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How To Deal With Painful Intercourse After Menopause

Have you experienced painful intercourse after menopause?

With the onset of menopause comes irregular periods, mood swings, hot flashes, night sweats, weight gain, lack of vaginal discharge, problems falling asleep, and even pain during intercourse.

You’re going through a period of change, and not all of it is pleasant. But two things are certain — your vaginal health is important, and sex should always be pleasurable. 

Did you know that between 25% and 45% of women who have experienced menopause say they feel pain during sex? 

Don’t worry — while it may seem like the end-all, you’re not alone. 

In this article, we’ll cover the many reasons why sexual intercourse is painful, what you can do to make sex pleasurable again, and what hassle-free products you can try

Let’s get started.

The Article Will Explore:

Understanding Your Vulva

Your vulva (“wrapper” or “covering” in Latin) has many distinct structures like your clitoris, labia, and the openings to your urethra and vagina.

Your vulva has two skin folds that protect your more delicate parts:

  • Labia majora: This is a large outer area that has fat cells and hair follicles. It serves as padding for the delicate areas of your vulva.
  • Labia minora: This is inside the labia majora and has many vaginal mucosa glands that secrete fluids for lubrication. Vaginal mucosa shields the skin inside the vagina.

Your clitoris has about 8,000 nerve endings that, when touched, can result in sexual pleasure. Rest assured, your clitoris is key to great sex. It’s protected by the labia as well as the prepuce or clitoral hood.

How does estrogen fit in?

The ovaries produce estrogen and encourage the body to release natural lubricants. It also helps with growing new cells to restore the vaginal lining. 

When you hit menopause, your vulva goes through vaginal tissue changes. Estrogen levels will decrease during and after menopause.

When estrogen levels drop, these are some of the vaginal symptoms:

  • A loss of fat in your labia majora. This drops the size of your labia. 
  • The labia minora shrinks or thins. When the labia minora gets thinner, it produces fewer secretions and makes your vagina less elastic.
  • A lack of vaginal lubrication or padding. This leads to an exposed clitoris and vaginal opening that brings about vaginal bleeding, chafing, irritation, tearing, and trauma. 
  • You can develop urinary tract problems.

Many women experience varying levels of discomfort from vaginal tightness to extreme sexual pain during intercourse due to this drop in estrogen. 

How To Tell If You Have Vaginal Dryness

No more painful intercourse after menopause

Medically speaking, the term for painful intercourse is dyspareunia. It’s a persistent or recurring pain in the genitals that occurs just before, during, or after sex. About 30% of postmenopausal women that don’t do any hormone therapy say they have dyspareunia. 

There are a few varying degrees of dyspareunia. 

  • Superficial pain: This is something most women complain of, particularly during vaginal penetration. The pain can be sharp or burning.
  • Deep pain: This happens during deep penetration or thrusting, and can lead to severe pain.

Many women can experience both superficial and deep sexual pain. And while dyspareunia is temporary for most, it can turn into a pain disorder for many others.

If you’re a menopausal woman and dealing with dyspareunia, one reason may be vaginal dryness, a.k.a Vulvar Vaginal Atrophy (VVA). 

Today, vulva vaginal atrophy is mostly known as Genitourinary syndrome of menopause. It is a more inclusive term that explains the range of changes resulting from a lack of estrogen during menopause. 

Nearly 50-70% of postmenopausal women are affected by vaginal dryness or genitourinary syndrome after menopause.

With vaginal dryness, the vaginal tissues begin to thin and dry out. There is also a loss of vaginal discharge and elasticity. Vaginal atrophy can make your vaginal opening narrow and, eventually, shrink your entire vagina. More often than not, vaginal dryness boils down to a lack of estrogen. 

These are some of the symptoms of vaginal atrophy:

  • Insufficient vaginal lubrication
  • Pain or dyspareunia at penetration
  • Burning in the vagina
  • Inability to reach an orgasm
  • Urinary tract infection
  • Pain when urinating
  • Vaginal discomfort during certain types of exercise like bike riding

What else causes the fall in estrogen?

