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Why Is Sex Painful When We Have Endometriosis? Two Possible Reasons I Can Think of and Some Tips to Make It Less Painful

I have covered the topic of sex with endometriosis a few times in this blog and I am always amazed at how many people read it, yet we don’t seem to comment much about it. I figured this meant you want me to write about it more—even if you are a little shy to comment.

Initially when I used to get pain with sex it used to actually worry me. I used to think it was causing things to get worse and so I would refrain from having sex too often. Having studied Endometriosis a little more and understanding how things work a little more, I can share with you that having sex with Endometriosis is not a bad thing, even if it is painful.

Let me explain. The first reason sex is painful with Endometriosis is due to the formation of adhesions and cysts in the wrong places. So, essentially the cysts form on the very organs that move when we have sex. If cysts have been there for a long time, they develop into adhesions, which are essentially long stringy bits of blood, much like bridges, and they cause organs to stick together, making it hard for them to move. When we then have sex, where some movement occurs down there, they push on these organs, pulling at the adhesions and pulling the organs they are attached to. This is the pain we experience with sex. These organs are not meant to be stuck in one place and should be free to move around as and when needed.

I did write a slightly controversial article that indicated that having sex with endometriosis might actually be a good thing. The reason being that we would encourage movement and blood flow to the area and essentially get things moving out at the same time.  It is just a theory of mine but I have actually seen this statement mentioned in a Chinese Healing book.

Essentially, the cysts and adhesions are made of stagnant blood. This is misplaced blood, which is essentially what Endometriosis is. That stagnant blood will only keep getting stickier and adhere to more organs if it is not moving or broken down.

So, if we get movement happening down there, in various forms then the adhesions will loosen up and their “bridge strength” will weaken. The less adhesions we have, the less pain we will have. There are a number of ways we can weaken those adhesions. The key element here is movement—this can be in the form of exercise, castor oil packs, massages, heat applications, herbal remedies that heal the uterus area and yoga poses which flex the various organs in the abdominal area.

One of my personal favourite supplements which really focuses on breaking down the dead cell formation is Serrapeptase. It is an enzyme, which essentially “eats” away dead cells.

The second reason sex can be painful is only indirectly related to Endometriosis. Many women who suffer from Endometriosis also suffer from what is commonly called estrogen dominance. Essentially, it means we have too much estrogen versus progesterone. This imbalance causes a series of symptoms and one of them is a lack of libido and dryness. These symptoms would indirectly cause pain with Endometriosis as, simply put, we are not ready for insertion and are not lubricated enough. This lack of lubrication can cause tenderness and pain in the vagina itself.

The combination of dryness and internal pain can also cause women with Endometriosis to quite simply “close up” more. So, we clamp and squeeze those abdominal muscles for fear of it being painful. This clamping and squeezing will often make things worse as we are using more muscles in the abdominal area and it will tighten things up, making it likely that we then have vaginal pain.

The best thing you can do for vaginal dryness is to use the most natural lubricant, called coconut oil. It is fantastic and is a natural antibacterial product at the same time. It lubricates well without destroying anything like some of the other lubricants do.

Naturally, getting your hormones checked and assessing the severity of your estrogen dominance will help increase your libido. Apparently eating home-made fermented Sauerkraut does wonders for this.

Now that you know the reason why sex is painful with Endometriosis, you can feel much more relaxed about it all and really focus on enjoying each other. Remember that sex is not the only way to feel close to your partner and that honesty is vitally important. If it is too sore, just stop—it isn’t much fun for either of you that way anyway!

Feel like sharing your personal experience with sex and endometriosis? Don’t be shy! It might help someone out there who is struggling with it all.

Hugs, Melissa x
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This Post Has 25 Comments

  1. Helena

    I also have a lot of lower back pain with my endometriosis and l would say rectum pain also. I have had endometriosis for over twenty years. The pain during sex comes and goes. Sometimes it can last for months and feels like my hubby is hitting something during sex. Then l get sharp pains down my side’s. I also have been diagnosed with adenomyosis in my late forties. I have had surgery only once as l do try to do it naturally. Yet l feel l need surgery again as the pain is getting so painful and l feel causing painful bowels.

