Postmenopausal women talk about many of their physical symptoms regularly and with candid honesty. Hot flashes, night sweats, mood swings, low libido, lack of energy, and more come up often in social settings and even on the internet. However, another side effect of menopause that women often keep to themselves is painful sex during menopause. Up to half of all women experience pain before, during and after sex post menopause. It is possible to make sex feel good once again, though.

What Causes Painful Sex During Menopause?

Women who experience painful sex during menopause can clearly remember the days of mind-blowing, toe-curling, earth-shattering orgasms. However, when women are trying their best to stave off the pain in order to make their partners happy (after all, this is what women do), orgasm is the furthest thing from their minds. Any number of things can actually cause painful sex during menopause. They include:

Hormonal Imbalances 

During and after menopause, your hormones are all over the place. Unfortunately, postmenopausal women must cope with a dwindling amount of estrogen in their bodies. When estrogen dips, the tissues in the vagina become thinner over time, and natural lubrication wanes. What's more, the vagina loses elasticity as you age, making sex more uncomfortable.

Medical Problems 

Some women have medical problems that can contribute to pain during intercourse, even after menopause. They include chronic pain in the vulva, urinary tract infections, yeast infections, or some other type of skin problem. Even mental conditions such as past trauma or abuse may cause discomfort and pain during sex.

Fear of Pain

Sometimes, when women have one or more painful sexual encounters, they grow apprehensive of future encounters because they are afraid it will hurt. Unfortunately, this fear and apprehension only adds to vaginal dryness and makes the muscles in the vaginal wall even tighter.

Is There Any Relief?

The good news is that you do not have to "get used to" painful sex. In fact, you can do several things to help ward off painful sex during menopause and bring back the enjoyable, mind-blowing experiences you crave. 

  • Sexual Pain, Menopause Use a supplement. With so many doctors touting the dangers of hormone replacement therapy, and with bioidentical hormone replacement out of financial reach for many of today's postmenopausal women, supplements are the best route. All-natural products containing herbs like maca can help rebalance your hormones, improve your libido and even relieve postmenopausal symptoms exist—and some actually work.
  • Use it or lose it. The muscles in the vagina are just like any other muscle anywhere else in your body. You have to use them regularly to keep them in shape. Have sex often, and if you cannot, self-pleasure works just as well. Kegel exercises are also a great way to keep your pelvic area in shape over time.
  • Use a moisturizer. Vaginal moisturizers exist, and you can purchase them over the counter. You should use these all the time, and not just before sex. They help replenish the moisture that keeps you comfortable all throughout the day.
  • Choose a good lube. You will want to find a good water-based lubricant to avoid stickiness, but be aware that some products can and often will cause irritation. Postmenopausal women should use lubrication both before and after sex to keep things comfortable and pain-free.
  • Take your time with foreplay. Although we all get in a hurry from time to time, it is important to explore other avenues that bring about pleasure. Rushing right into things can cause pain, as it does not give your vagina time to prepare for the activities to come. Oral sex, caresses, and alternate positions can help improve everyone's experience.
  • Avoid soaps and perfumes. This also goes for the ones that are "dermatologist tested" or made for use on your sensitive lady parts. Douche is also a bad idea since even a mild vinegar solution can cause irritation and actually lead to more dryness. Avoid using soaps, bath oils, perfumes, deodorants, scented pantiliners, or even heavily perfumed laundry detergents and softeners on your panties. Plain white cotton panties washed in dye- and perfume-free soaps are best. Furthermore, vaginas are self-cleaning. All they need is a warm water rinse.

Prescription Treatment as a Last Resort

These days, a chemical solution by the brand name of Osphena treats painful sex during menopause. Though the FDA approved it and it was successful in clinical trials, this drug does not come without side effects. In fact, it may increase the risks of things like endometrial cancer, blood clots, and stroke—which are the same side effects of hormone replacement therapy. Prescription treatment for pain during intercourse is a last-resort treatment option.

The aforementioned tips and tricks provide a significant amount of relief without any of the associated risks. No one should have to put up with painful intercourse. After all, sex should be a time for you and your partner to bond and enjoy each other. If sex hurts, remember that there are things you can do to aid in your comfort—and in your pleasure.

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It Might Be Menopause: Common Signs and Symptoms
A Woman's Guide to Getting Your Mojo Back