More than just painful periods, endometriosis comes with another major symptom for some sufferers: painful sex. But does BDSM hold the key to pleasure in a world of pain?
When you think of sex, there’s a good chance you think of pleasure. Or at least the possibility of pleasure.
But, if you have endometriosis, the thought of sex—especially penetrative sex—might cause more anxiety than excitement, particularly if one of your symptoms is pain during penetration.
Amid a search for solutions, some sufferers are exploring BDSM as a way to transform their relationship with pleasure and pain—for the better.
But first, what exactly is endometriosis?
Aside from being tricky to pronounce, this chronic condition can be even trickier to define, as it’s so much more than just painful periods. Endometriosis occurs when tissue similar to the lining of the uterus grows outside of the uterus. This tissue can cause lesions to grow, bind organs together, and cause chronic inflammation. While endometriosis can be found on reproductive organs such as the vagina and ovaries, it’s also been found on other organs including the lungs—proving that it’s not just a “period” condition.
Because of how complex the condition is, some sufferers might have painful periods. Others may experience pain with bowel movements or urination, while some are left with agonizing pain during or after sex, making penetration difficult or impossible. This isn't just typical period cramping either—some sufferers describe the pain as feeling like being stabbed repeatedly, or like having barbed wire wrapped around their organs.
Among those who do experience symptoms around penetration, many understandably report feeling robbed of their sexuality, confidence, and libido—adding an extra layer of complexity to the condition, and their experience of intimacy.
Why does endometriosis cause pain during sex?
According to Consultant Gynaecological Surgeon and founder of The Endometriosis Clinic, Mr. Peter Barton-Smith, it can be down to a range of factors:
“There are multiple reasons why sex can be painful in endometriosis patients. Pain can be either in the skin of the vulva, lower down the vagina at the entrance, in the pelvic floor muscles, or deeper in, especially behind the cervix.” As Barton-Smith adds, pain can be caused by things like:
- direct physical contact with inflamed areas
- pelvic floor dysfunction and inflammation resulting in pain and tightness
- nerve irritation that feels like extreme tenderness or burning in the skin around the vulva and entrance to the vagina
- anxiety because pain is expected
For some, this means that penetration—whether with a penis or sex toy—and lack of lubrication can trigger the pain.
So when sex becomes associated with so much agony and fear, it’s little wonder some people abstain from it entirely.
But there is another option: to get a little creative. One method? Experimenting with BDSM to transform the experience of pain and pleasure.
How can BDSM help with endometriosis pain?
To overcome some of these challenges, two women share how BDSM—a type of kink that involves dominance, submission, and consensual power play between partners—has helped them exert control over their pain and experience pleasure again.
For Kelly*, a 40-year-old project manager from London, delving into power dynamics around foreplay (and diverting away from penetration) held the key. She explains:
“When I first experienced pain during sex, I was 32 and could barely leave my bed for days. This was the start of years of pain and fear, which made dating really hard. Every time a man pulled down his pants for the first time to do the ‘big reveal,’ my whole body would tense up and freeze if he was big. Size really did matter… and I needed small! Given my limitations, I became interested in sub-dom power play dynamics. While I had always been turned on by this, it allowed me to experience pleasure again.”
“Everything became about foreplay, and sometimes, for days,” she continues. “Being told what to wear, asking for permission to self-pleasure, being spanked. Sex became fun again, and so much more than penetration. Plus, BDSM helped me be more communicative about my needs and boundaries.”
Emma*, 42, an interior designer living in New York, shares a similar story of how BDSM not only revived her sexuality, but helped save her marriage.
She recalls: “My whole body would tense up every time we tried to have sex. My pelvic floor muscles were so tight, it felt like my vagina had shrunk and was all dried up. It not only ruined my confidence, but it was really hard on my marriage. I never wanted sex. It was a sex therapist who finally suggested we experiment with BDSM. We had never really tried anything like this, but to our surprise, we loved it! For my husband, being dominant has helped him feel desired and confident after years of feeling rejected. For me, being submissive is such a mental and physical turn on. He only needs to say ‘good girl’ and I’m wet. While we still have some limitations, BDSM has opened up a world of possibilities that ‘normal’ sex never could.”
