You might already consider your physical, mental and spiritual health to be important to your overall well-being. But how often do you think about the importance of your sexual health? Sexual quality of life is growing in importance for everyone since people are living longer.
If you’re living with endometriosis, your sexual health might need some TLC. Painful periods, painful intercourse and painful bathroom trips can all be part of daily life. And this amount of pain can have a negative impact on your mood, self-esteem and sex life.
You’re not alone if this is something you’ve been embarrassed to tackle — but you don’t have to deal with the condition in silence. Explore these ideas to start making your sexual health a higher priority.
Be conscious of endometriosis symptoms
Endometriosis can be tricky to diagnose because the symptoms can vary quite a bit and they can overlap with symptoms of other diseases. Studies have found that the average time to get a diagnosis of endometriosis can be 4.4 to 6.7 years. And the only way to definitively confirm endometriosis is through surgery to take a tissue sample.
If you haven’t been diagnosed, these are some common symptoms that can indicate endometriosis:
- Cramping and pain before and during your period. Pelvic pain, lower back pain and abdominal pain might be part of the mix.
- Pain during or after sex. This is also known as dyspareunia.
- Pain when you urinate or have a bowel movement.
- Difficulty getting pregnant despite regularly trying.
There are other symptoms that might seem general but can be caused by endometriosis. Fatigue, diarrhea, constipation, bloating, nausea, depression and anxiety can all be indicators. With this variety of symptoms, it’s not surprising that many people with endometriosis think of it as a whole-body disease.
Ways to avoid endometriosis pain during or after sex
Dyspareunia can put a real cramp on your sex life, and unfortunately, it’s a common symptom for people with endometriosis. Some people experience pain for hours or days after having sex. Here’s why: Endometriosis can inflame and cause hard nodules to form around the pelvic organs. The impact of intercourse can make the inflammation or nodules hurt.
It might seem like your options are to avoid sex or endure the pain, but there are things you can try that may help with sexual pain.
- If it hurts during initial penetration, starting with foreplay can help stimulate your natural lubrication. You can also use a personal lubricant to make sex more comfortable.
- If it hurts during deep penetration, try different positions, such as being on top. In this position, you might be able to regulate penetration to a depth that feels good to you.
- Talk with your partner about what feels good. If you need your partner to go slow, say so. You might also explore other ways to be intimate, such as sex without penetration.
- Talk to your healthcare team about pain during sex. It’s recommended that healthcare professionals address sexual health when seeing patients with endometriosis so that they can help you find ways to make sex more enjoyable.
Don’t let endometriosis ruin your sex drive
Up to 70% of women with endometriosis experience some type of sexual dysfunction like having a reduced desire to have sex, feeling less sexually aroused, having a harder time reaching orgasm, or feeling physically tense or anxious before sex.
It’s understandable that you might not be feeling in the mood if you expect it’s going to hurt. But you can take steps to support your quality of life and well-being. For example, after talking with your healthcare team, you might explore medication or other treatments that can address the impact endometriosis symptoms can have on your sex life.
Endometriosis medications can sometimes provide pain relief
Some people with endometriosis use medication, which can help to treat symptoms but doesn’t cure endometriosis. One study found that women taking pain medication reported higher quality of life regarding sex.
Medication options for endometriosis pain can include:
- Nonprescription pain relievers like ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).
- Hormonal therapies such as contraceptives, like birth control pills, intrauterine devices with levonorgestrel (Mirena, Skyla, others) or a contraceptive injection with medroxyprogesterone (Depo-Provera). Birth control medications are not recommended if you are trying to get pregnant.
When you stop taking these types of medication, your symptoms may return.
Endometriosis treatments may help increase intimacy
In addition to medication, surgery has the potential to help reduce pain, which might improve intimacy with your partner. Surgery to remove, also called excise, endometriosis tissue is done laparoscopically with a small incision near the navel and several other small incisions in the abdomen. With surgery to remove endometriosis, your uterus and ovaries are preserved, making pregnancy a possibility. It’s also possible that endometriosis pain could return. That’s why you might also be prescribed hormone medication to help reduce the likelihood of future growths. The other less common option to treat pelvic pain is to surgically remove the uterus and ovaries. This is not a direct treatment of endometriosis but can help with uterine or ovarian sources of pelvic pain.
Psychotherapy and sexual counseling are other treatment options for endometriosis that might help you focus on increasing intimacy with your partner. For example, living with the symptoms of endometriosis can be stressful, especially when it comes to intimate relationships. Psychological support can help you better cope with related stressors. Additionally, sexual therapy might help you have more enjoyable sex.
If you and your partner have been trying to have a baby and aren’t conceiving, infertility might be impacting your intimacy too. That’s why fertility treatment can also be part of treating endometriosis.
Finally, your healthcare team may refer you to a pelvic physical therapist.
Whether you’re hoping to improve intimacy, rev up your sex drive or address pain that’s making sex unpleasant, the key things to remember are:
- You are not alone.
- There is help.
- Help starts with talking about how you’re feeling — with your partner and with your healthcare team.
Relevant reading
Your Sexual Health
This book is intended for people with a vagina, of any identity or orientation. Gain a better sense of what your body’s telling you — and how to know when not to worry about what you feel or see. A crash course in sexual, reproductive and pregnancy health.
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