GUEST WRITER: Sex and Endometriosis – a Painful Problem.


This article was written by my lovely friend Libby.  

SEX! It’s this magical, intimate experience where both parties involved experience pleasure! Right? WRONG! Sex can be the complete opposite for some people; bloody, painful, awkward, uncomfortable, scary and not very sexy at all. 

Painful sex can be caused by a lot of different conditions;

  • Endometriosis
  • PCOS (Polycystic Ovaries Syndrome)
  • Sexually transmitted disease
  • Vaginismus (a condition that causes involuntary contractions of the muscles around the opening of the vagina)
  • Pelvic inflammatory disease
  • Cancer

But the important thing to remember is that sex should not be painful. If you experience pain during or after sex then it’s important you speak to a doctor.

Earlier in the week, I posted a Q&A session on my Instagram account (@myendodiary_) for my followers to ask any questions they had about what sex is like for those of us with chronic health conditions. I was prepared to answer anything! Here are the top questions I was asked and my answers;

Have you always experienced painful sex?

No I haven’t, sex was ‘normal’ for a while, then I started to experience cystitis after I had sex for about 10 days each time and it escalated from there.

Can I have sex at all?

Yes I can – I have sex about twice a month but no it isn’t always ‘successful’ as such. Sometimes the pain is too bad to allow penetration.

When did you first experience pain with sex?

At first it was just pain after sex including the cystitis (irritation of the urethra and bladder) that I’ve mentioned previously. But in October 2017 we we’re on holiday in Bali and sex became more difficult and uncomfortable, although not unbearable. It’s gradually gotten worse – last weekend I ending up sitting on the bathroom floor (after storming out of the bedroom ) crying uncontrollably and not able to get myself up because it had been that painful.

Did surgery help?

I underwent my first laparoscopy in December 2018, but unfortunately it was unsuccessful and I am now pushing for another surgery with an Endometriosis specialist. I have experienced a lot more bleeding since my surgery, but because it was unsuccessful I don’t feel I can comment as to whether it’s had any positive impact on my sex life. However, after doing some research I’ve read a lot of success stories of Endometriosis patients where surgery genuinely helped any problems they were experiencing with sex. Its important to remember that everyone is different though, and some patients may find surgery makes it worse.

Does your boyfriend know you’re talking about this?

No he doesn’t, but he will see this before its published, so by the time you read this he’ll be fully aware.

Does your boyfriend get mad when you can’t have sex?

This question bothered me a little. Not because I didn’t want to answer it (as I said I will answer anything), but because it made me think – if someone is asking this does that mean that they’ve experienced this? – and that’s upsetting. No one should be made to feel bad or guilty for not wanting to have sex, especially when it might be due to factors out of our control. But for me, my boyfriend is never mad about not having sex. It does effect our relationship in the fact he worries about hurting me (even when I’m okay) but he is 100% the most supportive person I have ever met and not having sex is not a big deal to him at all. 

Does your boyfriend blame you?

No he doesn’t, not at all. He knows it’s obviously unfortunate that it’s happened but we’re in this together and he takes as much of the weight as I do. 

Should I see a doctor if sex hurts?

Absolutely, yes! It could be as simple as you need to use some lubrication but it’s so important that you get everything checked out and given the okay. 

Do you avoid sex because of the pain?

After what happened to me a couple of weeks ago, I have been very concerned about the next time we have sex. My boyfriend and I have spoken about it a lot and it’s one of the reasons I decided to post about this too. It currently is an every day battle in my head but Jake (my boyfriend) is extremely supportive and does everything he can to make me comfortable. 

I need someone to talk about painful sex – can I message you? 

OF COURSE YOU CAN (and that goes to anyone!). My inbox is always open, if you need to chat about anything! Even if I can’t help I can still listen. 

What are the best position for painful sex?

It seems that it’s different for everyone. It can sometimes depend on how your pelvis is tilted, so that might impact on what’s most comfortable for you. But a few suggestions I have are;

  • Try sex from behind (doggy style), as your bum will prevent full penetration
  • Try being on top (cowgirl) as you can control the depth, speed etc
  • Try the spooning position – its a gentler approach

Do you get pain with orgasm?

Personally no, but if you watch my fellow friend Claudia’s (@me_myself_and_endometriosis) live on painful sex from the other day she mentions this too. I’ve actually found that it can help my pain, but pain with orgasm is not uncommon with Endometriosis (and other conditions). This is because an orgasm causes muscle tension and contraction, which can cause intense pain and pulling.

When was the last time you had painful sex and how bad was it?

Two weekends ago we were away for the week. It was late, very late, and my boyfriend was asleep on the sofa whilst I was crying my eyes out watching the film ‘A Star is Born’. I woke him up, he went to bed and I followed later on, then we had sex. He accidentally hit my face (quiet lightly may I add) but it just for some some reason set me off. It sounds absolutely crazy now I think about it but I stormed out, swore at him and slammed the bathroom floor. I then collapsed to the floor crying uncontrollably not being able to get up. Of course this had nothing to do with him accidentally hitting my face. Sex is a constant battle in my head recently and at that point it just exploded and I couldn’t cope.  I might add that he took it very well, scooped me up and put me in the shower and cuddled me until it stopped. I was in bed most of the next day. 

Is it just penetrative sex that hurts?

For me, yes. But others can experience pain from orgasm and any other form of sexual activity. This is a great question though because sex doesn’t have to be penetrative, there are plenty of ways to make each other feel good without actually having sex. That could be something to experiment with if you’re really struggling. 

What would you suggest for someone trying for a baby but experiences painful sex?

