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Can Sex Be Painful During Menopause

Men Get Real About Sex After Menopause

Menopause and You: Painful Intercourse

I’ve run a few pieces in this Sex After Menopause series, each of them documenting real-life stories of women navigating midlife sexuality. Hearing from women is just half of the story, however. Men are clearly impacted by their lovers’ sexual evolutions, and their experience also deserves a forum. I’m grateful to the six men who agreed to share the most intimate details of their journey through menopause with the women they love.

I married my best wife when she was 48, after 14 years with my worst wife. Had about six years of a wonderful sex life — at last!

Then menopause hit and that was it. Sex became excruciating and libido packed up shop two years later . Doctors were no help. The only option they offered was HRT which she was afraid of due to the likelihood of encouraging breast cancer.

That was it. Game over. I’m eight years younger than my wife and frustrated as hell with no one to be angry at. I’m grateful to have met my wife and for the brief time where I did have a satisfying love life, but God, it’s been a tough road to hoe since then. I have to say, the letters you’ve gotten from couples bragging about “no problems here” do read like Penthouse Forum — unbelievable, given my experience.

James

We’re slowing down, but continue to make love five or six times a month, for which I am so very, very grateful. She is a sweetie.

Larry

Matthew

Phil

I am 68 and my girlfriend is 64. She is the sexiest, most orgasmic woman I have ever been with .

Carl

Womens Wellness: Painful Sex After Menopause

DEAR MAYO CLINIC: I am in my late 50s and have recently found that sex is becoming quite uncomfortable. I am assuming this is because Im past menopause, but whats the best way to make sex less painful?

ANSWER:Dyspareunia, the term for painful vaginal sex, is quite common. Estimates vary, but surveys of postmenopausal women not on hormone therapy report dyspareunia in as many as 20 to 30 percent. Its often divided into three categories: superficial pain, deep pain or both. Most women complain of superficial pain, which occurs upon vaginal penetration. Often, the pain has a sharp or burning quality. Deep pain occurs with deep penetration or thrusting. For some women, dyspareunia is temporary. For others, it can become chronic.

After menopause, painful intercourse often is associated with changes due to decreased estrogen levels. The vaginal tissues tend to become less elastic, more fragile, and more susceptible to bleeding, tearing or pain during sexual activity or during a pelvic exam. It can make sex painful or even impossible. The loss of estrogen can cause urinary problems, which also can make sex uncomfortable. Lack of sexual activity contributes to loss of tissue health and elasticity.

There also are a number of other treatment options. Vaginal lubricants help decrease pain during sex and can be applied as often as needed. Keep in mind that oil-based lubricants may degrade condoms. Vaginal moisturizers used every two to three days can help maintain vaginal moisture.

Moisturizers And Lubricants Often Help

For vaginal dryness by itself, I recommend trying over-the-counter moisturizers and lubricants.

  • Vaginal moisturizers add moisture around and inside the vagina. There are two types. Internal moisturizers are inserted into the vagina, where they help build up vaginal tissue. External moisturizers are made for the vulva.

  • Lubricants decrease discomfort during intercourse. Sexually active women should use lubricants in addition to a vaginal moisturizer. I prefer water-based lubricants, though they dont last as long as silicone-based products. Skip oil-based lubricants. They can cause irritation and make condoms less effective.

See your ob-gyn if irritation and pain during sex dont improve after 2 months of use, or if you have other symptoms.

Read Also: Can You Go Into Early Menopause After Tubal Ligation

Exercise Tips For Staying Active

Keeping active can help reduce body aches and tone muscles, making you less susceptible to injury. If you find that aching knees make running, dancing, or brisk walking difficult, try using knee sleeves. They provide compression, which can help keep active knees comfortable. They also make injury less likely. You can also forgo the running track for the pool. Swimming is an easy-on-the-body alternative and may help you get your mind off of any pain you are feeling.

Other ways to reduce pain can include deep muscle massage, acupuncture, heat or cold application, and hypnosis. If you smoke, or have other habits which adversely affect your health, work on eliminating them. This may increase feelings of vigor, improve circulation, and reduce stress, which may all help to reduce pain.

