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What Causes Pain During Intercourse After Menopause

Why Does Sex Hurt After Menopause

Menopause and You: Painful Intercourse

Post-menopausal intercourse pain is due to the decrease in the bodys estrogen levels. Estrogen is responsible for the normal functioning of your reproductive organs, including the vagina. The hormone stimulates the release of natural lubricants and usually stimulates the repair of damaged cells in your vaginal lining.

Without your bodys normal production of estrogen, you may notice vaginal dryness, laxity, burning, pain, and itching. For many women, those symptoms amplify with sexual intercourse. Altogether, these symptoms represent a condition called vaginal atrophy.

Whats more, is that sexual activity encourages blood flow to the vagina. If you avoid sex, you may experience even more tissue thinning and pain.

What Are The Common Causes Of Pain During Sex

Valentines Day always puts the focus on love, romance and, yes sex. Unfortunately though for some women this may not be cause for celebration. If you are one of the estimated 20% of Australian women who experience pain with intercourse, date-nights might even be viewed with dread at the expectation that they will end in sex. So what are the causes of sexual pain?

A great way to work out the possible causes and communicate effectively with your doctor is to start by answering these questions:

How old are you?

Some causes of sexual pain are more common at certain life stages. For example, a young girl is more likely to be tense during early sexual encounters and have a tight vaginal opening. A post-menopausal woman however is more likely to experience vaginal dryness and tissue fragility, called atrophy due to estrogen deficiency.

Where is the pain?

Is it on the outside or the inside? Superficial or deep? For example, pain on the vulval or labial areas suggests completely different causes compared to pain only felt deep inside the vagina. During intercourse, pain that is felt with initial penetration of the vagina is called superficial dyspareunia whereas pain that is felt only higher up with deeper penetration or thrusting is call deep dyspareunia.

When does it happen?

Have you ever had sex that wasnt painful?

Can you see or feel anything different?

Are there any other symptoms or significant medical conditions?

Putting it all together

Health And Skin Conditions

When youre under the sheets, certain sex positions can lead to pain. This pain is usually because your pelvic muscles arent sufficiently relaxed.

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

  • Pelvic floor dysfunction
  • Endometriosis
  • Uterine fibroids
  • Scarring from pelvic surgery
  • Pelvic radiation treatments

Once your doctor examines your pelvic muscles and genital area, he or she will be able to find out where your pain is and whats 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 thats not pleasurable.

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Menopausal Pelvic Organ Prolapse Symptoms

Symptoms associated with pelvic organ prolapse can range from minor pain and difficulty urinating to emotional distress. Unlike other symptoms of menopause, such as hot flashes, pelvic organ prolapse symptoms can increase with age.

Symptoms related to varying types of pelvic organ prolapse include:

  • Pain or a feeling of pressure in the pelvis or vagina
  • Feeling that something is coming out of your vagina or sight of tissue protruding from the vagina
  • Difficulty urinating or a feeling that the bladder will not empty bowel movement difficulty
  • Lower back pain

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Sex Isnt Supposed To Hurt

Dyspareunia (Painful Intercourse)

Just because painful sex is very common, that doesnt mean you have to accept it as “normal.” Occasional minor soreness is likely nothing to worry about, but intense or frequent pain is worth having a conversation with your doctor.

Sex should be a pleasurable experience, and if its not, dont hesitate to speak up to your partner and your doctor.

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Can Your Ovaries Hurt After Menopause Why

Typically felt below the belly button in the lower abdomen, ovarian pain can start during the period before menopause occurs, called perimenopause. During perimenopause, the areas around the ovaries and the ovaries themselves can become sensitive and painful. However, ovarian pain may continue well after menopause starts. Ovaries hurt around menopause because of hormones called prostaglandins. Prostaglandins affect pain levels and inflammation, and estrogen levels can influence the amount of prostaglandins in the uterus lining. As estrogen levels fluctuate, so do prostaglandins, thus causing pain.

Sexual Health Is Worth Prioritizing

Many women are hesitant to bring up sexual problems with their doctors, Dr. Eilber says.

“It can feel embarrassing,” she says. “Its difficult enough to share with our partners and friends, so telling a doctora strangercan feel intimidating.”

She likens it to mental health.

“Like mental health, sexual health can carry a stigma,” she says. “Mental health is slowly losing that stigma, and sexual health needs to follow that trend. We can look at these things as health conditions and normalize having these conversations as part of our regular healthcare.”

Read: How to Address Uncomfortable Topics With Your Doctor

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How Long Does It Take To Recover From Dyspareunia

The recovery time for dyspareunia varies depending on the underlying cause for the pain you feel during sex. The good news is that you can find relief and recover from painful sex. Whether it is medication, counseling, surgery or using lubricationyour healthcare provider can find a treatment that can improve or eliminate dyspareunia.

