Endometriosis and Sexuality

How endometriosis can impact your sex life – and what you can do to make things better.

Endometriosis and Sexuality

It's endometriosis awareness month and it's a topic I find there is very little discussion and education around.  Did you know that endometriosis will affect 1 in 10 women during their reproductive years (ages 15 - 49) yet won't often be diagnosed until they are 27 years old?  AND 30% - 50% of women who experience endometriosis may experience infertility.


So what exactly is endometriosis?

Endometriosis is when the lining of the uterus grows outside the uterus.  Even though this tissue (endometrium) is outside the uterus, it still acts as it normally would which means it thickens, breaks down and bleeds with each menstrual cycle.  HOWEVER, because this tissue has no way to exit your body, it becomes trapped.  As you can imagine, this tissue becomes irritated and can eventually turn into scar tissue and adhesion that leads to abnormal fibrous tissue that can bind pelvic tissue and organs.    If endometriosis the ovaries, cysts may form as well.


Painful right?

One reader said:

One reader said:

My endometriosis journey is going on year 15.  It's definitely something that still needs more awareness and information.  If there had been this kind of openness and understanding when I was a teenager, I would have felt so much more in tune with my body instead of hating it so much.  (Graphic Caroline Ballard)

How can endometriosis impact your sex life?

Many people describe the pain they experience as a stabbing, jabbing, a deep ache, ranging from mild to severe.

Some women experience pain anytime they have intercourse, others experience it only when there is deep penetration.  Some women experience pain anytime they have sex and others experience pain just during particular times of their cycle.

Another reader described how it impacted her sex life like this:

My experience with endometriosis had an impact on my digestive tract, causing gas, constipation, and bloating.  It made me not want to be touched for a pretty good portion of the time.  I should say, wanting to, but feeling so uncomfortable and unsexy.  This is something that doesn't get talked about but is definitely a factor.

While much is discussed about the physical pain that can occur during intercourse there is a lot of emotional pain and stress.  Many women feel anxious about any kind of physical touch that could lead to sex which can lead to pain.  Others might start to feel alone, discouraged, and broken or hopeless.  All of these emotions can take a toll on your day-to-day and impact a relationship.

So what can you do?

Get a correct diagnosis from a professional who knows about endometriosis and sexual health!  Believe it or not, many medical professionals and therapists have very little training around sexual health issues and endometriosis is unfortunately often misdiagnosed as something else.  If you are experiencing painful sex or physical symptoms on a regular basis, find a provider who can support you getting to the root of your symptoms.  If you've been to a provider but they didn't answer things for you or how they are approaching your problem isn't working for you, keep searching and don't give up!

Track your cycles to see if you have a pattern to your pain and symptoms.  You may find that there are times where you have more or less pain during the month and sexual activity can feel better or worse.  There are a lot of apps that you can track your cycle with such as Clue and Flo Period Tracker,.

Consider a holistic treatment approach.  Different approaches can help heal different symptoms.   According to Brigham and Women's Hospital, "The most effective approach to chronic pain management associated with endometriosis combines traditional medical and surgical treatment(s) with complementary therapies provided by a multidisciplinary team. Part of the treatment involves breaking the pain cycle which often includes the use of the following approaches,"  Some of the alternate therapies they recommend are:

  • Acupuncture
  • Herbal medicine
  • Behavior modification with lifestyle changes
  • Biofeedback
  • Physical therapy

Use lubrication that contributes to your sexual health.  Many women with endometriosis experience sexual pain because of vaginal dryness and lack of lubrication. Lubrication can be one of the best ways to reduce pain and friction and increase pleasure.   Think of water-based lube as a lotion for your vagina.  You don't need it only when you are having sex but can use it to hydrate vaginal tissues daily. Because lubrication is currently not regulated by the FDA here in the United States, most grocery store lubes contain ingredients that erode and irritate vaginal tissue.  A few lubrication favorites are:

  • Good Clean Love
  • Uber Lube
  • Coconu

Try different positions. Adding a variety of sexual positions to your repertoire can help with reducing sexual pain.  Whether a certain position helps during a more painful time of the month or another position feels better majority of the time, discover the positions that support your body.   *Hint: missionary position can actually be one of the most painful positions for women who experience endometriosis.

Develop communication skills.  Learn how to talk about how endometriosis effects you!  This is an area of sexual health that so few people really know about and while learning about it generally is a great start, sharing how it impacts you specifically is critical.  Talk about your symptoms with your partner, share how penetration effects you and explore other ways to be sexual that ease your physical and emotional concerns.  This can be an area where a sex therapist can be helpful in your journey.

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