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Why Is Sex Painful After Menopause

Why Sex Hurts After Menopause

Menopause and You: Painful Intercourse

When you reach menopause, your ovaries stop producing estrogen. This loss of estrogen has a broad impact because estrogen helps maintain the health of nearly every tissue in your body. Your bones are just one example. Estrogen is essential for building strong bones, so when its levels drop, your risk of developing osteoporosis significantly increases.

The tissues that line your vagina are especially vulnerable to the decline in estrogen after menopause. As a result, half of all women develop a condition called vaginal atrophy, or in medical lingo, genitourinary syndrome of menopause.

When you have vaginal atrophy, your vaginal lining begins to thin. Folds in the vaginal wall begin to disappear, so your vagina loses its natural elasticity. At the same time, production of substances needed to keep your vaginal lining strong and hydrated begins to slow down. The decrease in estrogen also leads to reduced blood flow and less lubrication.

All these problems combined the lack of lubrication and persistent vaginal dryness and thinning cause painful intercourse. In addition to the pain, youre also likely to experience bleeding as intercourse causes small tears in the fragile vaginal lining.

Although hormone replacement therapy is one treatment option, you can overcome the problem without taking hormones when you choose treatment with the MonaLisa Touch.

Pain May Be Caused By Surgical Menopause

After your body has fully healed from a hysterectomy, its still possible for you to experience painful sexparticularly if the procedure involved removing your ovaries. Removing the ovaries creates a sudden drop in estrogen levels in the body and sends you directly into what is known as surgical menopause.

In addition to commonly-discussed symptoms like hot flashes, mood swings, and night sweats, menopause also marks the beginning of vaginal atrophy, or atrophic vaginitis. Atrophy means muscles and tissues of your pelvic area get thinner and weaker due to surgical menopause, causing side effects like incontinence and uncomfortable sex. Many women also struggle with vaginal dryness during menopause, which can make sex more painful.

Menopause is the most significant hormonal shift in a womans body, aside from puberty and pregnancy. It brings about major bodily changes and can involve a significant amount of stress, embarrassment, and discomfort even when it occurs naturally. Undergoing menopause suddenly and at a younger age than expected can be quite a shock. We know that psychological factors like these have a great deal of influence on sexual function, and its possible that the difficult emotions associated with surgical menopause might be contributing to the pain you experience during sex. The good news is that there are a wide variety of treatment options available to you, should your menopause symptoms become unacceptably disruptive.

Ask Your Doctor About Testosterone

Testosterone replacement has long been used as a solution for men with a waning libidoand it can help rev up your own sex drive as well. Still, not all doctors are OK with prescribing synthetic versions of this main male hormone . Testosterone is by no means a cure-all and can come with side effects like acne and thinning hair. Luckily, newer remedies to enhance libido are being worked on even as we speak, Dr. Minkin says.

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Laser Therapy The Ideal Solution

If youre ready to put an end to painful intercourse for good, look no further than MonaLisa Touch laser therapy. MonaLisa Touch uses fractional CO2 laser technology to renew and revitalize the delicate tissues that line your vaginal canal. During the quick in-office treatment, we use a slim probe to ease the laser into your vagina, where it emits gentle pulses of energy that create painless micro-perforations in the surrounding tissues.

These microscopic perforations stimulate your bodys internal healing mechanisms, prompting ongoing tissue repair through cell renewal as well as collagen and elastin production. On top of completely revitalizing your vaginal tissues, MonaLisa Touch laser therapy also rejuvenates the vaginal mucosa, re-establishes normal lubrication, and restores proper function.

Nearly 90% of women affected by estrogen-related vaginal dryness and sexual pain are happy with the results of MonaLisa Touch treatments. For most women, it only takes three treatments to reverse the effects of vaginal atrophy, restore normal functionality, and return to pain-free sexual intimacy.

So what are you waiting for?

You dont have to let unavoidable hormonal changes upset your sex life. Call our office today to find out how MonaLisa Touch laser therapy can restore your vaginal health and your sexual vitality. Or simply click the request appointment button to schedule your visit.

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Why Do Women Stop Enjoying Sex After Menopause

Painful Sex After Menopause: Causes and Treatments

When women stop enjoying sex after menopause, it can be for a number of reasons. Some of those are physical. For example, if you have vaginal dryness, it can make sex uncomfortable or even painful.

Other reasons can be psychological. After menopause, some people find it harder to tolerate behaviors in others that previously didn’t bother them.

If you’ve stopped enjoying sex after menopause, think about why. Depending on the reason sex has become less fun, the solution could change a lot. You might need more lubrication. You might also need to sit down and have a talk with your partner.

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Possible Causes Of Painful Intercourse

Pain during sex happens to women for many different reasons, including physical problems, gynecological conditions, and emotional issues.

Emotions that inhibit arousal and interfere with lubrication can make intercourse painful, especially if those emotions make it difficult to relax. Shyness, embarrassment, sexual anxiety, and a lack of body confidence are just a few causes of emotions that might get in the way of a normal physical response.

