Medically Reviewed by Dr. Melissa Thompson, PT, DPT, MTC
Dr. Thompson is board certified and the owner of Louisiana Pelvic Health. Her expertise is in alleviating bladder, bowel, and sexual pain symptoms during pregnancy, postpartum, and throughout a woman's life.
Libido, sex drive, mojo... whatever you want to call it, endometriosis can do a number on yours.
Endo can have a negative effect on relationships as a whole, not only because those with can experience large amounts of abdominal pain and hormonal imbalances, but it can also cause your sex life to suffer.
Thankfully, you don’t have to be stuck with low sex drive. There are some pretty easy things you can do to increase it.
What is dyspareunia?
Simply, dyspareunia is the medical term for painful intercourse and because of it, endometriosis and sex drive (or lack of) can be closely related for many women.
It can vary from person to person, but during ovulation the pain caused by inflammation can be at its peak.
This causes a decrease in sex drive based on the fact that there is often dyspareunia.
What causes endometriosis symptoms to flare up?
When the endometrial tissue begins to grow outside of the uterus, inflammation occurs in the growth areas, causing most of the issues.
Depending on the stage and location of endometrial tissue, some women only experience flare-ups during ovulation and some can be in pain and fatigued the whole month.
While there are many factors that can cause a flare-up, doing things like changing your diet and living a healthy lifestyle can help reduce chronic pain.
Sounds like a bleak, no-win situation? Not at all! Don’t worry, there are things that you can do to help get your libido back.
But, does endometriosis actually cause low sex drive?
Endometriosis itself doesn't cause low sex drive. But, the symptoms of endometriosis - dyspareunia, emotional pain & disconnect during sex, fewer orgasms, less sexual satisfaction due to female dryness, and more can lead to decreased libido.
Ways to increase your libido
There are two main areas to focus on when you are looking to increase your sex drive.
First would be in the physical category and second would be in the emotional category. By combining the two, you have the greatest chance of making a long-term change for yourself.
Let’s dive into each one.
Physical ways to increase sex drive
Some women say that the pain from sex is so great that it isn’t worth the climax at the end. Chronic pain is no joke and most people don’t want to sign on to making things worse.
1. Try Tracking Your Cycle:
To help with this, try tracking your cycle and see what times of the month the pain is decreased. For many this will be a week after ovulation or two weeks after menstruation. Even set a timer on your phone (or on your partner’s calendar) that it is a low risk day for endo flare ups during sex.
2. Use Lube
Using lube is really helpful! This is an important one. Find a good lubrication and when you think you have applied enough, apply a bit more.
3. Reducing Inflammation:
Keeping the inflammation at bay is a big help when trying to lower the pain during sex and thus increase your drive to want it.
4. Try other things besides intercourse:
You may find that you like things, like types of foreplay, that don’t cause you pain. These may be good alternatives if you are experiencing pain but still want to be intimate. In addition, foreplay can help get you in the mood.
Emotional ways to increase sex drive
There is a large emotional component to sex drive.
It is natural that if you are having anxiety over the pain you think you will experience during sex then your body may react in a way that will decrease your desire for it.
To help avoid this, try to communicate with your intended partner about what it means to have endometriosis.
Communication - but a little different than you think:
By feeling like you have someone aware and understanding of potential problems that arise, you can go into the bedroom with less angst about trying something out that will cause you pain.
Remember that there can be reluctance on both sides that can have an effect on libido. Your partner may not want to hurt or upset you by bringing it up.
By making it an open conversation you can help your partner understand that finding out what works for you may be an experimental process, but you can make a game out of it together instead of just putting up with sex enduring any the pain it causes.
It's about making him understand more about you AND endometriosis. Because let's be honest, how can he understand without you teaching him, pointing him in the right direction, or him doing in-depth research by himself?
What are treatments besides endometriosis surgery?
While there is no perfect cure, there are a few endometriosis treatments that you can employ, both outside of surgery and the bedroom, to help the chance of increasing your desire to get back into it.
1. Look into changing your diet.
That will help to decrease inflammation can help reduce the pain. When you don’t fear the pain that sex will bring, you may start to see a natural increase in your sex drive.
By increasing the oxygen in your system and blood flow, you can do wonders on reducing the monthly discomfort.
Just with these two changes, you can help to increase your libido.
So while the symptoms of endometriosis can affect your sex drive, take the power back into your own hands and study your body and individual symptoms.
Make the decision to work at getting your sex drive back and you may be surprised by the results.
3. Make an appointment with a Pelvic Floor Physical Therapist
Pelvic PT is one of the first lines of conservative care for dyspareunia. While pelvic PT cannot cure the root of disease, it can help make the secondary effects of painful sex more comfortable and help get out the cycle of pain.
Most women have tight pelvic floors, so penetration can hurt adding to the psychological factors of producing less moisture and losing sex drive. Combining physical therapy, endometriosis treatment, and using a lubricant would be comprehensive care.