There’s no denying that endometriosis can have an impact on a woman’s quality of life, including her libido. That’s because the condition can lead to a wide range of symptoms, such as painful sex, painful cramps during periods, and even seemingly unrelated problems like bowel pain and digestive problems.
“Endometriosis is not just a disease of period pain,” says Karli Goldstein, MD, a gynecologic surgeon at the Seckin Endometriosis Center in New York City and a consulting surgeon for the Endometriosis Foundation of America. She also has endometriosis. “In my case, I had bowel pain and assumed for years that I had a digestive problem like irritable bowel syndrome or celiac disease.”
The Effects of Endometriosis on Libido
Endometriosis occurs when endometrial-like tissue develops in locations other than the uterus, such as the ovaries and fallopian tubes. These tumors can cause discomfort and swelling, especially during ovulation and menstruation.
The consequences for a woman’s sexual life can be severe. “Deep penetration during sex can be painful when the area behind the cervix is inflamed,” Dr. Goldstein says. “If sex is associated with pain, a woman may want to avoid it more.”
Endometriosis can also cause a woman to feel more stressed and have an impact on her personal relationships, which can have a significant negative impact on her sex life, according to research from 2023.
Top Sex-Boosting Strategies to Try
Despite the difficulties that endometriosis can present, it is still possible to enjoy sex and feel comfortable in your own skin. Consider the following strategies to improve your sex life:
- Seek endometriosis treatment.
Seeking effective treatment is the first step toward feeling better. Consult a gynecologist if you suspect you have endometriosis.
“If you’re experiencing pain only during your period or between your period and ovulation, that’s a sign it could be endometriosis rather than another type of pain,” Goldstein says.
If you are already aware that you have it, work with your gynecologist to manage it over time. Treatment may include over-the-counter pain relievers, hormone therapy, or surgery to remove endometrial scar tissue, depending on the severity of your symptoms and whether you’re trying to get pregnant.
My vagina was so ‘closed up’ after I was diagnosed that I had to use a dilator, which is a special device that looks like a vibrator and is used to’stretch’ the tissue to make sex less painful. I’ve also discovered that certain lubricants cause pain and symptoms, so I now only use water-based lubricants.
- Speak with your partner.
“It’s critical for women with endometriosis to have an open conversation with their partner,” Goldstein says. Even though endometriosis is common (at least one in every ten women has it), your partner may be unaware of how these symptoms are affecting you and that you are avoiding sex not because of him or her but because of the physical pain. Goldstein also suggests bringing your partner to a gynecologist appointment so they can learn more about the condition.
- Allow time for foreplay.
Instead of immediately jumping into sex, which you might not be in the mood for, ease into intimacy with some satisfying foreplay. Cuddling, kissing, and erotic massage can help you feel more connected to your partner and aroused before engaging in sexual penetration.
For deep penetrating pain during sex, I use the ‘Ohnut’ product, which shortens your partner’s length and can help if you have endometriosis. Women must understand that painful intercourse and pelvic pain are not unavoidable. There is hope, and there are solutions.
- Use lubricant and pain relievers.
Although pain or the anticipation of it can make getting aroused difficult, using lubricant can make sex easier and more pleasurable for both you and your partner. You can also try taking an over-the-counter pain reliever like ibuprofen or acetaminophen an hour before sex and another dose after intercourse if the pain persists.
- Experiment with various positions.
“Explain to your partner what hurts and what feels better in various sexual positions,” Goldstein advises. You’ll find positions that are comfortable and satisfying for both of you with some trial and error.
For example, having side sex may make you feel better. If deep penetration causes pain for you, you should avoid it.
Certain sex positions are simply off limits to me! Determine which positions are pain-free for you. Extra tip: Taking an anti-inflammatory before sex can help with the pain that follows.
- Keep a journal of your symptoms.
If you have painful periods, you should avoid sex during this time, as well as any other time of the month when you have pain. In other words, schedule a romantic rendezvous for a weekend when you know you’ll be pain-free.
Make a note of when your period is, when you experience pain, and what your specific symptoms are. Keeping a log can also help your gynecologist recommend the best treatment for your specific symptoms.
Take into account pelvic floor therapy or sex counseling. Endometriosis frequently causes the pelvis and pelvic floor muscles to be out of alignment, which contributes to pain during sex. “Your gynecologist can refer you to a physical therapist who specializes in pelvic health,” says Goldstein.
“This therapist can teach you pelvic floor exercises that can relieve pain and make sex more enjoyable.” Your gynecologist can also refer you or you and your partner to a qualified sex therapist, who can teach you physical coping skills as well as communication skills to help make sex more enjoyable.
