Ways to enhance sexual pleasure if you suffer from endometriosis

Because you deserve pleasure.

The far-ranging effects of endometriosis aren’t to be understated. The pain inflicted by this chronic illness is immense. Physical pain, expensive doctors’ appointments and lifestyle adjustments are necessary for those with the disease – that’s not to mention the mental anguish and costs associated with the diagnosis. In Australia, it takes an average of seven years to receive a confirmed diagnosis (and that’s on medical misogyny).

Endometriosis is when tissue similar to the lining of the uterus grows outside the uterus. Pain – whether that be around menstruating, ovulation, sex, bowel movements, urination or general discomfort – is part and parcel with the disease.

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What perhaps isn’t spoken about as much (understandably, as the underresearched and underfunded condition has a lot to work through), is how it affects sex and intimacy. “Endometriosis can cause significant and debilitating pain for many of those who have the condition,” sexologist and sex and relationship expert for Womanizer, Christine Rafe, says.

“Often people feel that the condition completely removes any opportunities for pleasure, particularly sexual pleasure,” she tells me. But sexual enjoyment and endometriosis can co-exist. Here, Christine shares some sexual wellness tips for people who have endometriosis.

How important is it to communicate with your partner about your condition?

If you have a partner, then any pleasure or sexual concerns are a couple’s issue. You both have parts you can play in reducing fear or likelihood of pain and increasing pleasure and overall sexual satisfaction. Your partner cannot know what’s happening to you unless you share with them.

If you can express what you understand about what supports your pleasure and reduces your pain, with a focus on what’s possible, you and your partner can develop routes to sexual pleasure together that work for both of you.

How can endo sufferers experience pleasure without penetration?

Masturbation is the best way for anyone to learn more about their arousal and pleasure needs! If you understand what types of touch feel the most pleasurable (as well as the types of stimulation that might aggravate or increase discomfort), this is invaluable in both solo and partnered sex.

Masturbation also releases hormones that act as our body’s natural ‘pain killer’ which can help reduce symptoms associated with endometriosis for some people. For those who experience pain with sexual activity because of endometriosis, psychologically, our brain builds a connection between genital touch and pain. This connection is strengthened with each experience of pain with sex.

Promoting pleasure with genital touch through masturbation helps a person have a connection with pleasure and their genitals. This can reduce fear, avoidance or low motivation for any type of sexual contact, as well as encourage a more positive relationship with genitals.

And if you do want to engage in penetrative sex, how can you prepare the body for this?

Even without any pelvic, endometriosis or penetrative pain, it’s essential for vulva owners to have adequate time to arouse their bodies to physiologically be ‘ready’ for penetration. This process includes the circulation of blood to the pelvic region and the engorgement of the clitoris (both external and internal).

It also includes the lubrication of the vulva and vagina to support friction-free penetration, and elongation of the vaginal canal through the retraction of the cervix. Research tells us this can take an average of 16 minutes from the beginning of sexual arousal for this process to occur (up to 40 minutes for some vulva owners).

This speaks to the importance of slowing down and spending time on non-genital and non-penetrative sensual and sexual activities in the lead-up to penetration. This includes all five senses and the whole body, focusing on anything that feels sensual and sexually arousing to you.

I’ve heard breathwork is also important when navigating endo pain during sex, can you elaborate on this?

Awareness of, and playing around with different types of breath, is an invaluable tool both outside and inside of sexual intimacy. Slow breathing and focused diaphragmatic breathing support the activation of our parasympathetic nervous system and can reduce tension in our pelvic floor which is often a contributing factor to endo and penetrative pain.

An example of a down-regulating breath would be to extend your exhale, so it’s slightly longer than your inhale. Something like four seconds in and four to six seconds out. In a calm state, our body becomes more receptive to pleasure, connection and presence and can reduce hypervigilance and the fear of pain.

Synchronising breath with a partner can be deeply intimate and connecting. If you notice any discomfort, pain, stress or fear during sexual activity, come back to synchronised breathing with your partner while hugging. Use this as an opportunity to check in and see what can support your pleasure from here.

What sex toys do you suggest endo sufferers integrate into their sex lives? 

Toys, lubricants and sexual support items can increase comfort and pleasure for those suffering from endometriosis or any type of painful sex. External toys such as the Womanizer Premium 2 are specifically tailored with vulva pleasure anatomy in mind and increase arousal and pleasure during sexual play.

External vibrators such as the We-Vibe Touch X are a great all-rounder and can be used on the nipples, clitoris, vulva, external anus, penis, perineum and absolutely anywhere else you want! While it’s important to spend time becoming aroused before any penetrative activities, I always recommend lubricant (water-based if you are using toys or condoms).

Reducing the depth of penetration through shallow penetrative positions (such as the side-spooning position) or the use of a product such as the Lovehoney Health Penis Bumper can psychologically reduce the fear associated with deep penetrative pain as well as alleviate some physical pain.

Does your partner have endometriosis? Here’s how to support them.