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Why Don't We Talk about Painful Sex?

Last updated: September 2019

When talking about symptoms of endometriosis, we mainly talk about heavy, painful periods, cramping, and pelvic pain. But we rarely talk about painful sex. Even the doctors I saw for my endometriosis symptoms never alerted me that sex could become painful. When I finally did mention it, right before my hysterectomy, my doctor dismissively admitted that endometriosis could be responsible for my pain during sex, as if this was not a big deal.

Painful sex as a symptom

Female sexuality, and especially female pleasure, is not a high priority for doctors... which is why painful sex as a result of endometriosis is often glossed over. Doctors are not only reluctant to discuss the problem; they often don’t see a need to treat this particular symptom. But for a lot of us, sex is an important part of our lives. And just because we are struggling with a chronic illness, does not mean that we can’t – or shouldn’t – have sex.


Luckily, sex is a very versatile activity and there are ways to minimize pain during sex. My doctor advised taking one or two painkillers a half hour before having sex, and although I did do this every now and then, it did take the spontaneity out of sex. And I didn’t particularly like the idea of having to take painkillers just to get through sex.

For me, and for a lot of women with endometriosis, not all sex was painful. I found deep penetration – and later all penetration – the most painful. My husband, worried about hurting me, made sure not to thrust too deep so that it was most pleasurable for me. Certain positions would work better for me as well – missionary became my favorite position (and that doesn’t have to be boring).


Make sure you have a lot of foreplay before penetration. It can help massively if your partner can give you one (or more!) orgasms before penetration; You will be more relaxed and your body will be less susceptible to pain. Clitoral stimulation is a great way to start and it’s often one of the most pleasurable ways to get an orgasm. You can even introduce toys in your sex life to make foreplay more interesting.

I also find that when I am warm, I can relax more and sex will be better. Make sure your room is nice and warm and if you have to wear socks, or have sex under the duvet – do so! You want to make sure you are as relaxed as possible, as stress can contribute to the inflammation of the endometriosis and heighten the pain.

Another way to relax is through breathing. Breathing has a great impact on how we feel, and on how relaxed we are, so trying some simple, deep breathing exercises can make you feel much more relaxed.

Exploration and communication

Sometimes, it takes a bit of time to work out what is the best way for you to enjoy sex. That is true for everyone, but more so when sex is often painful. I would suggest masturbating – find out in a relaxed setting what you like and what gives you the most pleasure. If you don’t have to worry about your partner having pleasure, or whether your partner thinks you take too long to climax, you can relax more and really explore what you like. When you have found the perfect way in which you get the best orgasms, you can teach your partner to please you like that.

There is no right way to have sex. We all find out what we like through trial and error, and with lots of communication with our partners. Make sure your partner knows what is painful and what isn’t and they should adjust to your needs. Don’t be afraid to be creative, and above all: have fun!

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