Menopause and painful sex
It can feel distressing and upsetting when what should be 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 being sexual. Thankfully, it isn’t all gloom and doom – 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 during 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. Find out more about why your vagina looks and feels different after menopause.
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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 normal
Read more about the stages of menopause.
SIGNS OF PAINFUL SEX IN MENOPAUSE
External pain on your vulva
Internal pain in your vagina, uterus or pelvis
Sharp pain, burning, stabbing, aching or throbbing
Painful sex during or after menopause may leave you with feelings of shame or that something is wrong. Have a read of our post on sexual self-esteem to find out how to address this.
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, not self inflict pain.
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 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 moisturisers work in different ways, so you may wish to try both.
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 and decrease your pain response.
Have sex with yourself
Just because you are having pain with sex does not mean that you don’t deserve to have pleasure. It is important to remind yourself that you can feel good in your body. Check out our sex toy guide here.
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 actually dry out and irritate the tissues.
Take pain-relieving steps
To reduce pain on deep penetration, you can try something like the Ohnut rings to adjust the depth of penetration to what feels comfortable. Other preventative steps include taking a warm bath or painkiller prior to sex. After sex, apply an ice pack to the vulvar area.
See a doctor
If you have painful sex, you should always go to see a doctor for review. They will be able to help you work 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 physio may also be helpful. See your doctor urgently if you have any bleeding after sex, bleeding in between periods, sores on the vulva or vagina or any other symptoms which are worrying you.
Consider topical oestrogen
This comes in the form of creams, pessaries or rings and is applied directly to the vaginal area. This is an effective, low-risk form of HRT and is used to treat menopausal changes in the vagina and surrounding tissues which could be causing your pain. Speak to your doctor for further advice about this and other forms of HRT.
Smoking can worsen dryness and contribute to painful sex.