Masturbation 101: A Guide for People With Endometriosis

Sexual pleasure is a sore topic for many individuals living with chronic illness—this is especially true for people with endometriosis (myself included). This is because, for many of us, sex almost always results in pain, and not in a good way.

Endometriosis drove a wedge right between me and my soon-to-be-husband. Before my official endometriosis diagnosis, I couldn’t bear the thought of sex—let alone masturbation. Instead of reaching out for help or communicating this pain to my partner, I kept my mouth shut and "dealt" with it. That silence eventually turned into resentment and I regularly thought about how much I hated him for using me (and for acting oblivious to what was going on). But, how could he know? I hadn’t said a word.

My silence eventually led to a disconnect — I became physically and emotionally unavailable, to him and to myself. I didn’t want to believe that I was “broken,” so instead of dealing with the issue head-on, I ignored it. Until one day, I snapped. I had a complete breakdown; sobbing, I told my partner every gut-wrenching detail, from lying in the fetal position on the shower floor to fuming with rage while he slept next to me.

Opening that line of communication was the first step to getting my life and my relationship back to where they needed to be. My diagnosis led to the validation I needed to accept that this may be an issue that I’ll have to deal with for the rest of my life and that acceptance taught me how to be an advocate for myself and for others.

What Is Endometriosis?

Endometriosis is a chronic, inflammatory condition in which endometrial-like tissue grows outside of the uterus. This tissue can grow literally anywhere in the body, including a person’s ovaries, fallopian tubes, and the lining of their pelvis.

Endometriosis can also grow within the bladder, bowel, and rectum, among other areas of the body. The only place endometriosis hasn’t been found is the spleen.

Endometriosis lesions grow only to break down during menstruation. But, because this tissue isn’t within the uterus, it has no way for it to escape. This trapped tissue then becomes inflamed, causing scars, cysts, adhesions, and a lot of pain.

If this tissue grows behind the vagina or becomes stuck between the vagina and the front of the rectum, penetration can pull or stretch it—which can be extremely painful. There are ways, however, to manage the pain and repair your relationship to sex. And, you may want to brace yourself for this: Sometimes, this reunion (between you and your sex life) starts with the OG form of self-love: masturbation.

Take Charge of Your Sex Life

In celebration of Masturbation Month, I’ve created the ultimate masturbation guide for people with endometriosis. In it, you’ll learn how to fall in love with yourself all over again, have an orgasm sans pain, and take charge of your sex life. This may seem like an outlandish claim, but trust me—I’m living proof that there is hope for your sexual independence. I also included advice from some of my favorite experts in the sexual health and wellness space.

Read: 8 Tips for Having the Best Masturbation Month Ever!

Be Open and Honest

Being open and honest with yourself and your partner is a great first step to take to get things back on track. This means paying attention to your pain points (i.e. vaginal penetration) and then discussing those issues with your partner and your doctor.

“Whether it’s solo or partner sex, you can improve your sex life by being open and honest,” says Megwyn White, a certified clinical sexologist and the Director of Education at Satisfyer. “It’s also important to be in constant communication with your doctor if you’re experiencing changing symptoms during sex or masturbation.”

Living with endometriosis can leave you feeling broken, sometimes in more ways than one. It’s important to remember that you have a right to sexual pleasure, too. Once you’ve made that realization, you’ll be able to create a pain management and intimacy plan that works for you.

“Sex with endometriosis can be incredibly painful and can lead to a disconnection between self, pleasure, and sex,” says Kate Balestrieri, a licensed psychologist, certified sex therapist, certified sex addiction therapist, and Founder of Modern Intimacy. “There is an element of powerlessness that often accompanies endometriosis and the pain that can accompany sex as a result. To reconnect with sex, the first step is to take your power back.”

Reconnect with Yourself

An issue that I struggled with was breaking the cycle of chronic pain, also known as anticipatory pain. Endometriosis is a whole-body condition and pain can very quickly become the only thing your body knows. So, if you’re used to being in pain either before, during, or after sex, your body will begin to anticipate that pain.

“Anticipatory pain can be especially challenging. Consider working with a sex therapist or sex coach as it can be a safe space for you to talk about your endometriosis and your sexuality while getting support from a qualified professional,” says White. “Having someone outside of your friends and family that can offer you specific suggestions and techniques while also letting you vent can be a wonderful way to get your power back and tap into your sexual mojo.”

If you’re not into the idea of talking about your sex life, keeping a pain journal is a great way to determine what works and what doesn’t. In it, write out your triggers, track your menstrual cycle, and make notes of the positions you tried and how it felt.

Explore your Body

Don’t try to do too much at once. Go slow and learn to appreciate yourself, your body, and the pleasure methods that work for you.

Read: 7 Ways to Incorporate More Lube into Sex With Yourself (Including CBD Lube!)

“Sex is a whole-body experience,” says Balestrieri. “By emphasizing the other aspects of your body, you can create pleasure on a multisensory scale, making penetration one of many options you can consider when you’re feeling sexual, but not the only option if it’s too painful.”