If you are one of the 10% of women in the U.S. with endometriosis, you may also experience dyspareunia. Simply put, dyspareunia is pain during sex. Sometimes pain occurs before, during, or after intercourse in women with endometriosis and can impact mental health and relationships. But here’s the good news: It doesn’t have to be this way. Read on to learn how to navigate (and enjoy) sex with endometriosis.
Endometriosis develops when the tissue that grows inside your uterus begins to grow on your ovaries, bladder, or other nearby organs. This means when you get your period, the tissue sheds just as it would if it were inside your uterus. But without its typical means of leaving your body, the tissue stays inside and hardens into scars and cysts. These scars are what cause dyspareunia, or pain during sex, as they move, contract, and extend. And because no woman’s body is the same, depending on how much scarring you have or how severe your endometriosis is, pain during penetrative sex can range from mild to severe and throbbing to acute.
If you have endometriosis and experience pain during sex, you are not alone. Our minds, however, can make it feel like we are, especially when the sex life we may have envisioned is different due to endometriosis. Depression and anxiety are common symptoms among women who find sexual activity painful. You may feel guilt or shame that you do not find sex or intimate time with your partner an enjoyable experience. To avoid these feelings it may be tempting to hide your pain, not talk about it with your partner, or avoid sex altogether. This is why one of the best ways to navigate sex with endometriosis pain is honest communication—with yourself and your partner. Building a positive relationship with your body, through self-guided resources or with the help of a therapist, can help you regain a positive self-image and confidence during sexual activity.
Many women wonder how they can explain endometriosis pain to a partner. Vulnerability is not easy for many of us and talking about our sex lives can feel uncomfortable. However, to reduce endometriosis pain during sex, you need to communicate when you’re experiencing pain and why. Together, share what you are feeling and take time to figure out what is and is not pleasurable during sex.
Endometriosis does not mean we cannot have a pleasurable sex life. It just means we’re going to need to think outside the box, which can make sex as (or even more) enjoyable than before. Follow these best practices to reduce endometriosis pain during sex.
- Time it Right – Many women find penetrative sex most painful right before or during their periods. According to one study, having sex while menstruating may also increase the severity of endometriosis. To reduce endometriosis pain during sex, check where you are in your cycle before proceeding.
- Use a Lubricant or Vaginal Moisturizer – Vaginal dryness can also be a symptom of endometriosis and contribute to pain during sex. Make sure you have lube readily available to help alleviate pain. Using a vaginal moisturizer regularly can also help relieve symptoms of vaginal dryness before and after intercourse.
- Find Your Position – Depending on the location of your scar tissue, different sexual positions can cause more pain. For instance, the missionary position can cause the most pain in women with endometriosis. Talk to your partner and experiment with different positions that bring the most pleasure and the least amount of tension and irritation.
- Practice Mindfulness and Deep Breathing – Our mental health has a direct impact on our physical health and wellbeing. Take a moment to walk through a mindfulness practice or deep breathing exercise beforehand to reduce muscle tension and increase relaxation. Sex with a partner should be a pleasurable experience, not one that contributes to fear or anxiety.
- Get Creative – Penetrative sex may be the most common, but by no means is it the only way to engage in sexual activity with your partner. Try experimenting with oral or other types of physical stimulation, massage, mutual masturbation, role-playing, and longer foreplay. Often, taking the time to explore each others preferences deepens intimacy and strengthens relationships.
- Make a Counseling Appointment – If you and your partner are struggling to find a way forward, you may want to talk with a therapist. A relationship specialist can provide insight into ways you can best communicate with each other as well as new methods to make sexual activity more enjoyable.
Remember, it’s important to normalize talking about our sex life with our doctors, care providers, and partners not only for our pleasure but our overall wellbeing.