How To Make Sex Enjoyable During Menopause

How and why is Sex affected post Menopause?

Approximately 25 to 46 percent of postmenopausal women experience pain during intercourse. This condition is referred to as dyspareunia, which is most commonly caused by vulvovaginal atrophy, a condition where your vaginal area experiences a lower presence of estrogen.

As women experience menopause, estrogen production decreases, which lessens blood flow to the vagina. This causes the vagina and vulva to shrink and atrophy. Penetration during intercouse can create dryness, a burning sensation, soreness, and even bleeding during and after sex.

One natural way to reduce vulvovaginal atrophy during menopause is to have more sex. Sexual activity increases blood flow to the vaginal area, which naturally keeps your vagina and vulva healthy.

Of course, this isnt always a good solution due to extensive atrophy already occurring. For women experiencing noticeable pain during intercourse throughout menopause, there are several treatment options to consider.

Vaginal Moisturizers and Lubricants

Over-the-counter moisturizers and lubricants are known to relieve discomfort during intercourse.Some lubricants do have cooling solutions to help reduce any burning sensations. As always, be careful when using any moisturizer or lubricant to see how your body reacts to application. If there is any sign of allergic reaction, its best to choose another product.

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What You Can Do To Relieve Pain

Try these tips to boost your sexual pleasure:

Go for more glide. Use a lubricant before and after sex to ease pain due to dryness. Silicone and water-based products are both sold over the counter. If one brand bothers your skin, try others.

Moisturize. A vaginal moisturizer can ease dryness over the long term. Use it routinely, not just before sex.

Make time for foreplay. Spending more time getting aroused makes you wetter. Don’t focus just on The Big Act. Take time to caress, have oral sex, or try varied positions. Talk to your partner about what feels good and what doesn’t.

Wash with care. Avoid using soaps, shower gels, bubble bath, and bath oils in the vaginal area. These can dry skin. A warm-water rinse will do the job. Also skip sprays and perfumes. When you’re having problems, wash your underwear in mild soap. Make your undies white cotton, too.

Have more sex. “Use it or lose it” is true when it comes to the health of your sex organs. Being aroused improves blood flow. So when you have sex often, you’re less dry. Self-pleasure can help if other sex acts hurt.

How Your Doctor Can Help

Don’t be shy about getting help. And don’t think sexual pain is just part of menopause. Sex should never hurt. Get an exam to help pinpoint the cause. This will help steer you to the right treatment.

If the pain is due to menopause:

  • Your doctor may prescribe low-dose estrogen to ease vaginal dryness. Three types — a cream, tablet, and ring — go right into your vagina.
  • Estrogen-like pills may also be an option. They act like estrogen in your body to treat painful sex and help improve some vaginal tissue changes that come with menopause.

If the pain is due to something else:

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When To See A Doctor

If lubricants and vaginal moisturizers donât give you enough relief, make an appointment with your gynecologist or OB/GYN.

Lauren Streicher, MD, clinical professor, department of obstetrics and gynecology, Northwestern University School of Medicine founder and director, Northwestern Medicine Center for Menopause, Northwestern Medicine Center for Sexual Health.

Kathleen Green, MD, assistant professor, department of obstetrics and gynecology, University of Florida College of Medicine.

Alyssa Dweck, MD, gynecologist, CareMount Medical Group medical consultant, Massachusetts General Hospital.

Laurie Mintz, PhD, sexual psychologist professor, department of psychology, University of Florida.

Ellen Barnard, MSW, certified sexuality educator co-owner, A Womanâs Touch Sexuality Resource Center, Madison, WI.

