Time to talk about menopause and painful sex

Time to talk about menopause and painful sex

The ‘painful’ truth is that menopause can be a reason for sexual intercourse to hurt.  Many women may not acknowledge that fact but a recent survey found that 62 percent of participants reported experiencing pain during or after sex, but less than half attributed that pain to be associated with menopause.


This same survey also found that 73 percent of postmenopausal women were still sexually active with 83 percent stating they experienced pain at least half or more of the time during sexual activity with 73 percent rating the pain from moderate to severe.

The question is, are women bringing this sensitive matter up with their doctor and what are they doing to treat the pain? Good question.  The other ‘painful’ truth is that almost 60 percent of women from the survey reported that they never brought up the topic with their health care provider.  A question from the survey on how the women managed their pain associated with sex and 45 percent of them responded that they used lubricants while one in three had decided to avoid sex altogether.

Why sex can become painful with menopause

After menopause, up to half of all women have pain before, during, or after sex.  Pain can be a natural symptom sometimes associated with menopause.  Before the change of life, the hormone estrogen helps maintain the thickness and elasticity of the vaginal tissues.  With age however, estrogen levels drop causing changes in these tissues making them thin and dry with the dryness adding friction during sex. The vagina will also stretch less, making it feel tight.  These changes can lead to a medical condition called vulvar and vaginal atrophy which can lead to painful sex known as dyspareunia.

Other causes of painful sex after menopause can be fear and worry about pain.  Once painful sex happens, a woman may dread it returning which in turn, can make the muscles in the vagina tight adding dryness.

Health issues such as a urinary tract or yeast infection, or a skin problem can make sex painful.  Other possible causes of painful intercourse are being stressed or depressed, having relationship problems, or past sexual abuse.

How to make sex feel good again after menopause

There is no need for millions of women to suffer in silence or to accept painful sex as a normal part of the aging process. If not properly treated, the pain will not go away on its own and could even get worse.  In addition, when sexual activity and desire are infrequent, this can strain relationships and erode a woman’s self-esteem associated with aging and body image.  

The first step towards regaining a good and pleasurable sex life again is to have the conversation with a health care provider.  Bringing up sexual issues can be embarrassing but an open, honest discussion of what is happening can be an important stride in the right direction of enjoying pain-free intimacy once again.  Menopause does not mean the end of sex for women.  Sexual satisfaction plays an important role in maintaining health-related quality of life at any age.

Healthcare providers can provide a multifaceted approach to treatment options for painful sex that might include using lubricants or moisturizers. Using such products however, often only provides temporary relief and does not address the underlying condition causing the pain. 

Prescription options might be a better answer for treating moderate to severe pain.  This could include taking a once-daily hormone-free oral pill, to provide a woman with an alternative option to vaginally applied or inserted treatments. 

Kegel exercises are another method women should try to help strengthen the pelvic floor muscles and improving the enjoyment of sex. 

Self-care of the vaginal area is important – treat vulvar skin gently washing it with a mild soap or plain water and pat dry.  It’s best to avoid perfumed products such as bubble bath and douches.  Always wear cotton underwear and avoid tight clothing.

Even though some women avoid sex because of pain, frequent sexual activity can help stretch and strengthen muscles and increase blood flow and lubrication.  For women who are too fearful of the pain, they can practice masturbation or different ways of being sexually intimate that don’t involve penetration.

One last thing, women who communicate with their partner during sex, letting them know what feels pleasurable and what causes pain, can be a huge advantage to regaining a pain-free sex life every woman deserves.