Endometriosis has a huge impact on not only your sex life but your sexuality as a whole. Pain during or after sex is one of the most common symptoms of endometriosis, and it can have a lasting effect on your mental health.
Not everyone experiences pain during sex, but those who do feel it in a variety of ways. It can range from dull and mild to sharp and excruciating. And for anyone, the experience can be so discouraging.
Endometriosis is common, but not everyone knows how to identify it.
Endometriosis is a condition that occurs when tissue that’s very similar to the uterine lining grows outside of the uterus. This is a problem because the tissue behaves just like the uterine lining does: it breaks down and bleeds during menstruation. Only, this tissue, with nowhere to go, becomes trapped and inflamed.
For a lot of people, it hurts. For others, that’s an understatement.
If you think you could have endometriosis, listen to Signs and Symptoms on Emjoy to learn more about the condition and what to look for.
The most common symptoms are:
- Dysmenorrhea. This is the medical term for pain during menstruation. If you get cramps like clockwork, you have dysmenorrhea.
Primary dysmenorrhea is your run-of-the-mill discomfort that comes before and during menstruation. It is the colic of the lower abdomen, caused by hormones that cause the uterus to contract and shed its uterine lining.
Secondary dysmenorrhea, however, is pain that’s caused by an underlying condition like endometriosis.
- Chronic pelvic pain. Pelvic pain is related to several conditions, and endometriosis is one of them. Pain can radiate throughout the pelvis and even extend to the back or thighs. It can happen during periods or between periods.
- Dyspareunia. This means pain from sex. It can be experienced during or after arousal, penetration, or orgasm.
Pain from dyspareunia can affect libido and lubrication, both of which result in more pain. Sometimes this results in a psycho-physical condition called vaginismus that makes penetration difficult and sometimes impossible to do.
People with endo all experience pain differently.
There are several factors that play a role in how you might experience pain during sex. The first is the timing of your menstrual cycle. Some women experience more pain when they’re menstruating, and for some, ovulation is a more painful time.
During certain parts of your cycle, the endometrial “implants” can become inflamed, and penetration can stretch, push, or pull the tissue. This causes pain.
The location of the implants can also determine how you experience pain, or whether you experience pain at all. If the endometrial tissue has grown near the vagina or the lower part of the uterus, then deep penetration can irritate the nearby tissue.
Many women find that deeper penetration is more painful while shallow penetration is the ticket to pleasure town. It’s also common to experience more pain with rough pounding and thrusting, so it’s important to let your partner know that slow and steady wins your race if this is the case for you.
Painful sex can affect your overall well-being.
Sex lifts our mood, releasing endorphins and oxytocin. It makes us feel good! It also helps us to bond with our partner/s and strengthens our romantic relationships. It helps us deal with stress and brings joy to our lives.
So it makes sense that if endometriosis is causing sex to be painful, you can become very frustrated with your inability to enjoy intimacy. It takes a toll on your mental health, your ability to connect to your partner/s, and can cause you to avoid sex altogether. Your libido may drop, your partner may wonder if you’ve lost your enthusiasm for them, and your relationships can really suffer.
People with endometriosis are no stranger to these very real hardships, nor are they strangers to anxiety, depression, and insecurity.
The biggest obstacle to this issue of sexual health is communication.
Why is it so hard to communicate about sex?
The answer is simple: we were never taught how to! Sex education is so important, but it’s culturally stigmatized. To make matters worse, we tend to teach young girls to expect painful sex from the get-go.
It’s no wonder it’s difficult to tell our doctors, our partners, or our trusted friends and family that we’re experiencing pain when we try to engage one of the biggest parts of ourselves.
The way to combat this is to learn how to confidently talk about sex and to share what you’ve learned with your loved ones. Once you can talk about what you like as well as what your difficulties are, then you can start finding your way to a solution.
And when it comes to painful sex associated with endometriosis, there are solutions.
Try new things, track your cycle, explore non-penetrative sex, and lube up!
A lot of women find that missionary is a very painful position. If this is true for you, try putting a pillow under your hips to raise your pelvis. Try spooning, or being on top where you get to control the pace and depth of penetration.
Enlist your partner to be your ally in trying all kinds of different positions and noting the level of pain, comfort, or pleasure. You’re going to have to trial-and-error a little because your endometriosis isn’t like everyone else's. But the good news is that it can make for a really good time.
Slow the pace wayyyyyyyyy down and experiment with shallow penetration if depth is an issue for you.
Next, track your cycle and take notes. There are tons of apps you can use to track the four phases of your cycle: menstruation, the follicular phase, ovulation, and the luteal phase. Get to know these four phases and take notes about your pain, comfort, and bliss levels. You may start to uncover a pattern that you can use to unlock great sex.
Try exploring non-penetrative sex. If you don’t already know, this is so much fun! Many people of all genders find non-penetrative sex more enjoyable anyway, and there are endless ways to experience pleasure outside of the vagina.
Want to know more about this? Head over to Emjoy and listen to Discover Your Body I, II, and III for some guided sessions on how to find other pleasure points on your body.
Last, spread the gospel of lube. Use lots of it, especially if lubrication doesn’t come naturally to you. It’s very common to need extra lubrication, and if you’ve had a lot of painful sex, bracing for another bad experience will cause your vagina not to lubricate. So do yourself a favor and lube it up.
Finally, communicate as much as you lubricate. Let your partner know what’s going on with you.
Endometriosis causes sex to be painful sometimes, so I need a slow pace, lots of lube, and a little understanding.
It’s as easy as that. Telling your partner beforehand makes it easier for you to speak up if you experience pain while you’re together. And when you do, you’ll both understand why it happened and be able to adjust together.
Endometriosis shows up differently for everyone, so learning how to enjoy life and sex looks different for everyone too. Remember that you’re not alone and don’t be afraid to share what you know about it.
Everyone wins when everyone is aware.