Menopause is one of the reasons your estrogen levels drop, but it isn’t the only one.

A drop in estrogen levels can be due to a few other reasons:

  • Breastfeeding
  • Removal of the ovaries
  • Certain medications like antidepressants and antihistamines
  • Chemotherapy and radiation for cancer patients

Other Reasons Sex Can Be Painful

There are a few other reasons why intercourse is painful. Here’s a quick look at them.

1. Health and Skin Conditions 

When you’re under the sheets, certain sex positions can lead to pain. This pain is usually because your pelvic muscles aren’t sufficiently relaxed. 

The pain can also be due to other pelvic-related issues like:

  • Pelvic floor dysfunction (too much tension in the muscles)
  • Endometriosis (a painful disorder where tissues grow outside your uterus)
  • Uterine fibroids (non-cancerous growths of the uterus)
  • Scarring from pelvic surgery
  • Pelvic radiation treatments (used to treat cancerous cells)

Once your doctor examines your pelvic muscles and genital area, he or she will be able to find out where your pain is and what’s causing it.

Certain skin conditions — like lichen sclerosus and eczema — can also lead to painful sex. 

If you are also prone to getting a urinary tract infection or any other genital-related infection, you may experience intercourse that’s not pleasurable.

2. Involuntary Spasms and Certain Medications

Vaginismus is an involuntary spasm that happens on the vaginal wall. It is usually brought about by fear after something traumatic has happened.

If you experience vaginismus, it can make any penetration severely painful. 

Even some medications (think high blood pressure meds or antidepressants) can play a role in a dry vagina. 

3. Vestibulodynia

If you look at your vagina, the vestibule is the spot where the vulva connects with your vagina. 

You can develop a pain disorder or vaginal discomfort, making the area sensitive to touch and penetration painful.

4. Vulvodynia

Many women undergo chronic pain or burning in the vulva for no apparent reason — that’s what vulvodynia is. 60% of women with this condition find intercourse painful.

5. Cystitis

Cystitis is essentially a bladder inflammation. You experience pain during sex because the bladder is right above the vagina. Interstitial cystitis can have adverse reactions on your sex life.

Now let’s discover what you can do to deal with painful sex.

How Do You Deal With Painful Intercourse After Menopause?

Many remedies to alleviate pain during intercourse, particularly after menopause

These are a few remedies to alleviate pain during intercourse, particularly after menopause.

1. Speak to your healthcare professional

You must speak to your doctor or healthcare professional about your pain and sexual health. The doctor will ask you a few questions about your medical history, sexual relationships, when the pain began, if you have vaginal bleeding, and more. 

If you have severe pain, be sure to explain when this happens and all your vaginal symptoms.  There will also very likely be a pelvic and genital examination to determine where the pain is coming from.

All this will help him (or her) determine the cause and if you require specialist treatment.

2. Use suitable bath products

For a super-sensitive vagina, stick to a warm water rinse. Stop using shower gels, soaps, bubble bombs, and the like. 

This also applies to perfumes and sprays. Until you find a remedy that works, choose cotton underwear to keep any discomfort at bay.

3. Opt for low-dose vaginal estrogen therapy

Some doctors may recommend some types of hormone therapy to replace the estrogen your body no longer makes. 

Hormone replacement therapy can relieve many of the symptoms presented by menopause:

  • Night sweats
  • Hot flashes
  • Mood swings
  • Reduced libido
  • Vaginal dryness

Hormone replacement therapy can also help with osteoporosis which becomes common in women with menopause.

One type of hormone replacement therapy is low-dose vaginal estrogen therapy for a menopausal woman. It helps reverse vaginal tissue changes.

They come in few forms that are inserted or applied into your vagina: 

  • A vaginal cream: You start by using a vaginal cream (or estrogen cream) once a day for a few weeks, followed by one to two times per week for maintenance.

  • Vaginal tablet: Much like an estrogen cream, you use this on a schedule.

  • Flexible vaginal ring: You place this in your vagina for three months at a time. It has a sustained release.

