Just because you’re having your period doesn't mean you have to forego sexual activity. For some women, sex during menstruation can be even more pleasurable than at other times of the month.
The need for lubrication lessens during your period, and having an orgasm can soothe period-related symptoms, such as cramps. Plus, a study published in Cephalalgia concluded that sexual activity (whether you’re on your period or not) may reduce migraine and cluster headache pain for some.
“Sex is a normal part of life and should be enjoyed by all women,” says Carrie Coleman, MD, an ob-gyn at Massachusetts General Hospital in Boston. “Basically, ensuring you have good contraception and sexually transmitted infection (STI) prevention throughout the menstrual cycle should make it even more safe and enjoyable.”
But before having sex, make sure you understand the risks of STIs, other infections, and pregnancy — even during your period.
Here’s what you need to know about having safe period sex.
Infection Risk From Sex During Your Period
It’s crucial to practice safe sex while you’re having your period because you could still get or transmit an STI, like HIV, during this time, according to the Centers for Disease Control and Prevention. The virus and other pathogens may be present in menstrual blood. Therefore, doctors strongly encourage using a condom to decrease this risk.
Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine in Chicago, says that anecdotally speaking, there are two reasons for this risk. “Any bodily fluid can carry HIV or [other] STIs, and [during your period], the cervix opens slightly, which might allow viruses to pass through,” she says. “My message to women is you’re not off the hook as far as using protection.”
You may also be more prone to some infections in general at this time. Your vagina maintains a pH level of 3.8 to 4.5 throughout the month, according to the American Congress of Obstetricians and Gynecologists (ACOG). But during menstruation, that level rises because of the higher pH level of blood, and yeast is able to grow more rapidly.
Symptoms of a vaginal yeast infection are more likely to occur the week before your menstrual period, and intercourse during this time can exacerbate symptoms. But clear evidence is lacking for any increased risk of getting a yeast infection if you have sex during your period.
There's also the dreaded UTI. “Some women can be more prone to having urinary tract infections after intercourse,” says Dr. Coleman. “This is most likely related to bacteria being able to easily travel to the bladder with intercourse, but it may happen at any point during the menstrual cycle.”
Risk of Pregnancy During Your Period
Yes, you can get pregnant when you have period sex, especially if you have a shorter menstrual cycle (21 to 24 days) and you have have sex toward the end of your period. Sperm can remain viable in your vagina for up to five days, so pregnancy is possible, and it’s important to continue to use birth control.
Less Need for Vaginal Lubrication
You’re less likely to need lubricants if you engage in intercourse during menstruation, because menstrual discharge tends to provide enough lubrication. If you do need a lubricant, then “water-based lubricants are widely available and safe both for sex and for condoms,” says ob-gyn James Simon, MD, a clinical professor of obstetrics and gynecology at the George Washington University School of Medicine in Washington, DC. “Silicone and hybrid lubricants that are water-based and silicone-based are likewise safe for both sex and condoms. Oil-based lubricants, especially mineral oil-based lubricants, can deteriorate condoms — increasing the risk of breakage — and are not recommended with latex condoms,” he says.
Period Sex as a Pain Reliever
If you experience symptoms such as cramping, feelings of sadness, or depression during your period, having sex at this time may be beneficial. Dr. Streicher says that because orgasms release endorphins — feel-good hormones like oxytocin and dopamine — in theory, la petite morte could also decrease some period symptoms, although there hasn’t been any specific research supporting this. Still, “there’s no harm in trying,” she says.
Women who have endometriosis, on the other hand, may experience more pain and other symptoms when they have their period, as well as pain that occurs with sexual activity or orgasm. However, treatments are available, and sex doesn’t have to hurt. Talk to your doctor as soon as possible; the earlier you speak up, the sooner you can feel better and enjoy sex again.
Sexual Arousal During Your Period
You may feel more sexually aroused and sensitive during this time of the month because of the changes in your hormone levels. Some women experience an increased feeling of congestion in the pelvic area, which can also ramp up your sex drive. But for some women, this extra sensitivity may make it uncomfortable to have sex during your period. (If you don’t like having sex when you have your period, there are birth control options that can make your period shorter, lighter, or less frequent, or even eliminate your period altogether.)
Remember that there’s nothing shameful or dirty about having your period — it’s totally natural, and there's nothing wrong with having period sex. The bottom line is to make sure that both you and your partner are comfortable with the situation. “Don’t assume anything,” Dr. Simon says. “Open questions with honest answers beforehand are paramount.”