How does BDSM psychology contribute to pleasure?
But what exactly is it about BDSM—which can involve inflicting pain—that can help women like Kelly and Emma feel safe to experience pleasure again?
London-based psychosexual therapist Michela Pucci has a theory. Exploring the Inner Child Model, she explains how “reconnecting with our playful, emotional selves can foster healing and pleasure.”
Pucci continues: “Painful sex often limits traditional intimacy, but engaging the child ego state—characterized by creativity, rebellion, and a desire for joy—can open the door to alternative expressions like kink and BDSM. These practices offer a safe, structured way to meet emotional needs and rediscover pleasure when the body requires protection and care.”
Plus, as BDSM can be as much about mental play as physical, it broadens the sexual menu, taking the pressure off penetration being the main event, which can often be a trigger for pain.
How to safely practice BDSM if you experience pain during sex
According to Tantric Sexuality and Intimacy Mentor, Sophia Leslie, BDSM can be a “profoundly healing path to truth and reclaiming your body and pleasure.”
But, before you begin, it’s essential to know what a “full yes” and a “full no” is in your body. As Sophia explains, “Many people with endometriosis have learned to override their needs, but learning to connect with their bodies and express boundaries can be life-changing.”
Sophia shares these tips to ensure pleasure and safety when practising BDSM:
- “Go deeper into consent: Pause, breathe, and speak clearly about your endo, what hurts, helps, or is off-limits.”
- “Pleasure without penetration: Breathplay, impact, ropes, different objects… even pain can become a portal to aliveness. Let your body lead. That’s where the magic begins!”
If you’d like to learn more about practicing different elements of BDSM, take a look at our guide to bondage sex, sensual restraint, and erotic power play, plus our explainer on subspace in BDSM. And if you’re a new or existing Feeld member, you can add BDSM as a Desire on your profile, which can help others understand what you’re into, and what you’re looking for.
Aside from getting kinky, what medical options are available for endo?
While BDSM can be a liberating way to experience pleasure for those who experience endometriosis-related pain during sex, it's unfortunately not a cure for the condition. The good news is: there are medical treatments available. Depending on the severity of symptoms and pain, the two most common forms of treatment are birth control and surgery. Birth control works by limiting the amount of blood flow during menstruation to prevent period pain and further lesions from growing. Surgery, on the other hand, removes lesions and can offer long-term relief without hormones. The most common kind of surgery is a laparoscopy—where a surgeon uses a small camera inserted through tiny incisions to diagnose, remove, or destroy endometriosis tissue.
Some sufferers with more complex cases like Kelly are now opting for robotic surgery instead of a laparoscopy, which is where a surgeon controls instruments from a console to remove endometrial tissue.
For Kelly, outside of exploring BDSM, robotic surgery has paved the way for pain-free sexual experiences. She explains:
“For the first time in years, I now have zero pain during sex. It took some time for my body to become less fearful because it remembered the pain, so after surgery I worked with a pelvic physical therapist and a tantric coach. But I’m happy to report that I can now do doggy style with full abandon, something that had become impossible!”
Be the biggest advocate for your health
If you’ve been diagnosed with endometriosis (or suspect you might have it) get a second, third, and fourth opinion until you find a medical professional who specializes in it (not all gynaecologists do), and someone who gives you a treatment plan for your unique symptoms—rather than offering a one-size-fits-all approach.
Plus, you can do your own research. Read books, join forums, and be the biggest advocate for your body, sexuality, and health—because no one knows your struggles better than you.
To explore more ways of navigating sex and your cycle, take a look at our guide to period sex. And if you want to continue your BDSM journey, or to connect with like-minded people, we’re waiting for you on Feeld.
*Names have been changed.