Pain During Sex After Hysterectomy: Why It Happens And How To Treat It

What causes post coital vaginal pain in women having a premature climax? – Dr. Shailaja N

Dyspareunia is a big, intimidating word for something most women dread: experiencing pain during sex. Especially for women who have recently undergone a partial or total hysterectomy, painful sex can be scary and even heartbreaking. Not only is it frustrating, it also causes some women to feel embarrassed or ashamed of their bodies and prevents them from participating in fulfilling sexual relationships. These reactions can make it difficult for women to discuss their symptoms with the doctors who may be able to help relieve their pain.

If you experience pain during sex after hysterectomy, you need to know that having your uterus removed does not inherently impact your sexual function in any permanent way. Research has shown that you dont need a uterus to have a fulfilling and healthy sex life.

However, you also need to know that youre not alone in experiencing pain. Due to recovery time, surgical menopause, and the emotional aftermath of a hysterectomy, many women experience painful sex for a time after this major surgery. But by honoring your bodys healing process and seeking appropriate treatment with your doctor, it is possible to ease back into pain-free sex in a healthy way.

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Sex Is Becoming Painful: What Can I Do

Pain during is called dyspareunia. Like other symptoms of the menopausal transition, dyspareunia may be minor and not greatly affect a womans quality of life. However, some women experience severe dyspareunia that prevents them from engaging in any sexual activity without pain.

Many find relief from vaginal dryness during sex by using a nonprescription, water-based lubricant, a variety of which can be found at most grocery and drug stores.

Other women try over-the-counter vaginal moisturizers, which are used regularly and not just during sex to replenish moisture and relieve dryness.

Your doctor might suggest prescription hormones. Local vaginal treatments are often used to treat this symptom. These treatments provide lower hormone doses to the rest of the body than a pill or patch.

The U.S. Food and Drug Administration has approved two nonhormone medications, called ospemifene and prasterone, to treat moderate to severe dyspareunia caused by vaginal changes that occur with menopause. Your doctor can tell you about the risks and benefits of these medications.

Seek Help From A Counselor Or Sex Therapist

Stress can have adverse reactions on your sex life. If youre dealing with emotional issues, a counselor or sex therapist can help with what youre 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.

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What Is Pelvic Pain

Pelvic pain is a common problem among women. Its nature and intensity may fluctuate, and its cause is often unclear. In some cases, no disease is evident. Pelvic pain can be categorized as either acute, meaning the pain is sudden and severe, or chronic, meaning the pain either comes and goes or is constant, lasting for a period of months or longer. Pelvic pain that lasts longer than 6 months and shows no improvement with treatment is known as chronic pelvic pain. Pelvic pain may originate in genital or other organs in and around the pelvis, or it may be psychological. This can make pain feel worse or actually cause a sensation of pain, when no physical problem is present.

Painful Intercourse Why Intercourse After Menopause Can Be Uncomfortable And What To Do

Dyspareunia: What Causes Pain during Sex &  its Treatment!

Menopause can bring about many physical and emotional changes in women. Apart from the end of monthly menstruation, the changes can affect almost every aspect of our lives, including our libido and our moods. One common side effect many women struggle with is painful intercourse, commonly known as dyspareunia, as a result of changes during and after menopause.

During menopause, a womans ovaries cease producing the estrogen and progesterone hormones. The decline of estrogen hormones can cause pain during intercourse, according to the North American Menopause Society. Estrogen produces a natural lubricant during intercourse, and it additionally helps in producing new cells in the vagina. The decline results in the vagina being dry and a less elastic vagina, resulting in uncomfortable and painful sex. After sex, some women have reported feeling sore or a burning sensation in their vulva or vagina after intercourse.

Depending on where you feel this pain, the causes could vary. Menopause is typically the cause for older women, but consult your doctor if you feel this type of pain in any of these regions.

Outer, Entry Pain:

Knowing where the pain is coming from can greatly help your doctor give you suitable treatment for the pain. If left untreated, the pain can trickle into other areas of your life, and could possibly damage your self image, or even your romantic relationships.

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What Causes Continuous Pain During Intercourse

Causes include: Certain illnesses and conditions. The list includes endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, pelvic floor dysfunction, adenomyosis, hemorrhoids and ovarian cysts. Surgeries or medical treatments.

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.

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Are There Medications To Take For Dyspareunia

Yes, there is a medicine available to treat pain during sex. If vaginal dryness due to low estrogen is the cause of your painful sex, topical estrogens can be applied to the vagina. The Food and Drug Administration approved a drug called ospemifene for dyspareunia due to menopause. It can be taken orally. Medication can also be prescribed to treat pain due to infection or underlying medical conditions.