The North American Menopause Society: âPain with Penetration,â âIllness, Medical Problems, Medications,â âPain in the Vulva or Pelvis,â âSex Therapy and Counseling.â

Pain Research and Management: âDyspareunia in postmenopausal women: A critical review.â

Harvard Health Publishing: âManaging postmenopausal vaginal atrophy,â âPostmenopausal bleeding: Donât worry â but do call your doctor.â

Mayo Clinic Proceedings: âRecognition and Management of Nonrelaxing Pelvic Floor Dysfunction.â

UpToDate: âPatient education: Vaginal dryness .â

Mayo Clinic: âWomenâs Wellness: Painful sex after menopause.â

Try A Lubricant During Sex

Gynecologist in NYC – Painful Intercourse in Menopause Doesnt Have to Be!

Intimacy can be even better if you combine polycarbophil gel with a lubricant during sex, says Minkin. There are plenty of lubricants available on the market, and finding the right one can take some trial and error.

I tell patients not to go out and buy the giant, economy size bottle until you know it will agree with you, says Minkin. Many contain fragrances, which can irritate especially sensitive vaginal and vulval tissues. Also, if youre using condoms to protect against sexually transmitted infections, be aware that an oil-based lubricant can degrade the latex in that case, choose a water-based or silicone lubricant.

Recommended Reading: Menopause And Dizzy Spells

Other Conditions That Cause Pain

Pain during sex isnt always due to atrophy. It could also be a sign of these conditions:

Vestibulodynia. The vestibule is the area where the vulva the outer parts of the vagina including the clitoris, clitoral hood, and labia connects with the vagina. In some women, the vestibule becomes very sensitive to touch. Having sex or inserting a tampon is very painful. Doctors can treat this condition with local anesthetic creams or gels, physical therapy, and mental health counseling.

Vulvodynia. This condition causes pain or burning in the vulva without any obvious cause. About 60 percent of women with vulvodynia are unable to have sex because of the pain. Treatments include topical anesthetics, physical therapy, and mental health counseling.

Vaginismus. In this condition, the muscles around the vagina contract painfully during sex, or whenever something is inserted into the vagina. It may be triggered by fear after a traumatic experience. Treatments include a dilator to widen and relax the vagina and physical therapy.

Cystitis. Bladder inflammation can cause pain during sex because the bladder sits right on top of the vagina. At least 90 percent of people interviewed by the International Cystitis Association said interstitial cystitis negatively affected their sex life. Treatments for cystitis include medication, nerve blocks, and physical therapy. Relaxation techniques, heat, or cold may also help relieve discomfort.

The Physiology Of Sex After Menopause

You might be familiar with the stereotype of menopausal women portrayed in the mediacrotchety, dried-up, and sexless after menopause. And yeah, your body is changing and this change comes with side effects, but you dont suddenly have a vagina-less Barbie body. Sex is still a basic part of your human experience and you can still enjoy it.

However, its best to just come out and say it: menopause will change your sex life. There are several reasons why:

  • Vaginal atrophy. During menopause your body halts estrogen production. A decrease in estrogen can lead to vaginal atrophy, which the Mayo Clinic defines as thinning, drying and inflammation of the vaginal walls. While that sounds scary, dont worry, there are treatments available. But before we go further its important to note that vaginal atrophy doesnt just affect your vaginal canal. It can also come with symptoms like recurring UTIs, burning when you urinate, and an urgency to urinate. In short, vaginal atrophy affects everything about your vulva, and not just the parts you use for sex. Its normal, and you shouldnt be embarrassed or ashamed. Most menopausal people have some of these issues!

Read Also: Relactation After Menopause

Painful Sex And Vaginal Dryness

Sexual intimacy is supposed to be an enjoyable experience that brings you and your partner closer together. But when sex becomes painful, it can have a major impact on your life and your relationship.

An estimated three in four women experience frequent pain during sex at some point in their lives, often the following menopause. Some women only experience pain during penetration, while others experience deep pain with each thrust. In some cases, throbbing or burning pain sensations emerge slowly and continue long after intercourse has ended.

Although a variety of factors can contribute to the development of dyspareunia, the problem is most common during and after menopause, when reproductive hormone imbalances are more likely to interfere with your bodys sexual response, weaken your vaginal tissues, and decrease your normal lubrication.

Pelvic Floor Physical Therapy

Painful Sex During Menopause: When to Get Worried ...

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.

