You Don’t Have to Suffer in Silence: Endometriosis, Sex, and Me

By Petra Lindnerova

Years ago, during a shift in my first job as a retail sales assistant, my brother drove from his house to bring me his wife’s strongest painkillers and pads. I waited for him slumped over the counter by the fitting rooms, clutching a clothes hanger and desperately imagining using it to perform some sort of medieval surgical intervention to scoop out my insides. It was day one of my period, the worst of them all.

The women around me strutted towards mirrors as if on a catwalk, giggling when the aircon plumped up their hair into a superstar blow dry. They admired the newest high-waisted jeans, which embraced their figures effortlessly like a layer of liquid denim. 

Despite knowing that one in ten of us in that fitting room probably entertain bizarre fancies of using random utensils to get rid of the excruciating ache in our bodies on a monthly basis, I felt alienated. I could barely walk in a straight line, my hair stuck to my forehead, and my stomach adamantly poked out. 

Elaine Scarry, in her book The Body in Pain, describes pain as an “absolute split between one’s sense of one’s own reality and the reality of other persons”. When it comes to period pain, especially in tandem with endometriosis, the bodies of those of us who menstruate become a source of regular physical and mental anxiety – we feel inadequate, weak, and undermine our own pain tolerance, all whilst comparing ourselves to healthy-looking, seemingly unencumbered bodies.

It’s just period pain. This is a phrase that those of us who menstruate have heard countless times when asking for a break at work, school, or requested a different prescription to help manage the pain. However, people with endometriosis do not experience symptoms during menstruation only. According to endometriosis.org, tissue similar to the one lining the uterus forms outside the uterus in people living with endometriosis and can be found on the pelvic peritoneum, ovaries, in the recto-vaginal septum, and on the bladder and bowel. The presence of this tissue causes painful periods as well as painful ovulation, pain during or after sexual intercourse, heavy bleeding, chronic pelvic pain, fatigue, and infertility.

In Invisible Women, Caroline Criado Perez highlights a whole series of medical mishandlings of female suffering and the brutal, at times fatal, institutional neglect of society to hear us out. Despite there being around 176 million women worldwide with endometriosis, “it took until 2017 for England’s National Institute for Health and Care Excellence to release its first-ever guidance to doctors for dealing with it”. This chronic invisibility leads women to shut up about our health issues, silently picking at our bodies and blaming them for what essentially manifests as lower quality of life on all fronts, instead of holding responsible the structural erasure of our pain’s value. 

In the private sphere of the bedroom, women like myself who suffer from endometriosis find this a tough subject to broach, even though sex with their partners might be an ordeal that rarely bestows enjoyment on both parties. I became accustomed to my painful reality to such a degree that the split between my pain-free partner and me turned into an insurmountable gap, taking all the pleasure of the sexual encounter away. I accepted this for a long time, telling myself, as the least-comforting phrase goes, it is what it is.

But it does not have to be. Here are three key things to take into consideration if you are having painful sex as a result of endometriosis:

Communication

There are ways of minimising pain during sex, and all of them start with communication.

If your partner does not care you are stifling whimpers while doing it (and I don’t mean the sexy ones), it’s time for them to leave. And no, you do not need to wait for them to get dressed before kicking them out. Once you find yourself in bed with someone with a backbone, it should be easier to talk about your needs. On a positive note, someone who actually wants to know what works for you is in itself a turn-on, which may be helpful for whatever is about to take place. 

Less Penetration

Who doesn’t love good foreplay? Make sure that you and your partner take the time to build up some natural lubrication, as it will be a big help in keeping you comfortable. I know some evenings might be more passionate than others, but there is no reason to rush if taking it slower means avoiding pain.

Positions

Discovering ways to switch things up is not necessarily just to keep sex fun and fresh. Depending on the location of the tissue outside the uterus, some people find it more comfortable to be on top of their partner, which allows for more regulation of where exactly pressure is being applied, and how much. Others place a soft pillow under their lower back. Medical News Today shared a list of positions with shallow penetration that are good for endometriosis sufferers. The positions include face-to-face, spooning, raising the hips of the person with endometriosis or a modified doggy style. 

Outside of these three key elements for less painful sex, my other tips include regularly taking magnesium for muscle relaxation, warm baths pre-sex, or timing intercourse according to your cycle – tracking pain levels can be helpful to discern which time of the month is the least painful. Nevertheless, it is advisable to contact a professional to consult opportunities to address pain during sex. Remember: you do not have to suffer in silence.