Endometriosis can be a debilitating condition, leading to both emotional and physical symptoms. Pain during sex, medically referred to as dyspareunia, while common is one of the least taking about symptoms of endometriosis.

In today’s blog, we address this sensitive issue head-on. We will offer practical solutions and advice for those dealing with pain during sex caused by endometriosis. Understanding and effectively managing this aspect of endometriosis is key to maintaining a healthy and fulfilling sexual life.

Why is sex painful when you have endometriosis?

Women who have endometriosis typically report pain during sex specifically in the genital and pelvic regions. This type of pain is primarily caused by endometrial lesions often located in the posterior pelvic cavity. These lesions are often hard, non-elastic nodules.

During sexual intercourse, the external force leads to increased tension and shifting. Endometriotic lesions decrease pelvic floor elasticity, which results in  deep, penetrating pain during, and sometimes after, sexual activity.

Endometriosis can also adversely affect the muscles and nerves in the pelvic region. The chronic inflammation and scarring caused by the disease can lead to muscle spasms and nerve irritation, amplifying the pain experienced during sex.

How common is painful sex with endometriosis?

According to a study published in 2020, endometriosis affects around 10 million women globally, and over half of them experience pain during sex. However, despite how common it is, dyspareunia is one of the most neglected symptoms of the condition.

There is a lack of awareness and understanding about endometriosis and its impact on sexual health. Many women may not realize that their painful sexual experiences are even linked to the condition, and as a result, they may not seek appropriate treatment. The intimate nature of the symptom can also make it a challenging topic to discuss, both for patients and healthcare providers.

Early diagnosis and intervention can significantly improve quality of life and reduce the long-term impact of the disease on a patient’s sex life.

How painful sex affects your relationship

Painful sex associated with endometriosis doesn’t just make it uncomfortable, it can also have a profound impact on your relationship.

A questionnaire-based study carried out in Europe revealed 97 out of 125 women suffered sexual distress. This led to avoidance of sex, a lack of enjoyment, and feelings of guilt towards their partner. They also have difficulty becoming aroused and achieving orgasm.

Their partners are also more reluctant to instigate sex and are fearful of causing pain. The lack of sexual activity can lead to frustration, a decrease in intimacy, and cause strain within the relationship.

What can you do to relieve endometriosis pain during sex?

There are some things you can try to relieve endometriosis-related pain during sex. These include:

• Be open with your partner
• Consult a professional
• Utilize pain management techniques
• Try pelvic floor physical therapy
• Use lubricants
• Practice stress reduction techniques
• Experiment with different positions

Discussing your pain with your partner can help them understand your needs and adjust during sex to reduce discomfort. You can also seek help from a professional who specializes in endometriosis to see if there are any treatments that may reduce the discomfort.

Over-the-counter pain relievers can be used before sex to alleviate pain; and pelvic floor therapy can help relax tight pelvic muscles. Using a lubricant during sex can also reduce discomfort by decreasing friction.

As stress can exacerbate pain, practices such as yoga, meditation, or deep breathing exercises can be beneficial. You may also find some sexual positions are more comfortable than others. Experimenting to find what works best for you can be helpful.

It is important to explore different strategies and consult with healthcare professionals to find the most effective approach for your specific situation. Taking these steps can significantly improve your quality of life and enable you to enjoy a healthier and more comfortable sex life.

Are there any positions to make sex not as painful?

With endometriosis-related pain, some positions are more painful than others. Generally, positions that allow you to control the depth and speed of penetration tend to be more comfortable. For example, being on top can give you better control, potentially leading to less pain.

It is also beneficial to experiment with different angles to find what works best. Some women find that side-by-side positions are less painful, as they tend to involve shallower penetration.

Pillows can be used for support and to adjust angles for comfort. Communication with your partner is vital here as it’s important to express what feels good and what doesn’t.

Are there any positions you should avoid when you have endometriosis?

While there is no one-size-fits-all answer, certain positions may exacerbate pain during sex. Typically, positions involving deep penetration can be more painful, as they can put more pressure on the areas affected by endometriosis.

For example, positions like traditional missionary, or those that allow for deeper penetration from behind, may need to be approached with caution or avoided altogether.

It’s important to remember that what might be painful for one person may not be for another. Paying close attention to your body’s responses and maintaining open communication with your partner is crucial in finding what works best for you. Experimenting and adjusting positions gently and gradually can help in identifying the most comfortable approach for your individual situation.

Pain during sex is not just distressing; it’s also a problem for couples who are trying to conceive. While more research is needed to determine its exact impact on fertility, current studies have shown a link between the two. For example, a study published in 2012, revealed between 30% and 50% of women with endometriosis struggle with infertility. Even if fertility isn’t affected, the pain experienced can make it difficult to conceive if the woman avoids sex to avoid pain.

Taking the next step

Whether you are currently trying to get pregnant or not, you don’t need to struggle with the pain of endometriosis. At GENESIS we have over 35 years of experience helping couples with all forms of reproductive issues. Treatment options are individualized based on your specific symptoms, age, and desire for pregnancy.