Endometriosis and Intimacy as A Couple

Jessica has endometriosis, and Chris is her partner. Together, they find ways to manage the condition and support each other through its challenges. Here they answer questions about endometriosis & intimacy, and how they navigate intimacy together.

What are the intimacy challenges you face as a couple living with endometriosis?

Jessica: I think there are four key things for me... First, energy – we don’t go to bed as early as I’d like, and it also takes me a while to fall asleep, so when we go to bed my main priority is getting to sleep as soon as possible so I don’t suffer from fatigue the next day. As we’re already getting to bed later than is good for my body, sex just isn’t an option for me at that time.

Another issue is low libido. I have hormonal imbalances, which I’m constantly trying to balance, and one of the side effects of these imbalances is a low libido. On top of that, when I’m stressed, anxious, or depressed, my libido disappears. Because endometriosis can cause all three of these, it does have an impact on my sex drive.

A third issue is my bladder. I have interstitial cystitis, which is very common for those of us with endometriosis. Most of the time, I feel like my bladder is full, and sometimes it’s painful too. Whenever I have sex, the slightest movement or stimulation triggers that feeling and then I end up needing to stop several times to go to the bathroom.

Lastly, and perhaps most obviously, is pain during sex. This varies, sometimes, it’s better, other times, it’s worse, but it’s always there in the background. I can never truly forget about it.

Chris: I think the challenges I face are a mirror of yours. By that I mean that as I don’t really have any physical or medical challenges of my own that get in the way of intimacy or intercourse, I am always reacting to the challenges you face. For example, I often feel directly responsible for the pain you get during sex, and putting you in pain is the last thing I’d want to do so that’s difficult to see.

Another challenge for me, which sounds silly when said (or typed) out loud but is real, is remembering not to feel rejected when you don't want sex. Even though we talk about it constantly and I write about it, it can be difficult to always remember that endo is such a big part of our lives. I forget that you are often fatigued or in pain, and instead take rejection personally and question what I am doing wrong. I guess the challenge is to always be mindful of your endo and the symptoms you are dealing with, even when I can't see them.

What has been effective for reducing pain during sex & making other intimacy issues more manageable?

Jessica: We recently tried the Ohnut and that made an instant difference to me.  I’m excited to see how that changes things for us moving forward, especially as it’s such an immediate improvement – you don’t have to wait for results, so that’s really encouraging.

Cycle tracking has been helpful too. I know that I’m more likely to want sex in my ovulation phase now, and so I try to be aware of that and make the most of when I do feel that way – as chances are I might not feel that way again for another month!

Eating an anti-inflammatory diet and to balance my hormones has made a huge difference as well. If I start eating inflammatory foods I notice I feel swollen and sore in my pelvic area and even in my vagina walls. Equally, if I stop eating for hormonal balance, I notice my energy fluctuating, my mood diving, and my sex drive dropping.

I’m also giving yoni mapping and yoni massage a go. It’s an ongoing process for me as I find it quite hard to connect with that part of my body and yoni massage can be not only painful physically, but emotionally too. However, I have noticed a change since trying these methods, and I’m interested to see how that unfolds.

Finally, a good natural and non-irritating lube has been essential. It just makes everything feel more comfortable.

Chris: I was definitely impressed by the immediacy of the Ohnut, even if it was a little uncomfortable from my end. A great thing about it is that because the depth of penetration is taken care of by a third party (the Ohnut), we can relax and not have to constantly think about it.

Also, finding positions that work for you has been important. I remember early on in our relationship we were always moving around, getting uncomfortable, moving again, more pain, change position, etc... It’s good to have positions that are comfortable so few so that, similar to the Ohnut, we can relax knowing that some of the pain is being taken care of.