  2. Marie

    I had 7mths of severe attacks around my period time (altho still regular) my female doctor said its bladder infections (so. Vomiting.temp.sweats.runs while curled up on floor is normal?) couldnt stand up for Or 4 days without servere pain.went to a male doc.got a scan. Had frozen pelvis ..cysts and endo on bladder and ligments (and wall tween girl bits and waste disposal.ha) anyway had my ops.went on progesterone pill… Now uncomfy during sex and 2 periods a month. Lucky me! Have stopped pill for now to ‘reboot’ system i hope..

  3. kelly

    Wow. You sound like me, 7 years I put up with the pain telling myself it was after pregnancy pain an d changes!!!
    Your uterus might not be sitting correctly and endo can hold it down in wrong position. I have pain through my rectum when I sit down, bloating, cramps most days!!!
    Get gyno to check position of your uterus, yes lap is the only way to know for sure its endo. Good luck. It is hard for men to get it my hubby is good but even started to say to me, he just had a higher sex drive, um no… I have PAIN!!!

  4. kelly

    My gyno just told me the main reason for my pain during sex is I have a retroflexed uterus that is bent back and laying on my bowel. Booked in for surgery to correct it. Was nice to be acknowledged when gyno said after my pelvic exam, wow, you must not want sex at all with the pain that would give you… oh no, but I did for my hubby!!!

  5. felisha

    I have had this pain for about 7 years. The last six and half years my (old) ob kept saying the pain was in my head. That she don’t per scrip pain pills so if that’s what I want I’m at the wrong place so on and so fourth. About 7 months ago I left her office in tears after a vaginal a ultra sound and exam, called around and found a new ob. This new one got me in the next day and did a vag and anal axam and said. I’m telling you its endo. (I have family history also) I’m technically not aloud to say you have it without the lap but it is what it is. Then explained it too me. Now sex has not been on the egenda. I feel emotionally and physically drained bc i can’t satisfy my man. He tries so hard to understand. But cant. I’m on a birth control pill (third kind in seven months) and still experience pressure if not pain 24/7. I would love to be able to please him but even the though of sex stresses me out. My nerves and emotions start up. Is it going to hurt? Will I be able to move or walk after? Am I going to give him blue balls bc we have to stop? Will this turn into another trip to the er?.. this all goes thru my head. I’m scared of this disease terrine us apart. Idk what to do. Any advice would be appriciated.

  6. Melissa

    Thank you Jaie. I hope it helps 🙂

  7. Jaie

    Finally after searching for so many articles about endometriosis, I found yours.
    You’re really an ENDOAngel 🙂

    I will show this post to my husband tonight 🙂

  8. Teresa

    I’ve been diagnosed with endo for about 7 yrs now. I’ve had 2 surgery from 2008 and another one on the way 🙁 I too have sever pain during intercourse and was wondering if anyone else has mid to lower back pain after intercourse?

  9. Melissa

    I am so sorry Shawna. The pain is obviously with the endo. I would highly recommend doing a Mayan Massage course. It does wonders for the pain, healing and really makes you feel so much better about being a women too!

  10. Shawna

    Even after 2 surgeries for endo, and trying to live a healthy lifestyle, I am totally unable to have sex. The pain is much too severe. I’ve tried to block out the pain, and continue anyway for my bf, but finally I just burst into tears from frustration, embarrassment and pain.
    I mentioned the problem to my gyno. He recommended lots of lube along with 2 Advil one hour before sex. Sadly, the pain is still too intense. I’m not sure what to do at this point. I’m in my 40’s, not married, without children, and now that I’m unable to have sex I’m feeling less like a woman. I try to keep my chin up and concentrate on the positive, but I miss the physical and emotional bond that comes with intimacy. I feel defective and afraid.

  11. Nelly

    Good post, I don’t feel so alone in this now… With me, I lost some libido with the onset of the serious symptoms, after surgery and hormonal treatment I lost ALL libido, all lubrication, and I am very tight down there – I guess a nervous reaction in anticipation of the pain and discomfort that I feel. The pain is not awful, more of a discomfort than pain, I am supposed to have been cleared of cysts and adhesions for 5 years now, but I still have very little lubrication, sexual desire and comfort when having sex… My partner is understanding but…this cannot go on forever, or at least I don’t think it would be right for me/us. I’m too young to be done with sex 🙁 The docs shrug their shoulders, they consider me healthy.
    Thank you for your blog, wishing health to all.