  • Vaginal suppositories: This mainly contains the hormone DHEA (your body naturally produces this in the adrenal gland) that converts into testosterone and estrogen.

These estrogen doses are low enough to reduce the risks of overall systemic estrogen exposure. Not only can it improve the blood flow, but it can restore elasticity and thickness to your vagina.

4. Add a vaginal moisturizer to your daily routine

A topical vaginal moisturizer can improve vulvovaginal atrophy. When used daily, it traps moisture in the tissues to relieve pain and dryness for longer periods.

5. Try estrogen pills

If you’re one of those women who’d much rather swallow a pill than relying on topical medications, estrogen pills may be an option for you. 

Certain drugs (like ospemifene) mimic estrogen on the vaginal lining without the harmful side effects on the uterus lining or breasts. 

Other hormone pills have possible side effects like:

  • Tenderness of the breasts
  • Bloating
  • Nausea
  • Gaining weight
  • Unusual vaginal bleeding
  • Headaches

6. Pelvic floor physical therapy

If you have tight or tender pelvic floor muscles, you can experience painful sex. A specialist performs pelvic floor physical therapy to relax these muscles. It can ease the pain you experience during intercourse. 

You may also learn about vaginal dilation exercises by way of a lubricated vaginal dilator. This will help stretch your tissues and keep your vagina from becoming too narrow. Seek professional expertise before trying a vaginal dilator for proper use. 

7. Try a vaginal lubricant

Use vaginal lubricant to elevate painful intercourse after menopause

A vaginal lubricant is possibly the easiest way to elevate painful intercourse after menopause and ensure pleasure in the bedroom. 

Best used before and after sex, they can help make your intimate experiences pleasurable and free of discomfort. 

Finding the right formula and brand may require some trial and error, particularly if it’s your first time experimenting with lubes. 

A few words of caution: 

  • It’s important to use proper lubricants and not resort to products like petroleum jelly, body lotion, or baby oil. These can irritate your skin and increase vaginal infections due to the harmful chemicals found in them.
  • Before shopping your choice of lube (i.e. water, oil, or silicone), be sure to do a patch test before applying the lubricants to sensitive areas.

Here’s everything you need to know:

There are three types of lube: water-based, silicone-based, and oil-based lubes.

Water-Based Lube

This type of lubricant is the best if you’re just getting into lubes. 

They are:

  • Water-soluble
  • Great with retaining moisture because of the added ingredients they contain
  • Resistant to contamination and dispersal

Water-Based lubes also come in two varieties:

  • With glycerin
  • Without glycerin (these are less likely to give you vaginal irritation)

Try the Coconu Water Based Personal Lubricant

If you’re looking for an excellet product that will offer lubrication while getting rid of painful sex, check out the organic Coconu Water Based Personal Lubricant. This is certain to leave your vagina sans any irritation thanks to incredible all-natural ingredients. 

Plus, there are no genetically modified organisms added. The product also has zero alcohol, parabens, gluten, phytates, petroleum, dyes, and fragrances.

The lube is hypoallergenic and also keeps your vagina’s pH balance intact. It’s perfect for sensitive vaginas that need a good moisturizer to rehydrate outside of the bedroom.

Use with: Silicone toys and latex condoms.

Ingredients include: Organic Coconut Water, Xanthan Gum, Sodium Benzoate, Cellulose Gum Cyamopsis Tetragonoloba (Guar) Gum, and Potassium Sorbate.

Price: $24.99 for 3 fl oz 

Do you know if your personal lubricant has expired? Find out with this detailed guide

Oil-Based Lube

Oil based lubes are great if you’re having a long intimate session. They work great with water play, oral sex, masturbation, and unprotected penetrative sex. 

With the oil components, the product is also great for an intimate massage. However, it’s tough to clean so be mindful of spills!

Most oil based lubes have plant-based oils such as sweet almond oil, sunflower oil, and coconut oil. The oil makes it riskier when using a condom — breakage or slipping are more prone to happen. Why? The oil dissolves the latex found in sex toys, condoms, and diaphragms.

