It was just their third date when Sophie and her new love interest Dillon visited a fertility clinic.

The pair had already discussed intimacy with a chronic condition, egg freezing and other “unsexy topics”.

For Sophie Richards, 29, those early conversations were just part of the daunting prospect of finding love when you have endometriosis, which can cause infertility.

The condition means cells similar to those in the lining of the womb (uterus) grow in other parts of the body, which can lead to symptoms including period pain, fatigue, plus pain in the lower tummy and back.

When Sophie first met her now fiancé, Wales rugby international Dillon Lewis, she felt she had to be up front.

At the time, she was freezing her eggs – a process she started because of potential fertility issues from her endometriosis.

“It can be very challenging, especially with endometriosis or something chronic, or infertility issues like I’ve struggled with,” Sophie said.

“How do you bring that up to someone new and hope it doesn’t scare them away?”

Despite it feeling uncomfortable, she brought the condition up soon after meeting.

“I was having to explain… about injections and surgeries, and all of that, very unsexy topics to be talking about.”

• Endometriosis is a condition where tissue similar to the lining of the womb is found in other areas of the body, such as the ovaries, fallopian tubes and lining of the pelvis.

• It also sometimes affects organs, such as the bladder and bowel. Rarely, endometriosis is found in areas outside the pelvis, such as in the chest.

• Symptoms include severe to debilitating pain often in the pelvic area, fatigue, and heavy periods, and the condition is also associated with infertility.

Source: NHS

It affects around one in 10 women in Wales.

There’s currently no cure for the condition but there are treatments to help ease symptoms including surgery to cut away tissue, or remove part of the organs affected by endometriosis.

Sophie credits fiancé Dillon with being supportive and keen to learn about the condition.

“I had plenty of hours of education from Sophie over a G&T, because Sophie was so open about it,” he said.

“It made learning a lot easier, but she didn’t mind the stupid questions as well.”

The Newport-based Dragons prop, 29, who has 57 caps for Wales, said asking questions and being open was key to offering a partner support.

“Just try to help in whichever way, like I always say ‘is there anything I can do’ with the answer 99% of the time being no but at least I like to ask… and get a hot water bottle every now and again,” he added.

Sophie, now a women’s health advocate and podcaster, said that being with someone supportive, whatever the challenges, was vital.

“I genuinely don’t think I could be with someone who didn’t want to understand the endometriosis, because ultimately, I will live with it forever. It’s chronic,” she added.

She wants more women to feel confident talking about the impact endometriosis can have on sex and intimacy, although acknowledged how daunting it can be.

“Now I’m an open book… six years ago, I couldn’t even say the words periods without flushing red,” she said.

Natalie Jones, from Cardiff, has endometriosis and adenomyosis, and is currently waiting for her fourth surgery.

The 35-year-old, who was diagnosed in 2018, has recently started to date again after a period of ill-health.

The PhD student described herself as naturally a “spontaneous person” but said often she is so exhausted she fears cancelling dates may give the wrong impression – that she’s unreliable or worse, uninterested.

“If you’re just exhausted sometimes and you have to cancel plans especially in a new relationship, that might sound like you’re just putting somebody off, or you’re unreliable or you’re messing someone around.”

The academic researcher said it can be particularly complicated when it comes to sex with the extra worry of heavy bleeding or pain.

“You don’t want to set that expectation that intimacy is going to happen by having that discussion too early on but then if one thing leads to another, when do you bring it up, do you stop midway and say, ‘oh by the way’,” she said.

The keen traveller and gym-goer said that while it can be difficult watching friends start to settle down, she doesn’t let it affect her.

“This is something that I can’t control, but that doesn’t take away from who I am and so if I’m dating or speaking with somebody who isn’t prepared to either learn or understand… then that’s probably not the right person anyway,” she added.

Pelvic health physiotherapist Pauline-Clare Callaghan said while there has been progress in recent years regarding open discussions around menstrual health and menopause, there’s still much more to be done especially in endometriosis-related sexual pain.

The healthcare professional, who has a special interest in endometriosis, said sexual pain with the condition can be complicated and may relate to the location of scar tissue, adhesions and fibrosis, or pelvic floor muscle being overactive, tight or inflamed.

“There are effective conservative treatments including pelvic physio but there is a care gap, there are many barriers to addressing sexual pain in endometriosis, including lack of awareness/understanding of support available, shame, embarrassment, cultural issues, and care access issues,” she said.

Faye Farthing from Endometriosis UK said the condition can have a “huge impact” on people’s sex lives and relationships.

“Sex can be a challenging topic to discuss with partners, especially if you’re in a new relationship, which is why it’s vital societal conversations continue around sex and endometriosis to break down the stigma,” she said.