6 Sex Positions to Try When You Have Endometriosis
Endometriosis, a painful reproductive health condition, impacts fertility in more ways than one. Most women with endometriosis are concerned about whether they can get pregnant with the disease or not, but then they also have the added difficulty of reducing the pain when trying to get pregnant.
Endometriosis and sex can be a tricky combo and can cause situations where you are slightly uncomfortable to downright painful and everything in between. The condition is characterized by endometrial tissue, normally found in the uterus, that begins to grow outside the womb. When this happens, endometrial implants continue to thicken, break down, and respond to menstrual cycle hormones even though they are outside the uterus, causing painful symptoms.
In this post we will look at how to manage endometriosis as well as the best positions for anyone trying to reduce the pain of sex.
How does endometriosis affect your sex life?
Endometriosis is painful on it’s own, but that pain is often amplified when you mix in intercourse. Penetration can push and pull the tissue growth behind the vagina and lower uterus caused by endometriosis, causing pain.
While everyone agrees sex should be fun, dealing with constant pain whenever you attempt it can kill the mood.
Here are a few of the common scenarios you might face when trying to have sex with endometriosis:
Pelvic pain during sex
Nearly two thirds of women with endometriosis report some kind of endometriosis pain during sex and pelvic pain is one of the biggest concerns. Discomfort comes from sexual activity, especially deep penetration and the pulling and stretching the tissues behind the vagina and lower part of the uterus.
Endometrial implants usually form in this area and pulling and stretching on that tissue can cause pain. Women with endometriosis have found ways to work around this, namely positions where deep thrusts or penetration are limited to keep any pain to a minimum.
Some women feel pain during sex because of vaginal dryness or lack of lubrication. If you have endometriosis, adding lube to your sex life can make all the difference (it can also help with fertility). Vaginal dryness may be caused by hormonal treatments taken to reduce symptoms of endometriosis, or as the result of other procedures such as the removal of the ovaries. Any reduction in circulating estrogen levels can lead to vaginal dryness and therefore discomfort during sex.
Emotional pain and fatigue
Physical symptoms aren’t the only cause of pain during intercourse and there may be many psychological implications as well. From sexual and physical trauma to anxiety about intimacy, there is an emotional component to sex and if sex is painful or difficult, you likely won’t look forward to it. Add on the emotional pain and fatigue from dealing with endometriosis, and it’s only natural that this would affect your sex life.
Best sex positions when you have endometriosis
Ready for some good news? Many women who experience pain during intercourse have found relief with experimenting with different sex positions.
Specifically, sex positions to reduce pelvic pain tend to have gentler angles and put less pressure on the ovaries and uterus, thereby causing less pain.
A classic for a reason, the reverse cowgirl position is a variation of the cowgirl position (another classic). The person receiving penetration sits atop their partner but instead of facing forward, like in cowgirl position, they face backwards or towards their partner’s feet.
A comfortable sex position with endometriosis, reverse cowgirl allows the partner on top to control pace, rhythm, and most importantly for endometriosis, depth of penetration.
A modification to the traditional missionary position, face-to-face is essentially missionary turned sideways. Turning things sideways allows partners to change the angle of penetration to make it more gentle, without sacrificing the intimate connection traditional face-to-face positions like missionary allow.
Sideways positions help with endometriosis pain during sex because they allow for gentler angles and shallower penetration without sacrificing intimacy. You can get face-to-face, spoon, or try variations such as putting a leg over your partner’s shoulder.
Woman on top
Much like the reverse cowgirl, woman on top sex positions allow the woman to control thrusting and depth of penetration. Controlling the depth and speed is key for women with endometriosis, as it allows you more control over penetration.
Modified doggy style
Classic doggy style penetration can prove too much for women with endometriosis, so don’t be afraid to modify it. Modified doggy style involves lying flat on your stomach instead of all fours. From there your partner can lie on top of you and use their arms to push up. This position allows for gentle friction as well as easy access for additional stimulation either from your hand or toys.
Often described as one of the most intimate sex positions, the lotus position involves one partner straddling the other while sitting cross-legged. It sounds complicated but really isn’t and it’s not hard to see why it’s championed for its intimacy. Partners are pressed tightly together and face-to-face which allows for other opportunities to increase closeness, like kissing and eye contact, rather than deep penetration. In addition to its advantages for intimacy, the lotus position offers many variations and is very adaptable and accessible for almost any partner.
What are the other ways to enjoy pain-free sex?
Beyond positions, there are many things you can do to lessen your pain and enjoy pain-free sex. Symptoms vary from woman to woman, so try one or all of these tips to keep the pleasure in your sex life.
Lubrication isn’t just a fun add on to your sex life, it can also help you stay safe. The key to preparing your body for penetration, lubrication reduces the friction of penetration and helps keep vaginal lining intact during intercourse. Since endometriosis can contribute to increased vaginal dryness, adding a water-based or silicone lubricant to your intimate activities can make all the difference.
Arousing alternatives to penetration, like sex toys, can increase sexual intimacy without triggering more pain. Finding other ways to be intimate, or kicking your sex life up a notch with toys is just one way to keep the fun in your sex life. Endometriosis may be a factor in your sex life, but it doesn’t have to define your intimacy and sex toys are a great way to expand you and your partner’s pleasure.
Find the right rhythm
Since deep penetration, and rapid thrusting can cause endometriosis pain both during and after sex, finding the right rhthym can help reduce your discomfort. Communication with your partner is key, as well as utilizing positions that offer a gentler angle of penetration. Work together to find a slow and gentle rhythm that doesn’t exacerbate the pain.
Take a pain reliever
Taking a pain reliever, like aspirin or ibuprofen, at least an hour before intercourse may reduce the pain you feel during sex. Over the counter pain relievers may also help with endometriosis pain after sex. Not just for headaches, pain relievers help reduce inflammation thereby lowering any pain or discomfort you may feel.
Not all women with endometriosis experience pain during or after sex, and symptoms can vary from woman to woman. However, if you suffer from endometriosis and are experiencing pain during sex, try implementing some or all of these tips to help bring the pleasure back to your sex life.
✔️ Medically Reviewed by Banafsheh Kashani, MD, FACOG
Banafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treatingcouples and individuals with infertility since 2014.
Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation.
Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.