New Study : Endometriosis and Semen

New unwrapped condom

So there’s an article that was recently published that has a lot of the EndoCommunity in an uproar today on Facebook.  The article was title, “How your sex life may influence endometriosis,” published on May 1, 2015, by MedicalXpress. My initial knee-jerk reaction last night was to be furious.

I interpreted the article as saying that sex can cause and affect Endometriosis growth; to be more precise: seminal fluid can affect Endo growth.  Semen.  Baby-MoJo.  I’ve had my Endo pain since my early years in high school.  And I did not have sex until I was 21.  And my cramps were pretty damn bad back then.  How dare a study suggest that sexual activity had anything to do to heighten my endo symptoms or progression.   And my outrage was further fueled by others’ reactions about the same conclusion.

I’ve decided to take my time, read the study slowly, and try to digest what it is the study is trying to tell us. Wait. Step back. Breathe, breathe.  Relax.  Now go read the study…

Prior Studies

There have long been studies of seminal fluid and any affects it may have on the female anatomy.  Some studies found that seminal fluid promotes an inflammatory response of the cervix, in order to facilitate fertilization.  One study concluded, “further studies are required to examine the duration of the response and whether seminal fluid signaling extends to the higher regions of the uterus to exert direct effects on embryo development and implantation, as well as to investigate the downstream effects of seminal fluid-induced immune responses on pathways affecting fertility and infertility, infection, and disease.”

A study published in 2010 was conducted to see if seminal fluid had any affect on the growth of endometrial cells in women who have endometriosis.  The study found that it “may promote the growth of endometrial cells derived from women with endometriosis. Our findings may suggest some detrimental effect of unprotected sexual intercourse in women with endometriosis.”

All the Hullaballoo

A new study published in The American Journal of Pathology in January of 2015, found that there may be a direct link between the contact of seminal plasma and endometrial cells, and the production of endometrial tissue and lesions. The study, conducted by the research staff at the University of Adelaide, found “these data suggest that seminal plasma enhances the formation of endometriosis-like lesion via a direct effect on endometrial cell survival and proliferation, rather than via macrophage-mediated mechanisms. These findings raise the possibility that endometrial exposure to seminal plasma could contribute to endometriotic disease progression in women.”

Associate Professor Louise Hull stated “the next stage of the research will look at what this means for women with and without endometriosis…we now need to apply these laboratory findings to real life and determine whether the exposure of seminal fluid that occurs naturally during intercourse puts women at increased risk of developing endometriosis. And if modifications to sexual activity could lower the severity of the disease in women with endometriosis,” (Courtesy of


A study published in 2009 suggests that a woman who has endometriosis may create a toxic and infertile environment for sperm.  Byproducts of our inflamed tissues and over-reactive immune system may produce toxic fluids which reach the uterus through the Fallopian tubes.  It concludes, “there was evidence of significantly higher sperm DNA damage in samples incubated with [peritoneal fluid] from patients with endometriosis compared with samples incubated with [peritoneal fluid] from healthy women and controls at the three incubation periods studied…We are proposing that endometriosis-induced sperm DNA damage may be one of the underlying causes of reduced natural fertility in these cases.” More studies, of course, are needed. It’s just frustrating for those EndoSisters who are striving to become pregnant.

In March 2020, Reproductive Biology published a study comparing peritoneal fluid of patients with and without Endometriosis and how it affected spermatoza. It found that the spermatoza cultured with peritoneal fluid from those with Endometriosis showed negative changes, including decreased movement and altered aminos. Although, the viability of the sperm remained intact. As usual, more studies are needed, but also points toward a potential for infertility causes in patients with Endometriosis.

My Two Cents

So, this new study is not saying that seminal fluid causes Endometriosis.  My knee-jerk reaction was done in poor taste. It is simply suggesting that seminal fluid may play a role in the development or progression of endo. However, it appears more studies will be necessary to determine if unprotected sex may influence the severity of symptoms in women with endometriosis, and if it may raise the risk of women developing endometriosis. On that note, there have been several Warriors on Facebook today stating they have had, and continue to have, protected sex using condoms, and the severity of their symptoms have always been severe. Also curious in the potential factor it may play toward attempts to conceive children. It will be interesting to watch how this develops.

(Updated May 25, 2021)


Fertile Care for Women

Fertility & Sterility (Article, 2009) The Impact of Peritoneal Fluid from Healthy Women and from Women with Endometriosis on Sperm DNA and its Relationship to the Sperm Deformity Index

The American Journal of Pathology (Abstract, 2015) – Seminal Plasma Promotes Lesion Development in a Xenograft Model of Endometriosis

The Journal of Immunology (Article,2012) – Seminal Fluid Induces Leukocyte Recruitment and Cytokine and Chemokine mRNA Expression in the Human Cervix after Coitus

European Journal of Obstetrics, Gynecology, and Reproductive Biology (Abstract, 2010) Effect of human seminal fluid on the growth of endometrial cells of women with endometriosis

Reproductive Biology (Abstract, 2020) Peritoneal fluid from women with endometriosis impairs human spermatozoa functionality

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 😉 Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa

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