  12. Abigail

    I am so sorry you are experiencing this. I suspect I may have Endometriosis as all my symptoms match up.
    You must tell a doctor about it, you deserve all the help and support in the world. No matter how embarrassing it is, that is over in minutes, whereas the pain of being alone in this will go on forever…
    Good luck x

  13. Melissa

    I am sorry to hear it is so painful. Perhaps try some Emotional Freedom Technique to find the source of inner emotional pain around this one.

  14. Mad minder

    It’s comforting to know others feel the same but everyone else has understanding partners I do and I don’t he can be sympathetic but then other times goes on about I don’t meet his needs we have gone years without real sex probably once or twice a year we have a little play but its just unbearable the minute I start feeling that nice sensation bang pain kicks in doesn’t matter if its actual sex or foreplay I have a mental block and just avoid sex our relationship is barely holding together with four children very little private time,gyne prescribed the pill and sent me off leaving me back in my gps care after three months I went to get prescription doc decided the pill wasn’t supposed to be used so stopped I changed docs but I haven’t been back I am so embarrassed I never told any doc or hospital how sex hurts I can’t say those words I just feel so upset and alone

  15. Melissa

    No. They work on different areas of the body. Best of luck with it and hugs to you Bussy

  16. Bussy

    I’ve been having painful intercourse since I was diagnosed with Endo 8 years ago.
    My pain has been terrible. Was placed on progesterone again 2 weeks ago but just discovered a herbal doctor who introduced me to Vitalzym. I’m expectant and hopeful. Please do I need to stop the progesterone for Vitalzym? Thanks.

  17. Wow! You hit the nail on the head. I was diagnosed in October and went undetected for several years and started getting pain last year. I never had pain or dryness from sex until the endi hit a critical point. It put a strain on my relationship since I didn’t know what was happening. Thank you so much for posting this.

  18. Melissa

    That is a great find! Brilliant and thanks for sharing. I had never even considered this as a factor. Hope I can help you with the endo side of things 🙂

  19. Ruth

    I would like to add another reason for painful sex (…or at least a reason for ADDED pain with sex!) I have pelvic floor dysfunction, even after birthing naturally my pelvic floor muscles are too toned. It has taken therapy with a women’s health physio to get to a point where sex and internal exams no longer make me cry. The chronic pain of the endo (I’ve had it for 16 years) has made my muscles get into a state where they do not ‘switch off’ – which goes in a cycle of causing pain, tensing the muscles, which causes more pain. I have met several women with endo that have tried pelvic floor physiotherapy with great results, so although I am sure it wouldn’t benefit everyone, it could be worth trying!!! Has made a big difference in our marriage (I have THE most wonderful and supportive husband, it’s just nice to be able to have sex without pain for days following)

  20. Melissa

    Hi Katie and welcome!
    I am so happy you are enjoying the site 🙂
    Love having your support and please comment lots so I know what you’ve read 😛



  21. Katie


    I just found your website and have been on it ALL DAY! So nice to know that there is a group of woman taking the natural route to cure this disease!

    Thank you for the support. Please don’t stop this blog! 🙂



  22. Melissa

    Hi Gretta,
    Not graphic at all and thanks for commenting 🙂
    I am sorry to hear your pain is back. I hope you found the bit about the Serrapeptase helpful as this might offer some relief to slow down the adhesion formation. I hope you also consider your diet with your healing journey as it makes a huge difference to how you heal your body 🙂
    Hugs and all the best.

  23. Gretta Lucey

    Hi Melissa,

    another great blog… sorry if I offend anyone if this reply is a little graphic

    Yes it hurts to have sex, I think most women feel a tug when they are active, for me it used to be a lot more than a tug. I used to get a sharp pain on my right side that was so bad I had to stop. It didn’t matter what position we tried it still hurt. I had surgery last June to remove large cysts & loads of adhesion’s. Thankfully this worked out great and our sex life got back to what it used to be.

    I now have to use a lubricant when we have sex as it hurts otherwise, I think its because I am afraid of the pain coming back and it wasn’t nice. I agree with you Melissa it’s defiantly a mind over matter thing …

    With the last 2 months I noticed that old pain during sex is coming back 🙁 I went for another scan & yep the cysts are back so I’m guessing the adhesion’s are too. We still have an active sex life with the help of the lubricant & try to block out the discomfort….

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I'm Melissa

Sick of dealing with endometriosis and ready to move forward?

I empower women to stop feeling like a victim to their endometriosis and find empowering ways to reduce pain & symptoms. 



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