7 Ways to Boost Your Sex Life When You Have Endometriosis

There’s no doubt that endometriosis can affect a woman’s quality of life — and that includes her libido. That’s because the condition can cause a slew of symptoms including painful sex, painful cramps during menstrual periods, and even seemingly unrelated issues such as bowel pain and digestive problems. “Endometriosis isn’t just a disease of period pain,” explains Karli Goldstein, MD, a gynecologic surgeon at Seckin Endometriosis Center in New York City and a consulting surgeon with the Endometriosis Foundation of America, who also has endometriosis herself. “In my own case, I had bowel pain, so I thought for years that I had a digestive issue such as irritable bowel syndrome or celiac disease.”

Endometriosis occurs when endometrial-like tissue grows in areas outside of the uterus, such as the ovaries and fallopian tubes. These growths can cause pain and swelling, particularly during ovulation and menstruation. The impact on a woman’s sex life can be profound. “When the area behind the cervix is inflamed, deep penetration during sex can be painful,” Dr. Goldstein says. “If sex is associated with pain, a woman may increasingly want to avoid it.”

Living with endometriosis can also cause a woman to feel more stressed and impact her personal relationships, which can also have a significant negative effect on her sex life, as detailed in research from 2023.

Despite the challenges that endometriosis can pose, it is still possible to enjoy sex and feel confident in your body. Consider these strategies to boost your sex life:

1. Seek treatment for endometriosis. The first step to feeling better is to seek effective treatment. If you suspect you may have endometriosis, talk to a gynecologist. “If you’re experiencing pain just during your period, or during the time between your period and ovulation, that’s a clue it may be endometriosis as opposed to a different type of pain,” Goldstein says. If you already know you have it, work with your gynecologist to manage the condition over time. Depending on the severity of your symptoms and if you’re trying to get pregnant, treatment may include over-the-counter painkillers, hormone therapy, or surgery to remove endometrial scar tissue.

2. Talk to your partner. “It’s important for women with endometriosis to have an open discussion with their partner,” says Goldstein. Even though endometriosis is common — at least 1 in 10 women have it — your partner may not understand just how these symptoms are affecting you, and that you aren’t avoiding sex due to him or her but because of the physical pain. Goldstein also suggests bringing your partner to an appointment with your gynecologist so they can learn more about the condition.

3. Make time for foreplay. Instead of jumping into sex — which you may not be in the mood for — ease into intimacy with some satisfying foreplay. Activities such as cuddling, kissing, and erotic massage can help you feel connected to your partner and feel more aroused before engaging in sexual penetration.

4. Try using lubrication and pain relievers. Although pain — or the anticipation of it — can make it hard to get aroused, using lubrication can make sex easier and more pleasurable for both you and your partner. You can also try taking an over-the-counter pain reliever such as ibuprofen or acetaminophen an hour before sex, and take another dose after intercourse if you still have pain.

5. Experiment with different positions. “Explain to your partner what hurts and what feels better when it comes to different sexual positions,” Goldstein says. With some trial and error, you’ll find positions that are comfortable and satisfying for both of you. For example, having side sex might feel better. Note that you may want to avoid deep penetration if this is painful for you.

6. Keep track of your symptoms. If you experience painful periods, you may want to skip sex during this time, or any time during the month that you consistently have pain. In other words, plan a romantic rendezvous for a weekend when you know you’re far more likely to be pain-free.

Write down when your period is, what time of the month you experience pain, and what your particular symptoms are. Keeping a log can also help your gynecologist suggest the best way to treat your particular symptoms. “A doctor might ask you which sexual positions feel the worst — it may be an uncomfortable question to answer, but that’s often the part of the body where the disease scar tissue corresponds to inside the pelvis. This becomes an important landmark to look for and treat in excision surgery,” Goldstein explains.

7. Consider pelvic floor therapy or sex counseling. Oftentimes with endometriosis, the pelvis and pelvic floor muscles are out of alignment, which contributes to pain during sex. “Your gynecologist can give you a referral to a physical therapist who specializes in pelvic health,” Goldstein says. “This therapist can teach you pelvic floor exercises that can ease pain and help sex feel better.” Your gynecologist can also refer you or you and your partner to a qualified sex therapist, who can teach you both physical coping and communication skills to help make sex more satisfying.

Endometriosis doesn’t have to spell the end of your sex life — it just requires some persistence and creativity to feel comfortable and confident. Talk to your gynecologist so you can get back to getting busy — and enjoying it!