When I talk to patients about chronic gynecological conditions, the subject of sex eventually comes up. Almost every woman admits that intimacy has become painful, uncomfortable, or simply unappealing. But before that conversation, she has often spent months suffering in silence, feeling embarrassed, enduring the discomfort, and hoping it will go away on its own.

It rarely does.

Chronic inflammation, endometriosis, fibroids, ovarian cysts, and the effects of surgery can all affect your sex life. You may experience pain during penetration, discomfort after sex, reduced desire, or vaginal dryness. These symptoms are real. They are not imagined, and they should not be dismissed as “all in your head.” They reflect changes in your body caused by an underlying condition.

You do not have to endure pain. If sex causes you distress, it is a problem to address, not something you need to accept.

This is what I usually recommend to my patients:

• Talk openly with your doctor. Do not say everything is fine when it is not. Explain exactly what is bothering you, where it hurts, when the pain occurs, and how long it has been happening. This information helps determine the right treatment.
• Discuss it with your partner. Without an honest conversation, your partner may not realize that you are in pain. Saying, “This doesn’t feel comfortable right now. Let’s try something different,” can make things easier for both of you. Together, you can find comfortable positions, adjust the pace, and use a lubricant when needed.
• Give yourself permission to change your approach. Sex does not have to look the way it did before. You can take breaks, explore forms of intimacy that do not involve penetration, and try new things. What matters is that you feel comfortable and genuinely want to be there.

A chronic diagnosis does not have to mean the end of a fulfilling intimate life. With appropriate treatment and honest communication, sex can remain a meaningful and enjoyable part of your relationship. Many patients feel significantly better after treatment and rediscover pleasure they thought they had lost.

If you find yourself avoiding intimacy because of pain or fear, speak with your doctor. You are not alone, and help is available.

2026 © Elena Konovalova