A guide to sex when you have endometriosis

Endometriosis can have a negative impact on many apsects of a person’s life, including their sex life. Symptoms of this painful chronic illness can make it a challenge to feel sexy, have sex, and enjoy sex. 

Learning about these symptoms can help you devise a plan for managing them. Here’s what to know, plus tips to overcome challenges for a better and healthier sex life.

Get diagnosed and treated

The first step to addressing any symptom or health condition is to see a healthcare provider (HCP) for a diagnosis. Endometriosis is no exception. If you have symptoms (see below), talk to an HCP about what you’re feeling. Many people spend years and multiple HCPs before getting an accurate diagnosis. So, it’s okay to seek a second opinion, or more, if necessary. 

Note there is no cure for the disease. But there are treatment options that can help reduce symptoms and prevent complications.

Endometriosis symptoms

Endometriosis can cause a wide variety of pain. This may include:

• Pain in the pelvis
• Lower back pain
• Abdominal pain
• Pain while going to the bathroom
• Painful periods

It can also include pain during or after sex. In addition to this, it can cause a number of symptoms that can damper libido or self-image. These can include:

• Fatigue
• Nausea
• Heavy menstrual bleeding, or spotting or bleeding between periods
• Bloating
• Constipation and/or diarrhea

Everyone’s experience with endometriosis is a little different, however. Not every person with the illness will have every symptom. The severity of symptoms can vary, as well.

Endometriosis and painful sex

The medical term for painful sex is dyspareunia. Why does endometriosis cause dyspareunia? It has to do with endometrial tissue. This tissue is similar to the tissue that lines the uterus, but it grows and attaches to places outside the uterus. 

Depending on where this tissue is growing, it can be pulled, pushed, or stretched during penetration or other sexual activity that focuses on the pelvic area. For example, the vagina often adheres to the rectum, which limits the vagina’s ability to move and expand. This leads to pain. 

Some hormonal treatments for endometriosis can cause vaginal dryness, which can also make sex painful.

If you experience pain during sex, it is important to discuss it with your OBGYN or another HCP. Dyspareunia affects many different parts of sex, from arousal to orgasm, and this can greatly influence your overall well-being and quality of life. To effectively treat the condition, an HCP needs to know about all your symptoms—even those that may feel embarrassing or upsetting to discuss.

Tips for sex when you have endometriosis

Sex can be an important part of physical, mental, and emotional health, and is often a key aspect of intimate relationships. While endometriosis can make sex challenging, there are ways to overcome this challenge. Trying these tips can help.

Communicate. It’s important to communicate with your partner about endometriosis and how it makes you feel emotionally as well as physically. This may include what feels good, what doesn’t feel good, and what you need. It’s also important to listen to your partner and try to understand what they are thinking and feeling.

Try different positions. Some positions may be more comfortable than others, particularly positions where penetration is shallow, or positions that do not apply a lot of pressure on the pelvis.

Use lubrication. Lube reduces friction. This might help lessen the pushing, pulling, and stretching that can result in pain. It can also help a person experiencing dryness.

Choose the right time. Endometriosis symptoms can vary throughout the menstrual cycle. Keeping track of these symptoms can help you recognize patterns, which may help you pick the best days of the month to have sex.

Experiment. When one position or form of sex is painful or not a possibility, it may help to try another. Oral sex or touch can be valuable, enjoyable parts of intimacy.