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Endometriosis and Sex

Endometriosis and Sex

Did you know that an estimated 170 million women worldwide have endometriosis? Characterized by chronic pain, this condition can make sexual activity difficult for many couples. Fortunately, there are ways to cope, and we’ll talk about them today.

What is endometriosis?

This gynecological condition involves the endometrium – the lining of the uterus. During a woman’s menstrual cycle, the endometrium prepares itself for a possible pregnancy. If no pregnancy occurs, the endometrium is shed and leaves the body with menstrual blood.

Sometimes, endometrial tissue grows outside of the uterus. Areas of this tissue, called implants, can form on the ovaries, fallopian tubes, bladder, rectum, and the lining of the abdominal cavity, among other areas. This is endometriosis.

Women with endometriosis may feel significant pain, especially during certain times of their menstrual cycles. They may also have pain during sex, while urinating, or while moving their bowels. Some women experience bleeding and spotting between periods. They might also have diarrhea, constipation, and or nausea.

Infertility is also a common problem for women with endometriosis.

Unfortunately, there is no cure. Depending on its location and severity, women might be treated with pain relievers, hormonal therapies (such as birth control pills), or surgery.

How does endometriosis affect a woman’s sex life?

Intercourse can be painful for women with endometriosis. This pain can fluctuate between mild or severe and may worsen at some points of the menstrual cycle. It might occur during all intercourse attempts or just during deep penetration. Much depends on the location of the affected areas. Some women continue to feel pain for several days after sex.

Not surprisingly, the pain of endometriosis makes many women anxious about having sex. The anticipation of pain can make it hard to relax. Some women start to avoid sex altogether, leaving their partner wondering what is wrong. Couples may start to distance themselves from each other and feel isolated and depressed. A woman might feel like a failure for not being able to please her partner. And her partner may worry that she no longer feels attraction.

What can women with endometriosis do to have sex comfortably?

If you have endometriosis, these tips could help:

·         Talk to your partner. Good communication is essential for couples dealing with endometriosis. Your partner may not understand how painful the experience is for you. If, during the middle of sexual activity, something hurts, by all means speak up. Suggest other intimate activities that are comfortable for you. Good communication is important outside the bedroom, too. Many couples have difficulty talking about sex, but being open about endometriosis can help you both work out ways to cope with it. You might consider seeing a sex therapist or couples counselor if you need more help.

·         Plan. You might find that you have more pain at certain points in your menstrual cycle because of hormonal fluctuations. If this is the case, try to plan sex for times when you have less pain. This strategy might not sound romantic, but you can make it so. If you know the pain tends to subside at a certain time of the month, try scheduling a date night or a quick getaway with your partner then.

·         Try to relax. We know this is easier said than done, especially if you’re anticipating pain. But keep in mind that tension in the body can make sex more difficult and add to any pain. When you’re in bed with your partner, focus on what feels good, like the intimacy you share, the kissing and caressing, or the excitement of your connection. Also, try to keep your general stress levels down and find ways to decompress. Don’t hesitate to ask for help from family and friends if you find your responsibilities too overwhelming.

·         Experiment. Some women with endometriosis experience more pain in certain positions, such as man-on-top. The depth of penetration, thrusting of a penis, or weight of your partner’s body can aggravate endometrial tissues. Instead, try other positions that give you more control, like side-by-side or “doggy style.” Remember, too, that while intercourse is often the main event, it doesn’t have to be. There are plenty of other ways to have sex and share intimacy. Oral sex, kissing, hugging, touching, are all ways to connect. You and your partner might enjoy this type of exploration, too.

Coping with endometriosis can take time and patience. But with some flexibility and creativity, you and your partner can still enjoy sex together.


American College of Obstetricians and Gynecologists


(October 2012)

“Interview With a Woman Who Had Endometriosis: Heather Roppolo-Guidone”

(Updated: March 29, 2012)

Davis, Julie

“Why Sex Hurts With Endometriosis”

(Last updated: May 21, 2010)

International Society for Sexual Medicine

“Endometriosis and Sexual Function”

“What can women with endometriosis do to improve their sexual relationships?”

“What kinds of sexual problems are caused by endometriosis?”


(Last updated: December 5, 2014)