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The Boss Babes’ Guide to Sex with Endometriosis

Medically reviewed by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT on January 30, 2018Written by Lisa Howard on January 30, 2018
guide to sex

I’m Lisa, a 38-year-old woman who was diagnosed with endometriosis in 2014. This diagnosis flipped my world upside down. I finally had answers to my severe period cramps and frequently painful sex. Sex would often lead to cramping that would last anywhere from a few minutes, to hours or even days.

After my diagnostic surgery in June 2014, I went on six months of hormone therapy that caused my once super healthy libido to basically wither away and die. When my husband and I were intimate, my body wouldn’t create any natural lube. And even with added lubricant, sex was still very painful.

After my regimen of that therapy ended, I was placed on 18 months of a continuous birth control pill to regulate my hormones in the hopes that it would also control my endometriosis. My nonexistent libido remained, sadly, nonexistent. My body was at least able to begin to produce its own lube again. Sex was still painful, but that may have been in part because the endometriosis had returned. So I underwent a second excision surgery in September 2016.

From then on, I began a journey to find a way to enjoy sex once more. Don’t get me wrong — sometimes sex is still painful — but it has dramatically improved.

Here are some tips I’ve tried in my own life that may help you too.

Talk to your partner

Let your partner know that you’re experiencing pain during intercourse. Many women I’ve talked to even experience pain just at the act of becoming aroused.

Communication truly is crucial to a great relationship. Let your partner know that sex is painful or that you’re anxious that it may be painful.

If you’re already in the act of the horizontal dance and it becomes painful, don’t be afraid to tell them to stop. Perhaps discuss taking a break from the physical act of sex and find other ways to express that intimacy: making out, heavy petting, oral sex, or cuddling.

Talk to your doctor

Please let your physician know that you’re having pain before, during, or after sex. Pain isn’t normal. There are many possible explanations as to why sex is painful for you. It may not even be endometriosis, but another condition. A diagnosis can be the starting point to less painful sex.

Your doctor may suggest Kegel exercises, different sexual positions, stretches, pelvic floor therapy, or even using dilators to ease into stretching the vaginal canal. Sex may be an embarrassing conversation to have with someone who isn’t your partner. But doctors have heard it all, and they’re there to help.

Don’t be afraid to experiment

We’ve all heard of the Kama Sutra, with all that bending around over and backward to achieve nirvana. I’m not saying you need to bend into a human pretzel to find a position that hurts less, but don’t be afraid to experiment with positions.

If deep penetration is what hurts, you may want to avoid “doggy style” and try something like the “spooning” sexual position. As well, numerous resources online discuss sexual positions that limit deep penetration and may ease painful symptoms.

Other women have found relief using pillows during sex that they wedge beneath the small of their back or chest. Find the position(s) that work for you. And have fun doing it!

Wetter is better

Although I despise using lube, I know that it truly makes a difference in my pain levels. It may take some trial and error, but find a lube that’s right for you.

There’s the good old-fashioned normal lube, but there are also lubes that warm, tingle, and even numb. Be careful, though, as some lubes aren’t intended to use with condoms. Make sure you read the fine print.

Do an allergy test of any lubricant. That is one area you don’t want flaring up in an allergic rash. If the lubricant doesn’t cause a reaction when a little is rubbed on your arm within a day, then it should be safe. Those with very sensitive skin in that area should choose natural lubricants, hypoallergenic with no added perfumes.

If you’re using condoms for safe sex or pregnancy prevention, avoid petroleum products, as these will break down the condom.

And if you live in a state where cannabis products are legal, many women are singing the praises of lube containing cannabidiol (CBD) oils. But, please, always check with your doctor first before trying these!

Love yourself

If you’re reading this article, you may have been there: that moment when you feel like you’re incapable of expressing yourself sexually without feeling pain. Or you’re withdrawing completely from being sexually intimate because of the pain.

And that begins to weigh you down. You may think less of yourself, think you’re unworthy, or think you’re a horrible person. Please try to turn that frown upside down. You are still worth it — all of it. You are beautiful, inside and out. Sex isn’t everything.

Hopefully, your pain will fade. Even if it doesn’t, you’re still fully capable of expressing your love — to others and to yourself.


Lisa Howard is a 30-something happy-go-lucky California girl who lives with her husband and cat in beautiful San Diego. She passionately runs the blog and endometriosis support group. When she’s not raising awareness about endometriosis, she’s working at a law firm, cuddling on the couch, camping, hiding behind her 35mm camera, getting lost on desert backroads, or staffing a fire lookout tower.

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