Endometriosis Awareness Month: OB/GYN Mary Jane Minkin, MD Offers Advice for Navigating Sexual & Reproductive Health

March 24, 2022 at 14:55 PM EDT

As endometriosis, a disorder that occurs when endometriotic tissue grows on the outside of the uterus, affects more than 11% of women in the U.S., awareness of symptoms and proper diagnosis is critical. Mary Jane Minkin, MD, OB/GYN, Clinical Professor of Obstetrics, Gynecology, and Reproductive Sciences at Yale University School of Medicine, and founder of MadameOvary.com, offers advice for those living with endometriosis and what to do if one thinks they might be experiencing it.

“The pain and discomfort associated with endometriosis is unique to each person. The amount and type of physical pain can vary, and because of this, it can often be a very isolating condition. Women and couples may also experience emotional pain and frustration with the inability to conceive,” says Dr. Minkin. “However, over the years, endometriosis awareness has become more prominent and continues to improve today. Contrary to past beliefs, endometriosis affects not only older women, but is a condition that can affect those as young as teenagers. It is important that those living with this condition, no matter their age, seek out suitable treatment and solutions that are right for them.”

Whether dealing with everyday pain and discomfort, coping with infertility struggles, or facing challenges with intimacy, Dr. Minkin shares advice to help women advocate for their health and take proactive steps to improve quality of life:

Tell your gyno everything and be honest about your symptoms – Experiencing pelvic pain or discomfort is the most common symptom of endometriosis, particularly if the pain grows to be constant. Sharing any kind of pain or other concerns that you may have with a gynecologist, like abnormally painful periods, excessive bleeding, lower back pain with menstruation, or discomfort while urinating is crucial in evaluating and diagnosing symptoms as soon as possible.
Educate your partner – It is normal for partners of those with endometriosis to feel helpless in the situation, so involving your partner in your experience is a must. Informing a partner of any symptoms that may interfere with intimacy, like pelvic pain, the type of pain, and where the pain is concentrated, fatigue, or heavy bleeding, can help them feel involved and informed. The best thing you can do is communicate openly and honestly about your condition and symptoms so that you can navigate any obstacles together.
Experiment with positions – Many women with endometriosis can experience discomfort with penetration as it can cause pulling or stretching of the irritated tissue. Positions like spooning or lying face down during sex may be more pleasurable as penetration is shallower in these positions. Using a vaginal moisturizer like Replens Long-Lasting, or Replens Silky Smooth silicone lubricant can aid in any dryness and ease irritation that may occur during intercourse. If penetrative sex causes too much discomfort, try options like foreplay, oral sex, and mutual masturbation. For couples that want to incorporate sex toys in the bedroom, I recommend choosing one that focuses on clitoral stimulation, such as the Trojan Pulse compact vibrator, instead of an internal device to avoid more pain and discomfort.
Find fertility support – It can be more difficult to become pregnant with endometriosis, as research shows 30-50% of women with the disease may experience difficulties with fertility. Considering that endometriosis can worsen over time as the endometrium continues to grow in the abdomen and block reproductive organs, it is important to discuss all possible options when trying to conceive, including fertility treatments. There are also products that can aid in conception, like Pre-Seed Fertility Lubricant that helps support sperm quality and can help enhance comfortability and desired intimacy as well.
Lower your risk and take back control – Although we can’t completely prevent endometriosis, there are steps to take to lower your risk and control symptoms. Low dose combined hormonal contraceptives can help suppress the growth of endometriotic tissue and can help control pain and bleeding. Other steps to take to prevent progression of endometriosis and control symptoms include regular exercise four to five times a week and cutting back on alcohol and caffeine as these can raise the amount of estrogen in the body. There are new emerging surgical and non-surgical treatments available for endometriosis, so you do not have to live with debilitating symptoms. Be sure to talk to your doctor about your options and be proactive in controlling symptoms and lowering your chances of developing endometriosis.

“I suggest that any woman who is experiencing unexplained pelvic pain, painful sex, or is having trouble conceiving should check in with her gynecological healthcare provider for an evaluation to learn more about endometriosis, helpful options for treatment and other solutions,” adds Dr. Minkin.