4 Best Sex Positions For Endometriosis

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. 


Women who suffer with Endometriosis not only suffer from daily pain.  They also suffer with pain during intercourse.

Sex is crucial in relationships with one’s partner. The Debrot et al. study proved sex provides a stronger, more positive and psychological bond with one’s partner. 

Good Sex Positions For Endometriosis Are Focused Around REDUCING Pain

Not every woman with endometriosis experiences pain during sex.  But for those who do, they have found certain positions to be more comfortable than others.  

A few key things to remember to help reduce pain are:

  • It may be less painful during the last weeks after ovulation 
  • Use plenty of lubrication during sex
  • Communicate with your partner about your comfort and pain level
  • Try different positions

Why Do Some Positions Cause More Pain Than Others?

Some positions are painful to women suffering from endometriosis due to the penetration, inflammation, and lesions that are sitting very close to the uterosacral nerve.  Certain sexual positions may cause more pressure on the pelvis, resulting in pain.

The etiology is that some of these lesions can be sitting on the sacral spine and sacral nerve roots (S2, S3, S4) and on the branches of the pudendal nerve - which is the main branch supplying the pelvic floor and generator of pain.

Painful sex or dsypareunia is one of the symptoms of endometriosis.  If you are experiencing painful sex, be sure to consult with your doctor.  

What If Your Partner REALLY Wants To Do Certain Positions That Hurt You?

It's important to be open and honest with your partner. Do not feel pressured to do certain positions that hurt you. 

Your male partner may feel rejected as if he is underperforming.  By communicating that certain positions hurt you due to endometriosis may help improve your overall sexual relationship and ease the stress of performance.  

Have a conversation about your sexual relationship.  This conversation may include explaining what endometriosis is and how it affects your daily and sexual life.  

Ensure you tell your partner which sexual positions are uncomfortable for you.  

Sex should be pleasurable and comfortable for you and your partner.  Bring up the issue as often as needed.  

Communication is key.  

1. Missionary

Missionary tends to be the most painful for women suffering with endometriosis.  This is due to the depth of penetration and the way the uterus is tilted.

However, using a pillow to help angle your pelvis and elevate your hips may help reduce some of the pain. 

Why This Is Likely To Cause Less Pain?

By using a pillow to elevate your hips gives a different angle and relieves some of the direct penetration. 

Since missionary is such a popular position, we want to give you tips on ways to reduce pain with this position.

How To Do It:

The woman is on bottom with her partner on top. The missionary position allows for more eye to eye contact with the man having more control of the force of penetration.

2. Girl on Top

Being on top allows you to control the depth of penetration. Since you're controlling the tempo, the depth, the force, etc, you're able to ensure that you experience as little pain as possible.

Why This Is Likely To Cause Less Pain?

Being on top allows you to take full control. Controlling the depth of penetration and pace will allow you to control any pain or discomfort you may experience during intercourse.

How To Do It:

You can perform this sex position wherever you'd like, as long as the woman is on top.  Your partner can be sitting in a chair, lying in bed, or lying on the floor.

3. Side Cuddle / Spooning

Side cuddle/spooning is often thought of as the laziest position. However, it’s a good sex position for women with endometriosis to control the pain.

Why This Is Likely To Cause Less Pain?

Spooning is less likely to cause the woman pain because the woman can control thrust by raising or lowering her leg. She can also take control of the tempo.

How To Do It:

Both partners lie on their side in a cuddling position.  The woman in front, as her partner cuddles from behind.

4. 69 (If Penetration Is Too Painful)

This sexual position is known as "69" because of the way it looks with the positioning of your partner's mouth to your vagina.

“69” allows you and your partner to perform oral sex on one another simultaneously.  Penetration is not the only way to fulfill one’s sexual needs. Oral sex is an excellent alternative to intercourse.  

Why This Is Likely To Cause Less Pain?

69 (oral sex) is less likely to cause pain because there is no penetration.

How To Do It:

  • You on the top - this allows you to control how much pressure you receive. 
  • Side-by-side - you and your partner lay facing one another with your mouth to their genitals.
  • You on the bottom - let your partner take control. 

With each of these positions, your mouth is always facing the same direction as one another's genitals.

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