Painful Sex After Menopause Can Be Temporary Or Chronic But There Are Strategies For Making It More Comfortable Including Hormone Therapy Menopause Is A Condition Where Menstruation Has Stopped For At Least 12 Consecutive Months Changes During And After Menopause Can Result In Painful Intercourse Also Known As Dyspareunia For Many Women However It Can Be Managed And Treatable

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

Menopause is a condition where menstruation has stopped for at least 12 consecutive months. Changes during and after menopause can result in painful intercourse, also known as dyspareunia, for many women. However, it can be managed and treatable with a better understanding of the issue and support from healthcare providers.

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What Tests Are Done To Diagnose Dyspareunia

To locate the source of the pain and diagnose any medical conditions, healthcare providers may perform the following:

  • Physical exam: This examination could include a pelvic exam, rectal exam and Pap test. Your healthcare provider may also collect a sample of vaginal fluid and urine to test for signs of infection.
  • Ultrasounds: Transvaginal ultrasound can get a better view of the female reproductive system.
  • Laparoscopy: In rare cases, laparoscopy is used if other tests are inconclusive.

What Causes Painful Intercourse

Pain during intercourse is one of the most common causes of problems of sexual dysfunction. The prevalence of such pain seems to be increasing over time. Possible reasons for this apparent increased prevalence include the following:

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Common Questions About Treatment Options

I have a history of breast cancer, Am I able to use any treatments?

If you have had breast cancer, you should talk to your healthcare provider. It is safe to use lubricant and moisturizers. If these dont work, there is a possibility you could use other treatments, but this should only be done in consultation with your oncologist.

How about herbal remedies and soy products to treat my vaginal symptoms and pain with sex?

We do not have enough data or information to support the use of herbal remedies or soy products to treat vaginal symptoms or pain with sex during menopause. Therefore, we cannot recommend these options.

Take Home Points

  • Sexual health is a very important part of your overall health.
  • Dryness and thinning of the vagina is the most common cause of painful sex at midlife and beyond.
  • Be comfortable discussing these matters with both your partner and healthcare provider. Remember, this is totally appropriate conversation to have.
  • There are a number of safe and effective treatments options to help you get better and improve your quality of life.

Additional Resources

Bacterial And Yeast Infections


Bacterial and yeast infections are among the most common and best-known problems capable of causing painful intercourse. These infections include bacterial vaginosis, candidiasis, and cervicitis, which is an infected and inflamed cervix. Of these, a yeast infection is most likely to cause painful sex.

As you can see, there are many possible reasons for painful intercourse before menopause. The good news is that we can help treat all of them: Call Fred A. Williams, MD, or book an appointment online.

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What Can I Take For Painful Intercourse During 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.

Pain With Sexual Intercourse And Vaginal Bleeding After Menopause

Reviewed on 8/5/2020

There are a few different medical conditions that are strongly associated with:

  • Pain With Sexual Intercourse
  • Vaginal Bleeding After Menopause

While the symptoms above can be considered a guide to help associate symptoms common among the conditions below, this is not a substitute for a diagnosis from a health care provider. There are many other medical conditions that also can be associated with your symptoms. Below are the top condition matches for your symptom combination from MedicineNet:

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Are There Different Types Of Dyspareunia

The location of the pain can help determine what type of dyspareunia you are experiencing:

  • Entry pain : This pain is felt at the entrance to the vagina during initial penetration. Some factors associated with entry pain can be lack of lubrication, injury or infection.
  • Deep pain : This is pain that occurs in deep penetration and can feel worse in certain sexual positions. You will feel this pain in the cervix or lower abdomen. A medical condition or prior surgery usually causes sexual pain that occurs deeper.

Pain during intercourse can also be described as primary, secondary, complete or situational:

  • Primary pain is pain you’ve had since becoming sexually active.
  • Secondary pain develops after experiencing pain-free sex.
  • Complete pain means you feel pain every time you have sex.
  • Situational pain is when the pain only happens at certain times.

What Causes Dyspareunia

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In many cases, you can experience pain during sex if there is not sufficient vaginal lubrication. In these cases, the pain can be resolved if you become more relaxed, increase foreplay or if you use a sexual lubricant.

In some cases, you have painful intercourse if one of the following conditions is present:

Like women, men can also feel pain if there is not enough vaginal lubrication during sex. This can be solved by using a sexual lubricant. In men, painful sex can be caused by certain penile disorders:

  • Foreskin damage: Damage to the foreskin caused by rubbing or tearing can lead to pain.
  • Sexually transmitted infections : Yeast infections or infections under the foreskin, as well as common STIs like genital herpes or gonorrhea, can make sex painful.
  • Penis deformities: Peyronies disease or other deformities of the penis can cause painful intercourse.
  • Painful erections: A condition such as priapism can lead to persistent, painful erections.

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