way or another, never something she enjoys very much, and often not worth the risk anyway. She either does it purely as a gift to me, or she pre-emptively shuts down any intimacy because she doesn’t want to lead me on to sex if she’s going to have to stop it anyway because it’s too painful. This means we also have far fewer intimate moments of any kind.

When we do get to the point of making love, she often pretends it isn’t painful so I won’t be ‘let down;’ however sometimes I can tell she’s hiding it and if I ask her she’ll then admit that it is. I can’t be sure how often she does this, but naturally neither of us is able to enjoy it if she’s in pain and pretending not to be, and I’m worrying about whether or not she’s in pain and trying to look for the signs. I’ve asked her many times not to let it continue if it’s hurting her, but she doesn’t want to deprive me so she keeps doing it anyway to try to be nice. Nevertheless the frequency of sex has steadily declined such that now we make love about once a month/two months.

I feel this is now the end of the road. Either we do something drastic to improve this or we’re going to have a sexless marriage for the rest of our lives. I’d greatly appreciate any advice.