I would suggest seeing a doctor if you haven’t already to see if they can help with the source of the pain. I would also say do not put any pressure on yourself, stress will not help with either sex being painful or conceiving. The average time for a couple with no health or fertility issues to conceive is one year so don’t lose hope and stay patient. 

Is it okay to have sex on your period?

Yes of course it’s okay as long as you’re comfortable with it! It can also act as extra but if lube but depending on your condition sex could be more painful around your period week so I’d keep that in mind too, but there’s absolutely nothing wrong with it at all.

If a mans penis is bigger then will it hurt more?

They say “size doesn’t matter”, but with this question, it actually might. Longer penises can cause more pain because they can hit your cervix. There are gadgets out there (e.g. cock rings) that act as a bit of barrier to reduce penetration depth. I’ve found this works a lot better for me. Regardless of size, lots of lube and at least 30 minutes of foreplay can help! 

Is foreplay important?

Yes. I can’t stress enough how important it is to ‘ready’ yourself before having sex even if it’s not usually painful, as it’ll be more enjoyable for you both too. But with painful sex I would 100% recommend 30-40 minutes of foreplay before actual penetration. 

Do you think sex is important in a relationship?

Yes, I do think it’s an important part of a relationship, but I also think that in a trusting adult relationship sex is not an essential part. If needed you can go without, as can your partner. It doesn’t have to happen regularly and it doesn’t have to be conventional. 

Is it okay to talk to your mum about painful sex?

Absolutely yes! Your mum is your best friend about all of this, you can tell her anything. My mum knows the ins and outs believe me! 

So what happens when you really want to have sex but it hurts too much? 

You’re human! You like sex, we all do right?! You should never ever feel guilty for wanting sex! So you want to have sex but it hurts right? How about trying a new position? Having non-penetrative sex (sex without penetration) or relax, get your partner to give you a massage, give him a massage? Try to push all of the worries out of your head before you attempt sex or it wont’ be enjoyable (trust me).

Do you get pain after sex?

Yes, most times I would say I get pain after sex, sometimes it’s much more intense than other times but more often than not I’m covered in heat patches or in bed the next day. 

Would you recommend pelvic floor exercises and what kind?

Yes I would definitely recommend trying some pelvic floor exercises! If you’re muscles are tight and tenses down there then it can really help to relax and loosen them up.  Pelvic floor drops or reverse kegels are good for this! And relaxation techniques and exercises wouldn’t do any harm either.

Conditions like Endometriosis can happen at a young age, when sex is confusing on its own let alone adding pain to the mix too! It so important to talk about things like this. Sex should not hurt, I can’t enforce this enough but if you’re reading this and you haven’t seen a doctor then please please do! 

Sex is not embarrassing, it’s not gross, and it you’re having problems it could be a sign you need your health checking. It could be nothing but it could be something. 

A doctor has seen it all before – I know that it’s not nice getting your bits out in a doctors office but it’s a must! Get checked and they could even be able to fix your painful sex, how great would that be?! 

My top tips are;

  • Lube is your best friend – it’ll help make penetration more comfortable and reduce any dryness
  • Don’t be afraid to ask to switch positions if it’s painful – sometimes simply tilting the pelvis can help
  • Communication is key – talk to your partner, doctor or trusted family/friend
  • If you’re not in the mood/hurting too much or for whatever reason don’t want to then don’t force yourself
  • Drink lots of water as staying hydrated allows your muscles to work better (yep, including those “down there”!) and can help aid natural lubrication
  • Try to clear you head before sex – it might sound silly but if you’re worrying about sex hurting/making you bleed etc you’ll be more tense ,making it more likely to hurt
  • If it hurts then just stop, there’s nothing wrong with that 

What about painful sex when you’re single? Even though I’ve been in a relationship for the last 3 years, there was a point when I was single that I was starting to experience painful sex. It was nowhere near as bad then as it is now, so I usually brushed it off as nothing. However, it can feel awkward if your with someone new and worried about whether sex is going to hurt, if you might need to stop halfway through or what the other person might think. That’s why it’s important to have that conversation with someone if you need to, it’ll save you feeling guilty or even a need to do something that you’re not comfortable with.  They will understand and if they don’t then they’re not for you! 

So what about your relationship with yourself? Living with painful sex has caused a constant battle with myself over the last year. I feel guilty for not having sex with my boyfriend, I feel like I’m broken, like it’s my fault and sometimes I am guilty of just gritting my teeth and waiting for it to be over. How bad does that sound now I’ve said it out loud? I don’t do it because my boyfriend makes me feel bad about it or anything like that. It’s actually quite the opposite, he’s understanding, he asks me if I’m okay, he stops if he can see it hurts me even if I haven’t said anything and when I say no not today he doesn’t bat an eyelid. 

But that doesn’t mean that I’m okay with it, the battle in my head is very real and no matter how much he reassures me I still fight it in my head. 

I haven’t mastered the art of painful sex, I don’t always get it right, I’m still figuring it out but I wanted to share this with you. I wanted to advocate for myself and you everyone who’s not ready to talk about painful sex. 

Libby x

Libby works in retail and has been fighting to get her Endometriosis treated. She’s passionate about raising awareness and helping others who are going through similar situations. You can find her Instagram account below;

Instagram: @myendodiary_

2 thoughts on “GUEST WRITER: Sex and Endometriosis – a Painful Problem.

  1. So I have Endo too and vaginal dilators paired with the Ohnut is great. The Ohnut works so well. It is rings that go around the male to act as a buffer. You should look into it. Have a great week!


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