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Painful Sex and Menopause

You may know all too well about hot flashes, night sweats, trouble sleeping, and other menopause-related changes. But if you experience pain during and after sexual intercourse, you may have a lot of questions. Many women don’t realize that painful sex can result from vaginal changes that happen as they get closer to or pass menopause. In fact, a study in women with certain vaginal changes after menopause showed that around 40% of them reported painful sex. The condition is more common than you may think.

Why does it happen?

As women approach menopause, their bodies makes less of the female hormone called estrogen. Estrogen helps keep vaginal tissue, or vaginal walls, lubricated and healthy. As estrogen levels drop, the vaginal walls can become dry and inflamed. These changes can make intercourse painful.

The lining of the vagina can also shrink and become thin with less estrogen. It can lose its ability to stretch—in other words, it can become less elastic—which can be a reason sex may become painful.

So what can I do?

Talk with your healthcare provider if you experience pain during sex after menopause. You may also want to talk with your partner about what you’re experiencing. Some women may feel embarrassed to bring this up. But keep in mind that there are some ways to help manage vaginal dryness or painful intercourse that may be the result from the vaginal changes associated with menopause.

Your healthcare provider may make some recommendations based on the type and severity of symptoms you are experiencing, your past medical history, and your risk factors. Some of the options include over-the-counter products such as lubricants or moisturizers. There are also prescription products that can be considered—some of which contain estrogen. They can be available as a cream, ring, or tablet.

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