Pain after intercourse as a symptom of endometriosis

How common is the symptom Pain after intercourse among people with endometriosis?

83,97% of people with endometriosis reported Pain after intercourse as a symptom of endometriosis in our survey.

How common is the symptom Pain after intercourse among people with endometriosis compared to the non-affected group?

21,56% of people with endometriosis suffer from the symptom Pain after intercourse very strong compared to a prevalence of 3,80% among non-affected individuals.
The following table shows the symptom Pain after intercourse in people with endometriosis compared to non-affected individuals. The scale ranges from 1 (not at all) to 5 (very strong).

Symptom Pain after intercourse in endometriosis - comparison with control group

Pain after intercourse in endometriosis
(n = 1716)
16,03%
14,57%
24,30%
23,54%
21,56%
Pain after intercourse in non-affected individuals
(n = 158)
63,92%
18,99%
11,39%
1,90%
3,80%

Tabular comparison of the prevalence of Pain after intercourse

Symptom severity Endometriosis Non-affected Comparison
not at all 16,03% 63,92% -47,90%
slightly 14,57% 18,99% -4,42%
moderate 24,30% 11,39% 12,91%
strong 23,54% 1,90% 21,64%
very strong 21,56% 3,80% 17,76%

Symptoms that could be related to Pain after intercourse

Based on the datasets, we calculated the Kendall correlation. The following symptoms could be related to Pain after intercourse.

Symptom name Correlation
Pain during intercourse strong correlation (67,00%)
Vaginismus moderate correlation (31,00%)
Pain during urination weak correlation (27,00%)
Bloated belly / Endo-Belly weak correlation (22,00%)
Lower abdominal pain weak correlation (22,00%)
Abdominal pain outside the lower abdomen weak correlation (22,00%)
Pain during bowel movements weak correlation (22,00%)
Exhaustion / Fatigue weak correlation (21,00%)
Kidney pain weak correlation (20,00%)
Joint pain weak correlation (20,00%)
Leg pain weak correlation (20,00%)

Pain after intercourse in endometriosis

Endometriosis can also be the cause of pain that occurs markedly after sexual intercourse. It is important to know that the pain actually begins during intercourse—but is only perceived later: Postcoital pain, if you have endometriosis, arises for the same reasons as pain during intercourse. The pain you notice is the “residual pain,” while the pain during intercourse was alleviated or completely suppressed by your body’s own painkillers. Sexual arousal, whether through activity with a partner or through masturbation, triggers the release of endorphins. These are messenger substances with analgesic or pain-blocking effects. Because they are broken down only gradually, it can sometimes take up to one or even two hours after intercourse before you perceive the pain.

The pain, even if initially eased by your body’s own pain relievers, is caused during the sexual act and not afterward: In endometriosis, tissue similar to the uterine lining grows in ectopic locations in the female body. The pelvis is particularly often affected. The uterosacral ligaments, the vagina, the rectum, and the ovaries can be involved. These lesions first grow during the cycle and then bleed, just as the endometrium in the uterus does. If the blood cannot be expelled from the body, cysts, adhesions, and inflammation can develop.

Sexual arousal leads to swelling and a pulsating sensation in the area of the female genital organs. Because of adhesions, traction is exerted on other organs, which triggers pain signals. Penetration during intercourse can also provoke pain. The more endorphins are released, the longer these pains are suppressed. Your sexual position also influences whether pain occurs and how intense it is. This means: robust endorphin release, for example through prolonged foreplay, and a “suitable” position during intercourse can result in you perceiving the pain only after intercourse and not already during the sexual act.  

Did you know that you can also have a big influence on endometriosis symptoms yourself? In the Endo App you learn self-management techniques for endometriosis and find many interactive exercises to relieve symptoms.