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Painful Sex And The Menopause

After menopause, up to half of all women have pain before, during, or after sex. And sex after menopause doesnt get talked about often. And yet, contrary to what some people may think, women do continue to be sexual beings as they age.

According to a survey presented at the North American Menopause Society, almost half of women believe that its normal for sexual function to decline after menopause, and only about a third had ever tried to get help correcting the menopause symptoms that were interfering with their sex lives.

A survey suggests that 84% of menopausal women find sex painful. In the survey, nearly 70% said their relationships had suffered as a result. A whopping 81% percent didnt know that vaginal atrophy or age-related vaginal drynessa common issue for many menopausal womenis a medical condition.

Why does vaginal dryness happen during perimenopause or menopause?

Bladder and urinary problems

Another common problem is bladder or urinary symptoms often recurrent cystitis or recurrent urinary tract infections . It might just be feeling a need to void more frequently, or getting up more during the night. Theres also a higher incidence of thrush and other vaginal infections like BV .

Hormones are important great sex

Top tips to help with vaginal dryness

its worth trying self-help options in the first instance. There are a variety of ways to relieve vaginal dryness and thus make sex easier and more pleasant:

Who Should Not Take Osphena

Osphena should not be used if you have unusual vaginal bleeding, have or have had certain types of cancers, have or have had blood clots, had a stroke or heart attack, have severe liver problems, are allergic to Osphena or any of its ingredients, or think you may be pregnant. Tell your healthcare provider if you are going to have surgery or will be on bed rest.

Also Check: Is Dizziness A Symptom Of Perimenopause

Find Other Ways To Connect

Do things together to help build your intimacy. It doesnt have to be fancy, but a regular date night or time for just the two of you can help keep a relationship strong and can help you form a deeper connection once youre ready for sex.

Finally, we cant stress enough the importance of good communication. Learn what works for you and communicate that to your partner. Its easy to fall into the trap of thinking you need to be having sex to be happy, but the truth is that whatever works for you is completely fine. That may be moving to more clitoral stimulation or snuggling – whatever makes you feel good. Focus on what makes you and your partner happy and dont worry about what you think others are doing or what you think you should be doing.

Painful Sex After Menopause Is Common And Treatable From The Harvard Womens Health Watch

Menopause and Painful Intercourse – What you can do about it – Naturally!

Millions of women experience pain before, during, or after sexual intercoursea medical condition called dyspareunia. This common problem can sap sexual desire and pleasure, strain relationships, and erode a womans quality of life. For postmenopausal women, in particular, it can bring up issues of aging and body image. Many women suffer in silence because theyre embarrassed or cant find a doctor who specializes in problems of this nature. The May 2012 issue of the Harvard Womens Health Watch describes how dyspareunia can be treated, and guides women to get the help they need.

Painful intercourse has many possible causes, including hormonal changes, medical and nerve conditions, skin diseases, and emotional problems such as anxiety and depression. Often, several are at work. The decline in estrogen production at menopause can thin vaginal tissue, resulting in dryness, burning, and pain. Another culprit is vestibulodynia, a chronic pain syndrome that causes discomfort with any kind of touch or pressure in the area around the vagina. Psychological factors may be involved, especially in women who associate the vaginal area with fear or injury.

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Recommended Reading: Perimenopause Dizzy Spells

Less Intercourse Is Natural

Despite what the media and prescription drug commercials would have you believe, intercourse in later years often isnt as pleasurable for couples as it used to be. Thats because of bodily changes such as vaginal dryness and erectile dysfunction, says Kraft. Half of women in their 50s continue having intercourse, but by their 70s only 27 percent of women are doing it.

That doesnt mean that you cant be intimate with your partner whether youre having intercourse with the help of lubricants, vaginal moisturizers or prescription drugs, or choosing other ways of staying connected.

About a third of long-term couples dont have sex or have sex only occasionally. But they dont necessarily consider that a problem. Its just where their relationships have evolved, explains Kraft. They do other things that are intimate that they enjoy like cuddling, sharing a bed and laughing together. And theyre happy.

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