Endometriosis is a really common and often very painful condition that affects approximately one in seven Australian people assigned female at birth.
Despite how common endometriosis is, it can be misunderstood and mis- and under-diagnosed. Endometriosis (often just called ‘endo’) can also have a big impact on the lives of those who have it, including the way they experience intimacy, dating, and sex.
In this article we’ll talk about endo: what it is, what it can look like for those who live with it, and what diagnosis looks like. We’ll also offer guidance on how to approach sex and dating with endo—and how to support your partner or friend who has endo.
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Endometriosis occurs when tissue similar to that of the lining of the uterus (endometrial-like tissue) grows outside the uterus. Often, but not always, this tissue grows on other organs in the pelvic region, like the ovaries, bladder, and bowel.
Although this tissue doesn’t shed in exactly the same way as the uterine lining sheds, it can still cause severe pain, scarring and inflammation for people with endo. Endo can also cause and exacerbate heavy periods, irregular periods, fatigue, pain when using the toilet, pain during and after sex, and infertility. For some, symptoms can fluctuate over time or worsen with stress, hormonal changes, or exhaustion.
That having been said, some people with endo have minimal symptoms—or none at all. It doesn’t look the same for everyone. The fact that endo presents with such a wide range of symptoms of varying severity means that some people with endo struggle to obtain a diagnosis. Endometriosis Australia notes that the current average time for diagnosis in Australia is between six and eight years.
Another barrier to diagnosis is the normalisation of pain. Many of us are told that a lot of the symptoms—like heavy, irregular, or painful periods—are normal, and don’t represent a problem. People with endo can be told that they’re too sensitive or overreacting to normal levels of pain when in reality that just isn’t the case.
Receiving a diagnosis of endometriosis can be really important for those living with it. Not only is it validating but it can be the first step on the road to accessing treatment, which can include medications that lessen the symptoms of endo or treat the pain associated with it, surgeries to remove endometrial tissue, or complementary therapies.
If you’re living with the symptoms of endometriosis, we want you to know that you’re not alone. While diagnosis can be tough, we hope that the increasing amount of attention on endo will make it easier and quicker for people to access diagnosis and treatment.
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There’s no denying that endometriosis can have an affect on how we experience sex, dating, and intimacy. Endo often causes painful periods and more generalised pelvic pain, but it can also cause pain during sex, which has a direct influence on how we experience intimacy.
Endo can also feel like a really ‘unsexy’ thing to talk about, even though it shouldn’t. Having that first conversation with a partner about endo and its effects on our body can be tough, and constantly navigating the symptoms while also trying to put effort into sex and dating can be exhausting.
We’ve put together some guidance to help both people with endo and their partners navigate sex, dating, and intimacy.
If your partner has endo…
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Learn as much about endo as you can. Your partner is the expert on their own experience, but it can be deeply meaningful when you take the initiative to educate yourself. Doing your own research isn’t about correcting or explaining their body to them, it’s a way of showing care, shared responsibility, and letting them know they don’t have to navigate this on their own.
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Support them as they find the right treatment. They may have to try one or more treatments to find the right one for them. Not every endo treatment works for everyone with endo, so support them as they find the one that’s best for their needs.
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Stay flexible. Understand that even if your partner wants to be intimate, their body and their symptoms may prevent them from doing so. Be open to changing your plans or your expectations to accommodate what your partner is able to do. Follow pleasure, be sexual in a way that feels like connecting rather than focusing on what it ‘should’ look like.
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Keep the lines of communication open. Discuss your desires, needs, and wants together. Stay curious and open-minded if you decide to explore potential alternatives to penetrative sex. Remind them, that sex is only good for both of you when it is free from pain, that you want to stop and try something new if anything is uncomfortable, offer different ways you two can have sex - be the one to share the modifications that feels exciting for you too.
- Separate pain from rejection. If sex needs to stop or change, it’s about pain — not lack of attraction or love. Naming this out loud can reduce misunderstanding and hurt.
If you have endo…
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Track your symptoms. As we said in our blog about PCOS, tracking your symptoms can help you to find patterns in your body and your experiences. It can also be really useful to have your symptoms written down and recorded for your next medical appointment.
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Have ‘the conversation’ when you’re ready. Don’t feel that you have to discuss endo as soon as you meet someone new—unless you really want to! If you want to talk about endo with a new date or potential partner, wait until the moment feels right for you.
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Listen to your body. A lot of people with endo are told that their symptoms are normal and that they’re just ‘sensitive’ or overexaggerating normal pain. You’re the expert on what you’re feeling—if something feels wrong or abnormal, pay attention to it.
- Focus on what feels good. If penetrative sex is off the menu but you’re still in the mood for intimacy, shift your attention to a type of touch or play that does feel good. Maybe it’s using an external vibe, sharing some erotica with your partner, or even just a sexy make-out sesh.
Together during sex:
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Build desire outside the bedroom. Flirting, affection, erotic messaging, and emotional closeness throughout the day help desire feel less pressured at the moment of sex. Do this everyday, reminding each other that flirting isn’t about the short term leading to sex, it’s about the long-term health of the sexual relationship.
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Stay in active communication. Check in during sex, not just before or after. Use clear language like “softer,” “shallower,” “pause,” or “that feels good.” Pain should never be pushed through.
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Experiment with positions and supports. Lying on your side, spooning, or positions where the person with endo can control depth and pace are often more comfortable. Pillows, wedges, or rolled towels can make a big difference.
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Use lots of lubrication. Vaginal dryness is common with endo and hormonal treatments. Generous, high-quality lube can significantly reduce friction and discomfort.
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Take penetration off the pedestal. Sex doesn’t have to involve penetration to be intimate or satisfying. Exploring hands, mouths, toys, mutual masturbation, or sensual touch can reduce pain while prioritising connection and pleasure in your relationship.
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Work with your body, not against it. Track when pain or fatigue is lower and plan intimacy around those windows. On harder days, choosing closeness over performance like being physically close, massage, or erotic talk.
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Slow everything down. Arousal takes time, especially when pain is present. Longer warm-up, gentler pacing, and gradual transitions help the nervous system feel safer and can reduce pain during sex.
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Get support together if needed. A sex therapist, pelvic health physiotherapist, or pain-informed clinician can help couples find ways to maintain pleasure, intimacy, and connection without causing harm.
References
- Endometriosis Australia. “What is endometriosis?”. Endometriosis Australia. Accessed 14 December 2025. https://endometriosisaustralia.org/what-is-endometriosis/.
- Epworth Healthcare. “Endometriosis | What is it and who does it affect?”. Epworth Healthcare. Accessed 14 December 2025. https://www.epworth.org.au/our-services/endometriosis-centre/about-endometriosis/what-is-endometriosis.
