Menopause and painful sex
It can feel distressing and upsetting when a pleasurable experience becomes painful. Painful sex can often wreak havoc on your libido, sense of self, and relationships. It can often make you want to avoid sex. Thankfully, it isn’t all doom and gloom – there are several potential causes of painful sex during and after menopause, and in nearly every case, it is treatable.
PAINFUL SEX DEFINITION
In medical terms, recurrent, or persistent genital pain that occurs before, during, or after sex is referred to as dyspareunia. This pain widely varies and can be:
- Felt on entry or deep penetration
- Vary in intensity from mild to excruciating
- Occur occasionally or every time
GSM is thought to affect up to half of the people who go through menopause, many of whom report their vagina feels dry, rough, or raw. The tissue in the vagina may also feel fragile and it may bleed more easily.
See what treatments are right for you
HOW LIKELY IS PAINFUL SEX DURING MENOPAUSE?
- If you experience painful sex, you are not alone
- Three-quarters report painful sex at some point and it is particularly common during and after menopause
- Although painful sex is common, you don’t need to accept it as your new normal
Read more about the stages of menopause.
SIGNS OF PAINFUL SEX IN MENOPAUSE
External pain on your vulva (the external genital area that touches your underwear)
Internal pain in your vagina, uterus, or pelvis
Pain may be described as sharp, burning, stabbing, aching or throbbing (although everyone’s experience will be different)
Painful sex during or after menopause may leave you with feelings of shame or that something is wrong.
HOW CAN YOU EASE PAINFUL SEX SYMPTOMS?
Sexual pain associated with the changes of menopause can often be easily and successfully treated.
Tune in with your body
If something hurts or doesn’t feel good, don’t force it or try to push through the pain. You need to love and respect your body.
Try a vulvar or vaginal moisturiser
These can help to increase moisture and the tissue quality of the vulvar and vaginal tissues. You can buy them without a prescription, and your pharmacist will be able to advise on which products to try.
Lube can help decrease pain during sex and can be applied as needed. Be aware that lubes and vaginal moisturizers work in different ways, so try a few and see what works best for your body. Read more about lubricants and sex.
Think outside the box
Sex can be so much more than just penetration. Try sexual activities such as touching, oral sex, or mutual masturbation.
Although foreplay alone rarely cures painful sex in menopause, it may help you become more aroused which decreases your pain response.
Have sex with yourself
Just because you are having painful sex does not mean that you can’t pleasure yourself. It is important to remind yourself that you can feel good in your body.
Communicate about sexual pain
Sexual partners are not mind readers – so it is important to communicate about painful sex, particularly if some positions feel more painful and can be avoided. Avoiding positions that inflict pain can help teach your body not to anticipate pain with sex.
Improve your washing and grooming habits
Avoid soap, loofahs, douches, or sprays to clean the vulva or vagina. These can dry out and irritate the tissues even more.
Take pain-relieving steps
To reduce pain on deep penetration, you can try something like the Ohnut rings to adjust the penetration depth to what feels comfortable. Other preventative steps include taking a warm bath or painkiller before sex. After sex, apply an ice pack to the vulvar area.
See a healthcare provider
If you have painful sex, you should always go to see a healthcare provider for review. They will be able to help you figure out what is causing the pain, and how best to treat it. Depending on the cause of your painful sex, seeing a sex therapist or pelvic floor physiotherapist may also be helpful. See your healthcare provider urgently if you have any bleeding after sex, bleeding in between periods, sores on the vulva or vagina, or any other symptoms that are worrying you.
Consider topical estrogen
This comes in the form of creams, pessaries or vaginal suppositories, or rings and is applied directly to the vaginal area. This is an effective, low-risk form of HT and is used to treat menopausal changes in the vagina and surrounding tissues that could be causing your pain. Speak to your healthcare provider for further advice about this and other forms of HT.
Smoking can worsen dryness and contribute to painful sex.