What Postmenopausal Woman Should Know About Painful Sex

·3 min read
Photo credit: Cavan Images
Photo credit: Cavan Images

If you’re postmenopausal and saying no to sex because it hurts, there are a few things you can do to improve your time between the sheets. For starters, let’s acknowledge that painful sex is, indeed, a real issue for many women who’ve gone through The Change—even if it’s not something that’s often discussed.

“Painful sex is a big surprise to women,” says Sheryl Kingsberg, PhD, chief of the division of behavioral medicine at the University Hospitals Cleveland Medical Center and the past president of the North American Menopause Society (NAMS). “Every woman knows about hot flashes and night sweats. They believe these are the classic symptoms of menopause, but it’s a conspiracy of silence that they don’t know about painful sex,” she adds.

Ultimately, to lessen the anxiety around this topic, it’s crucial to talk to your partner about how you’re feeling. “It’s so much better to have a conversation together,” Kingsberg says. “You can say something like ‘we need to find other ways to experience sexual pleasure because penetration has become painful.’ Then, find ways to have other intimate experiences while you work on finding a treatment.”

Your OBGYN can uncover what may be causing your pain and then offer solutions that may help. More likely than not, vaginal dryness or atrophy is behind the discomfort. Read on to learn about each and the available treatments.

Educating yourself before you seek medical care can empower you to find solutions that may work for you!

Vaginal dryness

After menopause, your estrogen levels naturally drop, which can lead to a host of genital and urinary symptoms that are otherwise known as genitourinary syndrome of menopause (GSM), according to Kingsberg. This can prompt dryness, burning, and irritation in your vaginal tissue that has thinned over time. “About 70 to 80 percent of women experience GSM and, unlike hot flashes and night sweats that eventually go away, GSM will not,” Kingsberg says. “It’s chronic and progressive.”

Vaginal atrophy

A women’s healthcare professional will be able to tell you if your vaginal tissue has thinned or changed since menopause, and if this is prompting painful sex, Kingsberg says. “With age, and the subsequent drop of estrogen, the length of your vagina can shorten and narrow,” she says. “That’s why oftentimes penetration, whether from a finger, toy, or penis becomes excruciating.”

Treatment options

Reach for a safe and effective treatment like a vaginal moisturizer or lubricant every time you have sex. (Avoid options that contain parabens, glycerin, and propylene glycol, which can be irritating.) “Keep in mind, however, that lubricants used during sex and moisturizers used a few times a week won’t help with the underlying issue,” Kingsberg says. “But they can help make the sexual experience less painful.”

To treat underlying dryness or atrophy, Kingsberg recommends asking a healthcare professional if a low-dose hormonal therapy is right for you. Options include vaginal inserts, estrogen cream, and rings, all of which go into the vagina. It may take some time to find the solutions that will work best for you, but rest assured there are plenty of ways to address painful sex after menopause.

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