Try the Coconu Oil Based Personal Lubricant

Everyone deserves mind-blowing and stimulating sex, and with the Coconu Oil Based lube, you can do just that. 

Here are a few reasons why we love this product: 

  • It’s 100% organic and free from harmful additives. 
  • It is also one of the only USDA-certified organic products, so you know you’re in good hands.
  • The Coconu oil-based lubricant goes on well as a massage oil. We think you’d love this as a warmup leading to any sexual activity.
  • You don’t have to worry about infections, and it works great on both the vagina and anus.
  • It stimulates natural lubrication.

Use with: Polyurethane condoms only.

Ingredients include: Cocoa Seed Butter, Beeswax, Shea Butter, Sunflower Seed Oil, Coconut Oil, Sweet Almond Oil, Kukui Seed Oil, and Sea Buckthorn Oil.

Price: $24.99 for 3 fl oz 

Discover how you can Enjoy a Full Body Massage with your partner.

Try the Coconu Hemp Infused Body Oil

The Coconu Hemp Infused Body Oil is a triple action product that you can use before, during, and after all types of play. Apply it as a pre-lube, a massage or body oil, as well as a lubricant. 

This is why we highly recommend this body oil:

  • One of the key ingredients is broad-spectrum CBD from hemp. It contains no THC levels, so there’s no danger of getting high when you indulge in any sexual activity.
  • The CBD oil aids in relaxing the vaginal muscles and can enhance your orgasms.
  • Bundled up in sustainable, plastic-free packaging, this body oil is edible, vegan-friendly, hypoallergenic, and cruelty-free.
  • It absorbs fast and reduces friction during sexual intercourse. 
  • It also eases inflammation, pain, and soreness.

Use with: Polyurethane condoms only.

Ingredients include: Beeswax, Cocoa Seed Butter, Sunflower Seed Oil, Sweet Almond Oil, Coconut Oil, and Shea Butter.

Price: $34.99 for 3 fl oz 

Read up more about Using Hemp as a Lube. 

Silicone-Based Lube

The Silicone based lubricants don’t have any water and can last longer compared to water based products.

With a glossier, thicker consistency than water, silicone lubes don’t absorb easily into the skin. It also doesn’t require frequent reapplication. So, it’s perfect for long sessions.

It is tough to wash off so watch your bedsheets. 

Silicone lubes work great for water play like that hot shower you were hoping to take since it doesn’t come off as quickly. 

However, don’t use this type of lube with all silicone-based products as it can eat into it. Instead, choose toys made of more rigid materials like ceramic, steel, marble, glass, aluminum, or hard plastic. You can use this with condoms. 

Here’s a round-up of some of the Best Lubes for Sensitive Skin.

8. Work in foreplay and have more sex

It’s a no-brainer, the more time you spend on becoming better aroused, the wetter you become.  Arousal leads to improved blood flow that will increase the elasticity of your vaginal wall and alleviate pain. 

Regular sexual activity (with a partner or on your own) will help maintain your vaginal health, particularly for postmenopausal women.

Talk to your partner and add adequate time for touch, oral sex, or different positions. Using a toy is a great way to also add pleasure to your intimate moments. A vibrator can increase pelvic blood flow, which will, in turn, add more moisture to your vagina. 

What may have worked for you pre-menopause may not work for you now. So have an honest conversation with your significant other. Communication is key. It may also help to revitalize your relationship.

9. Seek help from a counselor or sex therapist

Stress can have adverse reactions on your sex life. If you’re dealing with emotional issues, a counselor or sex therapist can help with what you’re going through and offer you ways to deal with it. 

Sex therapy can also improve how you communicate with your significant other while discussing anxiety and body image. Therapy can also help you to enjoy intimate moments better.

Enjoy Good Sex At Any Time

Although menopause is a natural aspect of aging, your sexual health should remain top of mind, and you shouldn’t have to suffer through painful intercourse after menopause. Although there are challenges in the bedroom after you hit a certain milestone, there is still hope. 

Sex should be a fun experience at any age, and with a little creativity in the bedroom, it can still be.