How to make painful sex comfortable with endometriosis.

February 27, 2025

Endometriosis is a chronic condition that affects millions of people worldwide. It occurs when tissue similar to the lining of the uterus starts growing outside of it, leading to a range of symptoms such as severe menstrual cramps, pelvic pain and in many cases, painful sex. Unfortunately, this condition doesn’t just impact physical health; it can also affect a person's emotional well-being and relationships, impacting intimacy. For those dealing with endometriosis, understanding the link between the condition, painful sex and sex drive is crucial in finding ways to improve sexual health and make intimacy more enjoyable.

In this blog, we’ll explore why endometriosis can cause painful sex, how it affects sex drive and the ways in which lubricants and vaginal moisturizers can help make sex more comfortable.

Why does endometriosis cause pain during sex?

Endometriosis can cause pain during sex for a variety of reasons. The growth of tissue outside the uterus, often found on the ovaries, fallopian tubes, bladder and bowel can lead to inflammation, scarring and adhesions. This can cause the organs in the pelvic region to stick together making the area sensitive and prone to pain, especially during vaginal penetration.

In addition to the physical discomfort caused by endometrial tissue growing outside the uterus, there are several other reasons that can make sex painful:

Inflammation and irritation: The tissue that grows outside of the uterus responds to hormonal changes during the menstrual cycle, just like the tissue inside the uterus. This leads to inflammation which can make the pelvic area extremely sensitive. The friction involved in intercourse can exacerbate this irritation, resulting in pain.

Scar tissue: Over time, endometriosis can cause scar tissue (adhesions) to form between the reproductive organs, the pelvic wall and surrounding tissues. When these adhesions are disturbed during sex, they can cause sharp or deep pelvic pain.

Muscle spasms: The pain associated with endometriosis can cause pelvic floor muscles to tighten. These muscle spasms, often a response to pain, can make penetration feel even more uncomfortable or even impossible.

Nerve sensitivity: Endometriosis can also affect the nerves in the pelvic area, leading to heightened sensitivity and even pain with sexual touch or pressure.

How Endometriosis affects sex drive

For many women with endometriosis, the emotional and physical toll of the condition extends beyond sex and impacts their sex drive. Along with the psychological stress of managing a long-term health condition many other factors can cause a decrease in libido, such as:

Chronic pain and fatigue: The persistent discomfort and fatigue that often come with endometriosis can make intimacy feel like a low priority. The pain can become overwhelming, making the thought of sex less appealing or enjoyable. This can lead to a reduced sex drive over time.

Emotional strain: Dealing with a chronic illness like endometriosis can bring about feelings of frustration, embarrassment or guilt, especially when intimacy becomes challenging. These emotions can further diminish sex drive.

Hormonal imbalance: Hormonal fluctuations may affect the body's ability to feel aroused. Estrogen, a hormone that plays a role in sexual desire and lubrication is often elevated in people with endometriosis. This imbalance can contribute to vaginal dryness, making sex more painful and less enjoyable.

Making sex comfortable again: Tips for people with endometriosis

While endometriosis may bring challenges to the bedroom, there are several things that women can do to make sex more comfortable and enjoyable. These practical tips can help reduce pain, improve comfort during sex and increase sexual satisfaction.

Communicate with your partner: One of the most important steps in managing painful sex is open communication with your partner. Talking about your pain, boundaries and what feels good can deepen intimacy and understanding.

Focus on relaxation: Tension in the pelvic muscles can make painful sex worse, so focusing on relaxation techniques such as deep breathing can help alleviate discomfort. You can also try mindfulness or yoga to reduce overall stress levels, which can improve both emotional and physical well-being.

Experiment with positions: Certain sex positions may be more painful than others. Be open with your partner and try a variety of positions to find what works best and is most enjoyable for you.

Pelvic floor therapy: Taking part in pelvic floor therapy can aid in relaxing tight pelvic muscles helping to elevate discomfort. It also strengthens muscles and improves blood flow to the pelvic region, improving overall sexual experience

The role of personal lubricants and vaginal moisturizers for endometriosis

One of the most effective tools for managing pain and discomfort during sex is using lubricants and vaginal moisturizers. Both of these products can alleviate dryness, enhance comfort and pleasure. Each has a slightly different benefit:

Personal lubricant: Many individuals with endometriosis experience vaginal dryness, either due to the hormonal fluctuations associated with the condition or because of the physical effects of the disease. Lubricant that is water based like AH! YES WB is designed to feel more like the real thing and add moisture to the vagina, making penetration smoother and more comfortable. For a more soothing experience that is long-lasting then AH! YES OB cares for your vagina while also reducing pain and discomfort during sex. For the perfect pairing, endometriosis sufferers may benefit from Double Glide which offers the best of both for the ultimate in comfort and pleasure.

Vaginal Moisturizers: Vaginal moisturizers are specifically designed to restore hydration to the vaginal tissues and are a good option for people who experience dryness outside of sexual activity. Like you would moisturize your whole body, endometriosis sufferers especially would benefit from regularly moisturizing their vaginas using a product like AH! YES VM . Designed to be used long-term, AH! YES VM will provide relief from dryness and irritation for up to 3 days. Helping to keep a balanced vagina with relief from burning, dryness and discomfort.

Using a lubricant or vaginal moisturizer can help reduce the friction that causes pain and make sex more pleasurable. The right lube can also make it easier to enjoy intimate moments without worrying about dryness or discomfort, helping to preserve your sex drive and enjoyment.

Endometriosis is a condition that can significantly impact sex but with the right guidance, women can take control of their sexual health and experience more comfort and pleasure during sex. From communicating openly with partners to experimenting with different positions and using lubricants and moisturizers, there are ways to make sex more enjoyable again.