abstract pain and relief from endometriosis
Illustration by Marta Pucci

How to Manage Endometriosis for a Healthy and Pain-Free Sex Life

Photo of Dr Katherine Hertlein
Reviewed by Dr Katherine Hertlein,
created by Blueheart
created by Josh Green
created by Sophie Browness
Date published:
Last updated:
Photo of Dr Katherine Hertlein
Reviewed by Dr Laura Vowels,
created by Blueheart
created by Josh Green
created by Sophie Browness
Date published:
Last updated:


  • Endometriosis is a disease caused by endometrial tissue growing outside of the uterus.
  • It can severely impact quality of life, causing pelvic pain, heavy periods and pain during sexual activity or intercourse.
  • There are ways you can improve pain during sex, such as experimenting with different positions or trying mindfulness techniques to reduce pain.
  • The Blueheart Sensate Focus therapy app is a simple and cost effective alternative to in-person therapy helping you reduce pain associated with endometriosis.


Endometriosis can be life-changing, resulting in chronic pain, particularly around your period and sexual intercourse. But while treatment and prevention can be difficult there is plenty of support available. And, you'll be pleased to hear, techniques that can be used to reduce pain and maintain a healthy sex life with your partner. 

What is endometriosis?

Endometriosis is a disease where endometrial tissue, similar to the lining of the uterus, grows outside of the uterus, including on the ovaries, fallopian tubes, or bowel. The WHO reports that endometriosis affects around 10% of women globally (160 million), causing pain that is so severe it impacts quality of life as well as in some cases infertility.  

Symptoms of endometriosis can include chronic pain in the lower stomach, back and pelvis, as well as heavy or painful periods and moderate to severe pain during sexual intercourse. Because of the debilitating symptoms, women with endometriosis often report fatigue and depression or anxiety as well.

It’s thought there are many factors that can contribute to the onset of endometriosis and unfortunately there is currently no known prevention, only early diagnosis and management to slow progress of the disease. Treatment options such as surgery and hormone therapies can sometimes help with the symptoms of endometriosis in the short term.  

How does endometriosis affect your sex life?

One of the key issues described by patients with endometriosis is the negative impact it can have on their sex life. Deep penetration often causes severe pain during intercourse, or even up to two days later. Pain during sex - or deep dyspareunia, as it is termed - can feel different for every woman. Some describe it as sharp or stabbing pains while others report pelvic pain or aching.

It’s unsurprising then that about two-thirds of women with endometriosis have some form of sexual dysfunction. This often leads to reduced sexual activity and a poor quality of sex life or reduced libido due to the pain.

Women with endometriosis won’t always feel confident in confiding in their partners to explain what’s going on. They might feel it’s their fault that sex is painful or that they’re doing something wrong.

Meanwhile their partner, if they’ve noticed the discomfort, might feel guilty about the pain they appear to be causing. Over time this can lead to a cycle of avoidance and feelings of rejection and resentment that, if not properly addressed, can start to seep into other areas of the relationship.  

We would always recommend talking to your doctor or gynaecologist if you’re suffering from pelvic pain, painful periods or pain during sex. This way they can take a view of your symptoms, make a diagnosis and monitor or make a treatment plan where possible.

But that’s not to say you can’t take strides to improve the problem on your own too.

How to reduce pain during sex with endometriosis

Take heart that there are ways to make sex with endometriosis less painful. These range from experimenting with different sex positions and techniques to seeking out medical interventions and diagnoses. You certainly don’t need to feel that you’ll have to give up your sex life any time soon.

First up, try experimenting with different times of the month, keep track of your cycle and the common symptoms you experience. You might find that certain times of the month you experience less pain during intercourse. And don’t be afraid to use plenty of lubrication if you suffer with vaginal dryness too.

Different sex positions and depth of penetration can result in different levels of pain too. The missionary position, for example, is often reported as more painful due to the way the pelvis is tilted and the deep penetration that results. Instead test out sexual positions that encourage shallow penetration for a more pleasurable experience.

And of course, sex doesn’t have to mean penetration all the time. There are many alternatives to intercourse. Find ways to connect with your partner through kissing, foreplay, mutual masturbation and other types of intimacy that should not exacerbate your endometriosis pain at all.

How can mindfulness help?

One other alternative, if you want to be able to continue with penetrative sex, is to find ways to reduce the pain you experience during intercourse with your partner. This could involve taking painkillers or medication a little while beforehand, or you could try mindfulness.

Studies have found that mindfulness exercises can help to reduce sexual pain by focusing on sensations within the body and being present in the moment. And not only can these techniques help with pain during intercourse they can improve sexual response, mood, quality of life, and general well-being too.

If you need professional support, a good sex therapist can help with techniques and exercises to help you get back to a healthy sex life. As an alternative, the Blueheart app allows you to use Sensate Focus therapy to introduce mindfulness into your sexual activity through a series of touch and sensation exercises.

The app will help you and your partner work together to move past the anxieties surrounding the pain and symptoms of endometriosis. Initially you'll move away from intercourse in order to build up trust and focus entirely on touch and sensations within your own and your partner’s body.

How can you help your endometriosis-suffering partner?

While women suffering from endometriosis may feel that the burden is all on them, a supportive partner can make a very real difference.

As the sexual partner, try to remember that it’s not anyone’s fault, everyone is built differently and has different physical and mental ailments. A woman should never feel pressured into having intercourse or made to feel guilty for being nervous or concerned about undertaking any kind of sexual activity.

Learn more about the condition and help your partner find ways to reduce the pain involved in sexual intercourse. And try to explore ways of being sexual and giving or receiving pleasure. Reframe what sex looks like to you – it doesn’t have to be about penetration if that’s painful at the moment. Besides, for most women penetration is not the most pleasurable way of having sex anyway.

Don’t suffer in silence

If you’re suffering with painful periods or discomfort during sex, don’t ignore it and hope it will go away. Getting a diagnosis of endometriosis could be the first step to getting the help you need. There’s no need to suffer in silence, speak to your doctor and find out what can be done and if you don’t feel they’re listening to you find another doctor and try again.

For support to help reduce pain during intercourse, consider trying Blueheart as an alternative to in-person sex therapy, helping you to focus on the sensations within your body and reduce the pain and anxiety associated with sex with endometriosis.

Learn how to manage Endometriosis
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