5 Best Sex Positions for Endometriosis

Endometriosis already asks a lot of you: your energy, your attention, your heating pad budget. So when sex becomes painful,
it can feel unfair in a very personal waylike your body is turning down the volume on pleasure and cranking up the discomfort.
The good news: pain with sex is common with endometriosis, and there are practical, comfort-first ways to make intimacy feel
safer, gentler, and more enjoyable again.

This guide focuses on five “best bet” positions that tend to reduce endometriosis-related pain because they emphasize control,
support, and shallow depth. We’ll also cover prep tips that matter just as much as the position itself (hello, lube and pillows),
plus what to do when pain keeps showing up. Think of this as your “mission plan” for comfortbecause you deserve intimacy that
doesn’t come with a side of regret.

A quick note on safety, consent, and medical context

This article is for health education. If you have recurring pain during or after sex, it’s a valid reason to talk with a
clinicianespecially if the pain is new, worsening, or impacting your quality of life. Also: you never have to push through pain
to “finish.” Stopping is not failure. It’s good body data.

Why endometriosis can make sex painful

Pain with sex is often called dyspareunia. With endometriosis, discomfort may be linked to inflammation,
adhesions (scar-like tissue), irritated pelvic nerves, or endometriosis lesions in areas that get tugged or pressured during
intercourse. Some people feel pain during sex; others feel it after, like a delayed “no thank you” from the pelvis.

Another common piece of the puzzle is the pelvic floor. When sex has hurt before, the body can learn to bracetightening pelvic
muscles as a protective reflex. Unfortunately, that guarding can make sex more painful, creating a frustrating loop:
pain → tension → more pain. This is why comfort strategies aren’t just “tips”; they’re often part of breaking a real pain cycle.

Before you try positions: the comfort checklist (the unsexy part that helps the sexy part)

Positions matter, but they work best when you set the stage. Here are the prep steps people with endometriosis and clinicians
commonly recommend to reduce pain and increase control:

1) Pick your timing (yes, it counts)

Many people notice pain changes across the menstrual cycle. If you tend to flare around ovulation or right before your period,
plan intimacy for lower-symptom days when possible. “Spontaneous” is overrated; “comfortable” is elite.

2) Warm upphysically and emotionally

Rushing is the enemy of comfort. Longer foreplay, slower pace, and relaxation help pelvic muscles soften instead of clench.
If anxiety is part of the experience (very common after painful sex), a brief resetdeep breathing, a warm shower, or simply
talkingcan make a measurable difference.

3) Lubrication is a tool, not a commentary

Friction can amplify pain fast. A generous amount of water- or silicone-based lubricant can help, especially if dryness is present
or if you’re using condoms. If you have sensitive skin, choose fragrance-free options and avoid products that sting or irritate.

4) Consider support: pillows, wedges, and the “angle upgrade”

Pillows aren’t just for sleepthey’re for geometry. Supporting hips, knees, or lower back can reduce strain and help you find an
angle that feels less “deep pressure” and more “okay, this could work.”

5) Use a pain scale and a stop-signal

Agree on a quick check-in phrase (“yellow means slow down,” “red means stop”) or a hand signal. If pain rises above a mild level,
pause. Your comfort is the point, not a hurdle.

The 5 best sex positions for endometriosis (comfort-first picks)

These positions tend to help because they prioritize control over depth, speed, and anglethree factors that often influence
endometriosis pain. Use them as starting points, not rules. Your body gets the final vote.

1) You-in-control on top

When you’re on top, you can usually control pace, angle, and how deep things go. That control is a big deal for endometriosis,
where deeper pressure can trigger pain for some people. Start slow, keep movements small, and adjust your torso position until it
feels more comfortable. If you like structure, treat it like a “volume knob”: tiny changes can matter.

Comfort tweak: use a pillow behind your partner’s lower back or under your own knees so you’re not doing an accidental leg day.
The goal is relaxed support, not athletic achievement.

2) Side-lying (spooning-style)

Side-lying positions often reduce intensity because they can limit depth and keep the body more relaxed. For many people, this is
a “gentle default” option: less pressure, less strain on hips and lower back, and easier communication (“too much” is simpler to
express when you’re not doing complicated choreography).

Comfort tweak: place a pillow between knees to reduce hip tension and pelvic floor guarding. If something feels pokey or sharp,
change the angle or pausethis position is meant to be soft and adjustable.

3) Seated, face-to-face (upright and supported)

An upright, seated setup can help some people feel more in control and reduce uncomfortable pressure. It also keeps intimacy close
and communication easyuseful if you’re experimenting to find what your body tolerates. The key is support: a chair, couch, or
sturdy surface that lets you relax your core and pelvis.

Comfort tweak: keep feet supported (on the floor or a footrest). If your legs dangle, your pelvis may tense. Pillows behind the
lower back can also help you find a neutral, comfortable angle.

