Endometriosis and Sex: Tips To Make Intimacy Easier

7 min readApr 27, 2021

Sometimes sex is freaking painful!! Painful sex is one of the most common endometriosis symptoms and it has such a stigma around it!

Sex doesn’t have to be painful.

In this blog post I’ll share all about endometriosis and sex. We will touch on 3 tips to make intimacy easier when you have endometriosis pain with sex.

What Is Endometriosis?

Endometriosis is a full body inflammatory disease that is centered around immune dysfunction. It is a disease where inflammatory endometriosis lesions that are similar to the innermost lining of the uterus are outside of the uterus. These lesions are hormone sensitive and respond to the hormones of the menstrual cycle, but endometriosis is not caused by excess hormones or excess estrogen. Some explain the lesions as tiny blisters all over your internal organs causing immense amounts of pain. It is also listed as one of the top 20 most painful conditions in the world and unfortunately, there is no cure.

There are an estimated 200 million people worldwide that have endometriosis and the reality is that number is probably a lot higher due to the lack of understanding from our medical community and the delay in diagnosis of this disease. 1 in 10 people have endometriosis and that does not include the trans and non binary folks who have not been studied. It takes an average of 10 years to get diagnosed with endometriosis. And the most common surgery performed by a normal gyn is ablation/coagulation which leads to more pain and scar tissue, prolonging pain and suffering for many women. Click here to read more about endometriosis and click here to learn more about common endometriosis symptoms

I want to start off by saying that the pain you are feeling is real. You are not faking it or imagining it. Your pain is there for a reason. In this blog we will be discussing three possible reasons why you are still feeling pain post excision surgery.

Endometriosis and Pain With Sex + Intimacy

Painful intercourse is an extremely common symptom of endometriosis. The pain can occur during insertion, in any position, only in some positions, after orgasm, after sex, only during certain times of the month, and/or only during deep penetration. The experience is different for each woman, and not all women experience pain with sex.

The pain can range from relatively mild to excruciating. The pain and cramping afterwards can sometimes last for days.

Seckin MD says that pain during sex can be caused by the endometriosis lesions being pulled and pushed, it can be caused by vaginal dryness, and even caused by tightening of the pelvic floor muscles.

Pain during sex can be one of the first signs of endometriosis so it is extremely important that you talk to your doctor about this type of pain if you experience it.

Sex has such a stigma around it, especially when its painful! But sex doesn’t have to always be painful! You don’t have to avoid sex and intimacy forever because of the pain! Keep reading for some tips on how to make intimacy easier! Read more about the symptoms of endometriosis here

How To Make Intimacy Easier With Endometriosis Tip #1: Talk About It

One of the biggest things you can do for yourself and your sex life is talk about it. Not only with your partner but also with your doctor! Your first instinct is probably to shut down and keep it all inside but letting those around you know what you’re going through can not only help them understand better, but also take some pressure off of you!

Talking to your doctor

Pain with sex is NOT normal! Your vagina, cervix, abdomen, etc should NEVER hurt after sex. If it does, it could be a sign of endometriosis! Talking to your doctor about these symptoms is an important part of your health! If it makes you uncomfortable sharing you do not have to go into detail about it. But you have to let them know it’s painful! There are many conventional treatments for endometriosis such as excision surgery or pelvic floor therapy that can be very helpful in relieving pain with sex! Check out more about excision surgery here

Also, you can find a FREE letter to your doctor template here

Talking To Your Partner

Having open communication between you and your partner is key to a healthy relationship and a healthy sex life! Intimacy isn’t a taboo topic, it is an important part of a healthy relationship. Letting your partner know that sex is painful, letting them know when you’re in pain can help them understand what is happening.

Having your partner come to the doctor appointment with you can give your partner some validation and a deeper understanding of what you’re going through. It can also be incredibly empowering for you as well!

If you don’t talk to your partner you could start to build up resentment, the pain could get worse and you might shy away from it all together with your partner thinking they’re doing something wrong, or there could be a misunderstanding about sex all together. There are a million things that could get misconstrued so keeping your partner in the loop of that is happening with you is important. You and your partner should be a team, and sex should feel good for both of you!

How To Make Intimacy Easier With Endometriosis Tip #2: Don’t Forget Foreplay

One of the BIGGEST mistakes I see women make when they’re trying to be intimate is they skip over a very very important part of sex… the foreplay!

FOREPLAY IS BAE

Jumping right into penetration without giving their bodies time to warm up is terrible for women with endometriosis! This is not the movies babes! You can’t go from a sexy stare straight into deep penetration! Our bodies aren’t made that way!

Our vaginas are delicate and we need that extra foreplay to engorge our vaginal walls to make penetration less painful!! This is especially important for those of us that have endometriosis lesions in our recto-vaginal space, or around the outside of the vagina, cervix, and/or uterus. You want as much space between those lesions and the inside of your vagina! Foreplay can help with this by engorging your vaginal walls!

Dr Debra Herbenick, a sex researcher, also found that when we engage in foreplay, the muscles around the uterus contract pulling the uterus up and elongating the vaginal canal. This is great as it makes more room between the penis and your cervix & uterus which means less jarring pain!

But a little side note, for some women, penetration is EXCRUCIATING. I am not saying push through the pain at all, sex isn’t all about penetration! But, you can get off and have an orgasm from oral sex, so before you ward off sex for good, I urge you to have your partner go down on you!

(Pain with orgasm, vaginismus, vulvodynia etc is a topic for another blog ❤ )

How To Make Intimacy Easier With Endometriosis Tip #3: Plan It

This is one of my favorite tips, and a tip that is usually overlooked or looked down upon. Planning sexy time! There is absolutely nothing wrong with planning when you are going to be intimate with your partner! And it is actually one of the most helpful tips for those of us that have endometriosis!

Sex is painful, so we have been conditioned to just stick to our routines and stay comfortable. But, what if you set aside specific time for intimacy? What if you made it an important part of your life like everything else that you plan?

We plan so many things in our lives. Our meals, work, playdates for our kids, lunch date with the girls, the list goes on and on. But one thing that is commonly pushed aside is our sex life. It is so common to never plan intimacy or sexy time. We get comfortable in our routines of coming home, watching TV, and then we are both too tired to even try so we just go to bed.

Planning and tracking your cycle is also helpful so you can know the times of your cycle that you have the most pain! For example, some women experience more pain around ovulation. If your pain is around ovulation it might be easier to plan sexy time just after or before your period and avoid it around ovulation. Every woman is different and it is going to take some trial and error to learn your body and figure out what works best for you!

If you are having pain with sex, there is a strong possibility that you might have endometriosis! Bring it up with your doctor at your next visit!

There you have it! How to make intimacy easier while living with endometriosis

Tell me about you! Do you have pain with sex?