The best sex positions when you have endometriosis—and tips for reducing pain during intimacy

Endometriosis can cause a considerable amount of pain and discomfort during sex for some women, so understanding the best sex positions when you have endometriosis is essential. While the best sex toys and app-controlled vibrators can help ease you into the whole process slowly and at your own pace, finding a specific position that works for you is so important.

Painful sex whilst dealing with endometriosis can be discouraging and challenging to overcome. However, Sarah Coulson, of Your Natural Endometriosis Expert, assured those with endometriosis, "The first thing to remember about sex and endometriosis is that it doesn’t have to be an issue. Many people with endometriosis don’t have any issues when it comes to sex. For many more, though, pain (which comes predominantly from the scar tissue and the inflammation that we get with endo) and bleeding (during and after) can make the whole thing a less-then-pleasant experience."

Fortunately, there are ways to reduce the amount of pain you feel (if you do get pain) so that you can maintain a deep sexual connection with your partner. These positions help provide optimal comfort, relief, and pleasure, to ensure you don't miss out on the joy of sex. With open and honest communication about how you feel emotionally and physically, the following techniques will be fun and enjoyable for both you and your partner. 

The best sex positions when you have endometriosis

1. The seated lotus

If you're familiar with yoga positions (our "which yoga is best for beginners?" guide will get you up to speed if you're not), you may also be familiar with the Lotus position—and the Seated Lotus is the more intimate, sexual variation. 

To do it, your partner sits in a comfortable, seated position with their legs crossed, as you slowly (take your time!) position yourself on top and into penetration. You'll be face-to-face and chest-to-chest in this sex position. 

The beautiful part about this position is how emotionally and physically deep the connection can be. You are on top, so you have complete control over how deep and fast movements are. This way, you can adjust to a more pleasurable and comfortable experience to help you achieve an orgasm.

2. Missionary, with you on top

Much like The Seated Lotus, being on top is an essential factor in making this sex position a practical option for you. It may seem basic at first since missionary is a traditional sex position with you on top and the man on the bottom. However, it can be a great place to start experimenting with what works for you and your partner, and can be both passionate and intimate.

If you're comfortable, it is also worth letting your partner get on top. But if you do, it is vitally important to continue open communication on what you like and don't like, or what hurts and what doesn't. Have them go slow and refrain from deep thrusts, while you find the right rhythm to suit your comfort levels. Don't force it if it doesn't feel right—there are plenty of other options if this position isn't the right fit.

3. Modified spooning

Having sex in a spooning position can be a passionate and low-energy option for both you and your partner. While many people like to use variations of bent and curled-up motions, it is more beneficial for those with endometriosis to remain in a straight position, to avoid the potential pain of other angles. 

Slow and shallow thrusts can make a considerable difference in reducing the pain you experience while having sex in this position—which is why it's one of the best sex positions when you have endometriosis.

You can also try this position with different types of vibrators too, to intensify pleasure; hands-free vibrators can be a great place to start. 

4. Doggy style with (or without) modifications

Shallow positions that put less pressure on areas of the pelvis that contain endometrial tissue are some of the best sex positions when you have endometriosis. As such, Coulson explained: "Many women with endo find that ‘doggy style’ sex is less painful." 

Some women enjoy doggy style during sex without modifications; on their hands and knees while their partner penetrates from behind. However, that's not the case for all women. Consider modifying it to your liking if you're experiencing pain or discomfort in the traditional doggy-style sex position. You can move down to lie on your stomach rather than hands and knees and incorporate pillows and blankets for added comfort. 

This is also one of the best sex positions for the summer, given that your bodies aren't too close together during the heat.

Helpful tips for having sex with endometriosis 

Knowing the best sex positions when you have endometriosis can be incredibly beneficial for maintaining a happy and fulfilling sex life, but there are some additional tips and tricks for staying comfortable during intimacy too, that can be really helpful:

• Take note of when you feel most pain during your cycle—Sarah Coulson explained, "Many women also find that the levels of pain differ depending on where they are in their cycle—for some women, it’s more towards the end of their cycle, but many experience pain also around ovulation. Tune into your body and take notice of where and when you get the pain—knowing where you are in your cycle and how that correlates to your pain will help you avoid uncomfortable experiences."
• Keep a symptom diary—Sometimes, your cycle may not match up as expected though, so it could be a good idea to keep a symptom diary too. "It sounds really clinical and boring but tracking your sexual experiences can help you to identify patterns around your needs," Katherine Irene Glyde, a menstrual wellbeing coach, said. "It could be that particular cycle days are more painful than others, or certain positions are uncomfortable during different cycle phases. Working to really understand your body can be really beneficial here."
• Try a pain reliever—Taking a painkiller, such as paracetamol, around an hour before sex can help to reduce milder feelings of pain during sex, so it's a tip worth bearing in mind. It's important to note though that you should never take more than eight painkillers within 24 hours, and that painkillers can interact with some medications—always check with your doctor first if you are unsure. This tip won't always be possible, especially if you prefer morning sex, but it can be helpful to try.

• Practice relaxation techniques—Often, the anticipation of pain or awkwardness can make you feel tenser than ever, making penetrative sex all the more difficult. Coulson explained, "When you start to expect the pain, your muscles contract, which heightens your pain levels. Practice some relaxation techniques every day so that when it comes to sexy time, you know how to relax and calm those muscles (and your mind). Yoni yoga can help, but please do try this with an experienced practitioner to ensure you’re using the best techniques for your personal circumstances.  Pelvic floor specialists can also be a good point of contact, but please make sure they know specifically that you need support with your muscles relaxing, not strengthening."
• Use lube—Lube, especially natural lube, can help to reduce vaginal dryness and ease discomfort, sometimes minimizing the pain triggered by endometriosis. Coulson said, "Coconut oil is a fabulous natural lubricant, but please don’t use it if you’re using condoms as it will react with the latex." Bear in mind that if you use it, you'll still need lube during shower sex—the water actually dries your intimate areas out.
• Explore alternatives to penetration—sex doesn't always need to mean penetration, and sometimes exploring other options can be really beneficial in maintaining intimacy without pain. Coulson said, "Knowing how to pleasure each other without penetration, and knowing what penetration can work (and when) means that neither of you has to miss out." This can be especially helpful if painful sex means you struggle with a loss of desire and libido. Coulson encourages you to "take a step back; take the pressure off by just enjoying each other without penetrative sex for a while. You can slowly and gently start to reintroduce it but don’t put pressure on yourself, or do anything that makes it worse."
• Consult your doctor—But, if you're finding things really uncomfortable, Glyde suggests that you don't hesitate to contact a medical professional. She explained, "You may need support from a healthcare professional—in the first instance I would always recommend speaking to your GP to make sure there isn’t something else going on for you. There are so many options out there for support, it’s just a case of finding the right one for you."

Endometriosis has some limitations, but sex doesn't have to be one of them. Positions and tips vary from person to person, but the key is to find what fits best for you and start from there. It is also vital that you are open and honest with your partner about how you feel and what you like. Be clear about the importance of patience and practice, as it may take time to find what works for you both.