4) Supported from behind (slow pace, shallow depth)

Some people find a “from behind” setup more comfortable when it’s modified for support and gentlenessespecially when it keeps
pressure from feeling too deep. The trick is to treat this as a slow, small-movement position rather than a
high-intensity one.

Comfort tweak: add pillows under the hips or torso so the pelvis isn’t bearing strain. Keep the pace controlled, and avoid angles
that increase deep pressure. If this position triggers pain for you, skip itthere is no universal winner.

5) Modified face-to-face with “pillow engineering”

Classic face-to-face positions can be comfortable for some people when they’re modified to reduce depth and strain. Elevating the
hips slightly (with a pillow or wedge) can change the angle in a way that feels gentler. Think: supported, slow, and easy to stop
if discomfort appears.

Comfort tweak: try a wedge pillow under hips or lower back support under the partner who is lying down. The smallest changes can
shift pressure away from tender areas. And yes, it’s okay if the bedroom starts to resemble a pillow fortcomfort is a design
aesthetic.

What if sex still hurts? The next steps that actually help

If pain persists, it doesn’t mean you picked the “wrong” position. It may mean your body needs additional support beyond
positioning. Here are evidence-informed next steps commonly recommended by clinicians:

Track patterns

Note when pain happens (during, after, specific times in your cycle), where it feels located, and what improves or worsens it.
This kind of tracking helps a clinician evaluate potential contributors and tailor treatment.

Talk with a healthcare professional

Pain with sex can have multiple causesendometriosis, pelvic floor dysfunction, infections, ovarian cysts, vaginal dryness, or
other gynecologic conditions. A clinician can help rule out treatable causes and discuss options like hormonal management,
pain strategies, or referral to a specialist.

Ask about pelvic floor physical therapy or sex therapy

Pelvic floor PT can be especially helpful if muscle tension or guarding is part of your pain pattern. Counseling or sex therapy
can also help if fear of pain, anxiety, or relationship stress has built up around intimacy. This is not “all in your head”;
it’s your nervous system doing its job a little too aggressively.

Know when to seek urgent care

Severe pain, heavy bleeding, fever, fainting, or symptoms that feel alarming deserve prompt medical attention. Trust your instincts.

Real-world experiences: what people with endometriosis often learn (and wish they’d known sooner)

If you talk to enough people living with endometriosis (or clinicians who treat it), a few themes show up again and again. Not as
one-size-fits-all rulesmore like hard-earned wisdom. Here are common experiences and lessons that can make intimacy feel less
like a gamble.

Pain changes, even within the same week

Many people report that sex comfort depends on timing: some days are “maybe,” others are “absolutely not.” This variability can be
confusing, but it’s also useful information. Tracking symptoms helps you stop blaming yourself and start predicting patterns.
Knowing your personal rhythm can make intimacy feel more planned in a good waylike choosing the right day for a hike, not forcing
it during a thunderstorm.

Control is calming (for the body and the brain)

People often describe feeling safer in positions where they can control pace and depth. That control reduces the “brace reflex,”
which can lower pelvic floor tension. In practice, this means comfort-friendly positioning plus clear communication: “slower,”
“shallower,” “pause,” “different angle,” or “let’s switch.” The couples who do best aren’t the ones who never have painthey’re
the ones who treat feedback as normal, not awkward.

Pillows are surprisingly emotional support objects

It sounds silly until you’ve lived it: the right pillow placement can turn a painful angle into a tolerable one. People often
mention experimenting with a wedge, a firm pillow under hips, or support between knees. Over time, pillows become less like a
“medical device” and more like a comfort ritual: a sign that your body deserves care, not pressure to perform.

“Outercourse” (non-penetrative intimacy) is not a consolation prize

Another common experience: redefining what counts as sex. When penetration is painful, couples often explore intimacy that focuses
on connection and pleasure without triggering symptoms. Many people say this shift reduced anxiety and improved closenessbecause
it removed the looming question of “Will it hurt this time?” and replaced it with “What feels good and safe right now?”

It’s normal to grieveand still be hopeful

Endometriosis can take up space in a relationship, even a great one. People describe frustration, sadness, or feeling “broken”
when sex hurts. But they also describe progress: better treatment plans, better communication, better boundaries, and better sex
over time. The turning point is often permissionpermission to stop, to speak up, to ask for help, and to treat pain as a health
issue, not a personal shortcoming.

A practical script many people find helpful

If you’re not sure how to talk about painful sex, try something like:
“I want to be close to you, and I also need to protect my body. Can we go slower, check in more often, and switch positions if
something doesn’t feel right? If I say ‘pause,’ I need us to stop without questions.”
Simple. Clear. Kind. Effective.

Conclusion

The “best” sex positions for endometriosis aren’t about being adventurousthey’re about being strategic. Prioritize control,
support, and gentle angles; use lube and pillows like the MVPs they are; and treat pain as actionable information, not something
to endure. If sex is repeatedly painful, you deserve medical support and a plan that addresses the underlying cause. Comfort and
pleasure aren’t incompatible with endometriosisthey just may require a more thoughtful approach (and, yes, a few extra pillows).