'You feel like you're drifting apart': a qualitative study of impacts of endometriosis on sex and intimacy amongst heterosexual couples

While a wide body of research reports the considerable impact endometriosis can have on sex for women with the condition, studies commonly use a quantitative design and often focus on dyspareunia. There has been a limited amount of qualitative research which includes partners and explores the broader impact on not only sex, but also intimacy and the couple relationship. This paper utilizes findings from the UK-based ENDOPART study which examined the impact of endometriosis on heterosexual couples, via in-depth interviews (n = 44). The paper reports the complex ways in which endometriosis symptoms, including but not only dyspareunia, can impact upon sex, intimacy and the couple relationship, as well as partners' emotional responses and the strategies they employed. It discusses specific and gendered ways in which heterosexual women and couples experience, navigate and manage these impacts in relation to conventions of menstrual etiquette, discourses of male sex drive and practices of emotion work. In demonstrating the range of impacts on women, partners and the couple relationship, and the importance of taking a couple-focused, relational and gendered approach, the paper will be of benefit to practitioners in healthcare and sex- and relationship-focused therapy working with women and couples living with endometriosis. Endometriosis is a gynaecological condition which can cause pelvic pain and pain during sex. This paper comes from research with 22 heterosexual couples where the woman has endometriosis. It explains how endometriosis can cause difficulties for sex, intimacy and the couple relationship, and how women and their partners worked to reduce these impacts.