At the Centre for Pelvic Pain and Endometriosis, we know that some people with endometriosis have pain, guilt, worry, frustration, and avoidance associated with sexual intercourse. To better understand the relationship between endometriosis and sex, we decided to compare sexual quality of life scores of 277 people with endometriosis. We found that people who reported pain with initial entry into the vagina, pain with deep penetration, or bladder pain syndrome had worse sexual quality of life that people without these symptoms. People with depression and who reported worrying about or feeling helpless about their pain also had worse sexual quality of life. Now that we know that painful sex, psychological factors, and other chronic conditions may worsen sexual function for people with endometriosis, we can work on targeting these issues with individualized care plans for our patients.