What Are Uterine Fibroids? Symptoms, Causes, Diagnosis, and Treatment
Uterine fibroids are abnormal tissue growths in the wall of the uterus that are almost always noncancerous but can often be hard to live with.
Fibroids are quite common among women of reproductive age, and as many as 4 in 5 women develop fibroids by the time they’re 50. Fibroids can grow as a single mass or develop in several parts of the uterine cavity at once, and they typically range in size from a tiny seedling to a giant grapefruit.
Signs and Symptoms of Uterine Fibroids
The size, number, and location of fibroids can make a big difference in symptom severity and treatment approach. Some women never experience symptoms or require treatment for fibroids. For others, however, symptoms such as heavy and painful menstrual bleeding, lower back pain, and pain during sex can be persistent and disabling. Fibroids are also associated with reproductive health problems, including an increased risk of infertility, preterm labor, and cesarean section deliveries.
If you’re experiencing symptoms — even if you have issues that seem unrelated to reproductive health — it’s important to see a gynecologist for a pelvic exam. Doctors can feel these masses during an internal exam and confirm a diagnosis of uterine fibroids with an ultrasound. Depending on the circumstances, treatment options may include medication to manage symptoms or minimally invasive surgery to remove masses.
Causes and Risk Factors of Uterine Fibroids
Scientists aren’t entirely certain what causes uterine fibroids, but hormones and genetics are thought to play a role. Some studies have identified genetic differences between fibroid masses and healthy tissue in the uterus. Other research suggests that the sex hormones estrogen and progesterone, which are responsible for helping to grow the uterine lining during monthly menstrual cycles in preparation for a pregnancy, may fuel fibroid growth.
While all women of reproductive age are at risk for developing fibroids — and many of them do — other factors can impact the odds:
Race Black women are more likely to develop fibroids, experience them at younger ages, and have more debilitating symptoms. One study found that Black women are 3 times more likely to have fibroids, as well as much more apt to have larger masses and multiple tumors. Another study of younger adults found that Black women are 4 times more prone to fibroids than white women.
Family History Women with a mother or sister who experiences fibroids are much more likely to develop them. Some studies have found that family history roughly doubles the risk.
Diet Certain eating habits can increase the risk of fibroids, including consuming lots of red meat and alcohol as well as eating too few fruits and green vegetables.
Age at Menarche (First Period) Women who start menstruation earlier are at greater risk for uterine fibroids, possibly due to increased exposure to estrogen over the years, some research suggests.
Weight Being overweight or obese is also associated with an increased risk for developing uterine fibroids. Research suggests that fat tissue is associated with higher estrogen levels, which may contribute to tumor growth.
Even when women have none of these common risk factors, they can still develop fibroids. There are no foolproof ways to prevent these uterine growths, although there are numerous other health benefits to maintaining a healthy body weight and eating a plant-based diet.
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How Are Uterine Fibroids Diagnosed?
Many women with uterine fibroids get diagnosed during a routine pelvic exam when a doctor feels something irregular in the shape of the uterus. Not all women will have symptoms when fibroids are suspected during an exam.
If something feels amiss during the pelvic exam or if patients complain of symptoms like intense menstrual pain or unusually heavy periods, doctors can do several tests to determine whether fibroids are the culprit and, if so, the size and location of any masses in the uterine cavity. These tests include:
Ultrasound A transabdominal ultrasound (with a device placed over your stomach) or a transvaginal ultrasound (with a wand inserted into your vagina) can get images of the uterus. This helps doctors confirm whether uterine fibroids are present, where they’re located, and how large they are.
Blood Tests Blood tests can rule out other possible causes of your symptoms, particularly if you’re experiencing anemia.
Advanced Imaging Sometimes an ultrasound is insufficient to map out fibroids inside the uterus. In these cases, doctors may use more advanced imaging such as MRI, sonograms after saline is infused into the uterus to expand the cavity and make it easier to see fibroids, or X-rays after injecting special dyes to enhance images of the uterus.
The prognosis depends on the size, number, and location of uterine fibroids as well as how fast they grow and what symptoms they’re causing. For some women, doctors advise what’s known as watchful waiting, which involves periodic exams, for fibroids that aren’t causing symptoms or growing aggressively. Other women may go through several decades of treatments to manage severe symptoms and recurring growths in the uterus.
Duration
Fibroids are often diagnosed in women in their thirties or forties. But once a woman has reached menopause, usually by age 52, and her hormone levels have decreased, the fibroids may shrink. Many women’s symptoms improve after menopause.
