Coping with painful  sex with endometriosis 

Many women with endometriosis find that sexual intercourse is painful, both during and after intercourse.  This situation simply compounds the guilt and adds more pressure to a relationship.  It is estimated that about 60% of sufferers experience painful sex.

Painful sex with endometriosis

Pain during sex is a common symptom of endometriosis. Penetration and other movements related to intercourse can pull and stretch endometrial tissue, particularly if it has grown behind the vagina or lower uterus.

Many women find that certain positions are better than others. For example, when a woman with endometriosis is on top, they can control the depth and speed of penetration, allowing them to determine a comfortable pace.

The pain caused by endometriosis during sex  comes from the inflammation and fibrosis fusing the front wall of the rectum to the back wall of the vagina. Using supplements that help with inflammation and fibrin can help.

Surgery for painful sex

Laparoscopic excision of endometriosis is the gold standard for conservative surgical treatment. However, in cases of painful sex, it is important to specify that there must be a focus on endometriosis infiltrating the anterior and posterior cul-de-sac.

By focusing on these areas, studies have found that upon removal of the endometriosis through excision surgery, patients experience improvements in dyspareunia symptoms as well as quality of their sex life. ( 1 )

Here are some tips that may help:

  • Make sure you are really fully aroused before penetration as it is less likely to cause pain, because you are properly lubricated. 
  • Full arousal also causes the vagina to elongate and the cervix to move further up and therefore you are less likely to hurt sensitive areas, such as the Pouch of Douglas or the pelvic organs. 
  • If you have problems with a dry vagina, try a natural lubricant such as vitamin E oil or Almond oil.  
  • There are products on the market for this purpose, but they do not feel very natural, whereas oils tend to feel nicer.  It is quite safe to use these oils; the rule of thumb  - never put anything on your body that you would not put inside your body.
  • Having penetrative intercourse at certain times of the month. It may be less painful in the week after ovulation, or in the 2 weeks following a period. 
  • Try different positions for intercourse as this will alter the angle of penetration and in turn will alter the sensation of pressure inside your body to other areas 
  • Remember, that you do not always have to aim for penetration to enjoy a loving sexual relationship 
  • Make more special time for love making - have a warm bath together, light some candles, and try to get as relaxed as possible

It is important to discuss this issue with your partner. They may not be aware of how much pain you are suffering, especially if you are good at concealing your endometriosis pain on a daily basis. Getting treatment as soon as possible for this disease helps to reduce the development of the disease and reduce the symptoms you suffer. 

Being open and communicating with your partner is vital to help reduce the emotional impact the problem of having pain with intimacy can have.  The goal is to foster genuine and open communication, to ensure that sex is pleasurable and free of pain for each partner.



( 1 ) Endofoundation

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