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Endometriosis and sex: Navigating intimacy and pain

Updated: Jul 5, 2023

Endometriosis is a painful and chronic condition that affects millions of women worldwide.

One of the most common symptoms of endometriosis is pain during sex, which can have a significant impact on relationships and mental health.

In this blog post, we will discuss why endometriosis causes pain during sex, what the pain can feel like, and how it can impact your relationships and mental health.

We will also provide some tips on what you can do about it.

If you are one of the 10% of women in the U.S. with endometriosis, you may also experience dyspareunia. Simply put, dyspareunia is pain during sex.

Sometimes pain occurs before, during, or after intercourse in those with endometriosis and can impact mental health and relationships.

But here’s the good news: It doesn’t have to be this way. Read on to learn how to navigate (and enjoy) sex with endometriosis.

What we are covering:

  • Why does endometriosis cause pain during sex?

  • What does the pain feel like?

  • How endometriosis pain impacts mental health during sex

  • How to enjoy sex with endometriosis

Why does endometriosis cause pain during sex?

Endometriosis develops when the tissue that grows inside your uterus begins to grow on your ovaries, bladder, or other nearby organs.

This means when you get your period, the tissue sheds just as it would if it were inside your uterus.

But without its typical means of leaving your body, the tissue stays inside and hardens into scars and cysts.

These scars are what cause dyspareunia, or pain during sex, as they move, contract, and extend.

And because nobody is the same, depending on how much scarring you have or how severe your endometriosis is, pain during penetrative sex can range from mild to severe and throbbing to acute.

What does the pain feel like?

The pain experienced during sex can vary from woman to woman. Some women describe it as a sharp, stabbing pain, while others describe it as a dull ache or pressure.

The pain may occur before, during, or after sex, and it can be felt in different areas of the pelvis, such as the vagina, vulva, or lower abdomen.

How endometriosis pain impacts mental health during sex

If you have endometriosis and experience pain during sex, you are not alone.

Our minds, however, can make it feel like we are, especially when the sex life we may have envisioned is different due to endometriosis.

Depression and anxiety are common symptoms among women who find sexual activity painful.

You may feel guilt or shame that you do not find sex or intimate time with your partner an enjoyable experience.

To avoid these feelings it may be tempting to hide your pain, not talk about it with your partner, or avoid sex altogether.

This is why one of the best ways to navigate sex with endometriosis pain is honest communication—with yourself and your partner.

Building a positive relationship with your body, through self-guided resources or with the help of a therapist or coach, can help you regain a positive self-image and confidence during sexual activity.

Many wonder how they can explain endometriosis pain to a partner.

Vulnerability is not easy for many of us and talking about our sex lives can feel uncomfortable.

However, to reduce endometriosis pain during sex, you need to communicate when you’re experiencing pain and why.

Together, share what you are feeling and take time to figure out what is and is not pleasurable during sex.

How to enjoy sex with endometriosis

Endometriosis does not mean we cannot have a pleasurable sex life.

It just means we’re going to need to think outside the box, which can make sex as (or even more) enjoyable than before.

Follow these best practices to reduce endometriosis pain during sex.

  • Time it right – Many find penetrative sex most painful right before or during their periods. To reduce endometriosis pain during sex, check where you are in your cycle before proceeding.

  • Use a lubricant or vaginal moisturizerVaginal dryness can also be a symptom of endometriosis and contribute to pain during sex. Make sure you have lube readily available to help alleviate pain. Using a vaginal moisturizer regularly can also help relieve symptoms of vaginal dryness before and after intercourse.

  • Find a comfortable position – Depending on the location of your scar tissue, different sexual positions can cause more pain. For instance, the missionary position can cause the most pain in those with endometriosis. Talk to your partner and experiment with different positions that bring the most pleasure and the least amount of tension and irritation.

  • Practice mindfulness and deep breathing – Our mental health has a direct impact on our physical health and well-being. Take a moment to walk through a mindfulness practice or deep breathing exercise beforehand to reduce muscle tension and increase relaxation. Sex with a partner should be a pleasurable experience, not one that contributes to fear or anxiety.

  • Get creative – Penetrative sex may be the most common, but by no means is it the only way to engage in sexual activity with your partner. Try experimenting with oral or other types of physical stimulation, massage, mutual masturbation, role-playing, and longer foreplay. Often, taking the time to explore each other's preferences deepens intimacy and strengthens relationships.

  • Seek help – If you and your partner are struggling to find a way forward, you may want to talk with a coach or ELANZA care navigator. A specialist can provide insight into ways you can best communicate with each other as well as new methods to make sexual activity more enjoyable.

The key takeaway

Pain during sex is a common symptom of endometriosis, but there are ways to manage it and improve your quality of life.

By communicating with your partner, using lubrication, trying pain relief methods, seeking medical treatment, and seeking support, you can navigate intimacy and pain and maintain healthy relationships.

Remember, you are not alone, and there is help available.

If you are having a difficult time navigating your relationships, our care platform is for you. Sign up today to access a library full of blogs, videos, stories and doctor interviews around endometriosis, management and the way forward.


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