Treatment and Medication Options for Uterine Fibroids
Treatment for uterine fibroids can involve medication to manage symptoms as well as surgical procedures to remove tumors. The best option for an individual will depend on the severity of their symptoms, the amount of fibroid tissue in the uterus, and whether they want to become pregnant in the future.
Medication Options
Medications can temporarily ease symptoms but will not eradicate these growths. Medicines to manage fibroid symptoms include:
Hormonal Contraceptives Birth control pills, or hormonal birth control in general, can sometimes help reduce heavy bleeding and menstrual pain. Intrauterine devices are a long-acting form of contraception. They release a small amount of hormone into the uterus and can curb heavy menstrual bleeding due to fibroids.
Hormone Blockers Medicines known as GnRH agonists (Lupron, Eligard) work by blocking production of sex hormones, which can reduce the amount of estrogen available to fuel fibroid growth. These drugs can temporarily shrink fibroids and may be prescribed before surgery to make larger tumors smaller and easier to remove.
Anti-Inflammatory Drugs Pain relievers known as nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin) or naproxen (Aleve) may be prescribed to ease pain caused by fibroids.
Surgery is the only way to remove fibroids, but the more conservative options that are preferred by many patients to preserve fertility can’t prevent future fibroid growth, according to John Hopkins Medicine. Less invasive, uterine-preserving surgical options that leave women with an intact uterus and able to carry a baby include:
Myomectomy This procedure involves removing fibroids but leaving the uterus intact. Doctors may cut into the abdomen to perform a traditional myomectomy, use minimally invasive techniques to access the uterus through tiny abdominal incisions, or insert a camera into the vagina to find and shave down visible fibroid tissue.
Uterine Artery Embolization This minimally invasive procedure uses X-rays to identify major arteries feeding into fibroids, then cuts off the blood flow to the tumors so that they shrink.
Radiofrequency Ablation This is a newer option that uses ultrasound images to locate fibroids, then heats them to make them softer and smaller.
Surgical Removal of the Uterus For women with more debilitating or severe symptoms, or intense fibroid growth based on the size or number of masses, a more aggressive approach may be warranted: a hysterectomy to remove the entire uterus. After a hysterectomy, a woman does not have a menstrual period and cannot become pregnant.
Fibroids are the most common reason that women get a hysterectomy.
Research and Statistics: Who Has Uterine Fibroids?
Uterine fibroids are common, especially among Black women. Not only are they more likely to develop fibroids, Black women are also more likely to experience them at younger ages and experience worse symptoms. One study found that Black women are 4 times more prone to fibroids compared with white women. Another study suggests that Black women are 3 times more likely to have uterine fibroids.
Complications of Uterine Fibroids
While it’s rare for fibroids to have severe complications, some serious health issues can result from these masses. One of the most common problems resulting from fibroids is anemia, or a lack of red blood cells, which can lead to fatigue, dizziness, shortness of breath, or a rapid heartbeat if left untreated.
Other complications that are less common are related to the location and size of fibroids. Larger masses that grow too close to the bladder, interfering with emptying urine from the kidneys, can lead to kidney damage. Bigger tumors that grow near the cervix can contribute to pregnancy loss and preterm labor.
Fibroids are also associated with an increased risk of infertility and cesarean section deliveries.
Another common symptom of uterine fibroids, heavy or irregular menstrual bleeding can be caused by several other conditions. Unusual or irregular vaginal bleeding might be due to fluctuations in hormone levels, certain sexually transmitted infections, irregular thyroid function, inflammation in the cervix or uterus, or cancer.
Fibroids are almost always noncancerous and don’t increase the risk of uterine cancer. Cancerous fibroids (leiomyosarcoma) are rare — fewer than 1 in 1,000, per the Office on Women’s Health, which notes that doctors don’t think these cancers develop from an existing fibroid.
Resources We Love
If you’ve been diagnosed with uterine fibroids or are experiencing symptoms that make you wonder if this is the cause, many resources can help you understand this condition. Here are some of our favorites.
Office on Women’s Health
Part of the U.S. Department of Health and Human Services, the office has a comprehensive online primer to help you learn more about uterine fibroid symptoms, diagnosis, and treatment options.
Mayo Clinic
The health system based in Rochester, Minnesota, offers a comprehensive rundown on uterine fibroids.
Johns Hopkins Medicine
This primer from the health system based in Baltimore has an excellent review of the surgical treatments for fibroids, including some newer options.
Mount Sinai Fibroid Care Center
This is one of the few health systems nationwide with a dedicated fibroid care center.
Resilient Sisterhood Project
This advocacy group focuses specifically on education around fibroids and other reproductive health issues that disproportionately impact Black women.