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Gynaecological conditions
Tissue similar to the uterine lining growing outside the uterus causes inflammation, adhesions, and deep pelvic pain, and the pain characteristically sits deep rather than at the entrance and is often worse in particular positions or at particular points in the cycle. Years of painful sex also teach the pelvic floor to guard, which adds a second, entrance-level pain on top of the original one.
See someone about this if
Editorial categories, not percentages, and never a prediction about you. Each links to the fuller picture of that change.
Burning, tearing, or aching pain with penetration. Pain is never a symptom to work around with a product — it is the one entry on this list that always deserves assessment.
Wanting sex less often, or losing the spontaneous interest that used to arrive on its own. This is the effect people most often assume is psychological and most often is not only psychological.
Sex stops happening because there is nothing left in the tank by the time there is an opportunity. A real medicine effect, not a motivation problem.
The body responds less, or much more slowly, even when the interest is there. Blood flow, nerve signalling, and hormone levels all feed this, and medicines can act on any of the three.
Less natural lubrication, a tight or raw feeling, or discomfort that arrives during rather than before sex. Medicines cause this either by drying mucous membranes generally or by lowering oestrogen.
Condition or treatment?
The hormonal treatments that suppress endometriosis also suppress oestrogen, which produces dryness and low desire of their own — and GnRH analogues do so profoundly. Opioids and gabapentinoids prescribed for the pain add sedation and hormonal suppression. So a treated person often has two overlapping causes and needs both named at the appointment.
For almost every condition on this site, the condition and the medicines that treat it both affect sex — by different mechanisms, on different timescales, and with different answers. Being able to say which half you are asking about is the single most useful thing you can bring to an appointment, and it is the thing patients are least often given.
Never stop, pause, reduce, or change a prescribed medicine because of anything on this page. Some of the medicines listed here are dangerous to stop suddenly, and the condition being treated does not pause while you experiment. Everything here exists to make your next conversation with a prescriber more specific — not to replace it.
Matters more if: menopause-related dryness; trying to conceive.
Tissue similar to the uterine lining growing outside the uterus causes inflammation, adhesions, and deep pelvic pain, and the pain characteristically sits deep rather than at the entrance and is often worse in particular positions or at particular points in the cycle. Years of painful sex also teach the pelvic floor to guard, which adds a second, entrance-level pain on top of the original one.
The effects reported most often are pain during penetration, lower sexual desire, and fatigue or sedation getting in the way. Reported does not mean inevitable — the picture varies a great deal between people, and most people have more than one thing contributing at once.
The hormonal treatments that suppress endometriosis also suppress oestrogen, which produces dryness and low desire of their own — and GnRH analogues do so profoundly. Opioids and gabapentinoids prescribed for the pain add sedation and hormonal suppression. So a treated person often has two overlapping causes and needs both named at the appointment. Timing is the most useful clue you have: an effect that appeared within weeks of starting or changing a treatment points at the treatment, while one that predates it points at the condition. Never stop, pause, or change a prescribed treatment to find out — take the timeline to the person who prescribed it.
The classes commonly used here that carry documented sexual effects are combined hormonal contraception, progestogen-only contraception, gnrh analogues, opioid pain medicines, and gabapentin and pregabalin. Each has its own profile, so which one you are on matters — and that is a prescribing conversation, never a reason to stop anything.
Position changes and timing around the cycle genuinely alter deep pain, and they cost nothing to test. Pelvic-floor physiotherapy addresses the guarding layer that builds on top of the original pain. Plenty of lubricant reduces the entrance-level component even when the deep pain is unchanged.
Sooner than most people do, and specifically without waiting: Pain that is escalating, or new bowel or bladder symptoms with it, needs review rather than adaptation.
Educational information about what a diagnosed condition tends to do — not a diagnosis, not a way to work out whether you have something, and not advice about your treatment. Conditions on this page overlap, and most people with a long-term condition have more than one thing affecting them at once. Nothing here can examine you or run a test. Pain, bleeding, or a new and unexplained symptom always deserves assessment.