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Writer's pictureCarri Dominick

Menopause and Painful Sex: Some Helpful Tips

Updated: Nov 3, 2023

Menopause is a natural biological process that signifies the end of a woman's reproductive years. It typically occurs in women around age 50, and it brings about various physical and emotional changes due to fluctuating hormone levels, particularly a decrease in estrogen. One common and often unspoken symptom of menopause is painful sex, technically known as dyspareunia. In this blog, we will delve into the causes, effects, and possible solutions for painful sex during menopause.

Understanding Menopause Menopause is a complex transition in a woman's life. It begins with perimenopause, a period during which hormone levels fluctuate, leading to irregular menstrual cycles and various symptoms like hot flashes, night sweats, mood swings, and vaginal dryness. Eventually, a woman reaches menopause when she has not had a menstrual period for a full year.


couples feet in bed

Painful Sex During Menopause Painful sex during menopause is a symptom that affects many women, although it often goes unreported or unaddressed due to its sensitive nature. The primary cause of painful sex during menopause is a drop in estrogen levels. Estrogen plays a crucial role in maintaining vaginal health, keeping the vaginal tissues lubricated, elastic, and well-nourished. When estrogen levels decrease, the vaginal tissues can become thinner, drier, and less elastic, leading to pain or discomfort during sexual intercourse.

Common Symptoms of Painful Sex During Menopause:

  1. Vaginal dryness: Reduced estrogen levels can lead to a lack of natural lubrication in the vagina.

  2. Vaginal atrophy: The thinning and shrinking of vaginal tissues can make intercourse painful.

  3. Irritation and itching: Dry and fragile tissues can become easily irritated.

  4. Pain or discomfort: Women may experience a burning, stinging, or sharp pain during sex.

Effects on Relationships and Emotional Well-being Painful sex during menopause can have a profound impact on a woman's emotional well-being and her relationship with her partner. The discomfort and anxiety associated with intercourse may lead to decreased sexual desire and avoidance of intimacy, which can strain a couple's relationship.


older couple on cruise ship

Addressing Painful Sex During Menopause Thankfully, there are several ways to address and alleviate painful sex during menopause:

  1. Menopause Hormone Therapy (MHT): Formerly called hormone replacement therapy, or HRT. Estrogen therapy, in the form of creams, gels, patches, or pills, can help restore vaginal health by increasing lubrication and elasticity. Consult a healthcare provider to determine if MHT is a good option for you.

  2. Non-hormonal Therapies: There are non-hormonal vaginal moisturizers and lubricants available over the counter that can provide relief from dryness and discomfort during sex. These can be used as needed.

  3. Vaginal Estrogen: Many women benefit from localized estrogen therapy, such as vaginal estrogen creams or tablets. These are inserted into the vagina and can improve the condition of vaginal tissues. They are local and not systemic, meaning they stay only in the vaginal tissues and don't effect the rest of the body.

  4. Pelvic Floor Physical Therapy: A pelvic floor therapist can assess whether there are also tight muscles in the pelvic floor and vagina that are also contributing to painful intercourse and give you exercises to help.

  5. Open Communication: Discussing the issue with your partner and healthcare provider is crucial. Open and honest communication can help you find solutions and maintain intimacy in your relationship.

  6. Foreplay: Don't forget the foreplay! It takes up to 45 minute for vaginal tissues to be fully expanded, lubricated and ready for sex. Skipping this step can lead to painful sex because the tissues aren't fully ready.

Conclusion Painful sex during menopause is a challenging symptom, but it is essential to remember that it is a common and treatable issue. Seeking help from your doctor and a pelvic floor therapist, exploring various treatment options, and engaging in open communication with your partner can help you maintain a fulfilling and satisfying sex life during and after menopause. There is help and there is hope! Schedule an appointment with us.


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