Shifting hormones is another thing that can disrupt your bodys sexual response and make intercourse uncomfortable. Low estrogen levels mean that women are more likely to experience vaginal dryness and painful intercourse as they approach menopause, but menopause isnt the only time a womans estrogen levels might decline.

Some women experience vaginal dryness and painful intercourse following childbirth, as their hormone levels slowly recover breastfeeding mothers may experience similar symptoms for as long as they continue to nurse. Receiving treatment for breast or ovarian cancer also can affect estrogen levels and lead to painful sex.

Other possible causes of discomfort during intercourse include pelvic floor muscle dysfunction, nerve damage, perineum trauma, and vaginismus or the involuntary tightening of vaginal muscles during sex.

How To Relieve Painful Sex After Menopause: Monalisa Touch

You have many options for relieving painful sex, including lubricants, moisturizers, hormone therapy, and more. But the providers at Suncoast Womens Care truly believe in the power of one special treatment: MonaLisa Touch.

MonaLisa Touch is a gentle, noninvasive treatment that can improve vaginal symptoms after menopause, including pain, laxity, and dryness. The fractional CO2 laser delivers energy to your vaginal tissue, stimulating your bodys natural healing processes. The laser energy also helps your body produce new cells and increase the production of collagen and elastin, two important components of healthy vaginal tissue.

The procedure is quick, with most sessions taking no longer than five minutes. You also wont endure any downtime, so you can return to your normal daily activities as soon as youre through. You should, however, abstain from sex for a day or two after your treatment. Some patients experience minor sensitivity or swelling after MonaLisa Touch and prefer to wait until it subsides. \You may notice improvements after just one session, but most patients return for a few sessions, each spaced out by about six weeks.

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What About During Partner Sex

Communication is an essential part of good sex at any stage in life, but it becomes even more important now.

Talk openly with your partner about the changes of menopause and how theyre affecting you to help reduce stress about how those changes might affect your relationship.

Regular communication can also increase emotional intimacy, strengthening your relationship and enhancing your physical connection.

Open conversations make it possible to explore solutions together, such as:

  • trying alternate positions or types of touch when your go-tos feel uncomfortable
  • spending more time on erogenous play and outercourse

You Could Be Going Through The Menopause

Get Rid Of Pain With Sex After Menopause

According to Corda, during the menopause, women experience a reduction in sex hormones which can lead to both vaginal dryness and sexual pain.

Do note here: Dont feel embarrassed about this or suffer in silence as Datta points out, lots of people experience sexual problems at different stages of life. There is a lot of help out there, so there is no need to deal with this difficulty alone, she shares. Do book an appointment with your GP if you think your painful sex may be because of menopausal symptoms.

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Your Libido Might Dip Thanks To Menopause

Its not universal, but some people with menopause report decreased libido, says Dr. Pizarro. Issue is, it’s tough for doctors to figure out how to combat a lowered sex drivethe cause isnt exactly easy to pinpoint. For decades, weve blamed loss of libido on a womans ovaries or hormones, says Libido is such a complicated thing that goes way beyond issues of the ovaries, uterus, and hormones, says Dr. Pizarro.

Beyond whatever mysterious physiological changes might affect someones libido at this life stage, adjusting to menopause’s physical changes might play a role. Adequate exercise helps make sure your blood is flowing properly, which is an essential part of getting wet during sex.

Painful Sex After Menopause: Causes And Treatments

As your periods become more erratic and then stop, youll see a number of changes in your body and health. Although every woman is different, symptoms like hot flashes, mood changes, trouble sleeping, and weight gain are normal during this time.

Between 25 and 45 percent of postmenopausal women say they have pain during sex. When sex hurts, you may avoid it, which could affect your relationship.

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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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Painful Sex Postpartum

You really want to orgasm, but, for whatever reason, you just cant seem to get there. This can feel so discouraging that, eventually, you might decide theres no point in trying and give up entirely.

While you can try a few different things to make an orgasm happen, its also important to keep in mind that you can still enjoy yourself, even without an O.

Focusing on the pleasure youre experiencing in the momentwithout fixating on orgasm as a specific goal might just help you get there more quickly.

For more satisfying sex, solo or partnered, try these tips.

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Most Important Information You Should Know About Osphena


Osphena works like estrogen in the lining of the uterus , but can work differently in other parts of the body. Taking estrogen alone or Osphena may increase your chance for getting cancer of the lining of the uterus. Vaginal bleeding after menopause may be a warning sign of cancer of the lining of the uterus. Your healthcare provider should check any unusual vaginal bleeding to find out the cause, so tell him or her right away if this happens while you are using Osphena.

Osphena may increase your chances of having a stroke or blood clots.

You and your healthcare provider should talk regularly about whether you still need treatment with Osphena.

You May Have Vaginismus

Ever heard of vaginismus? If you havent, its the tightening of your vaginal muscles automatically at the time of penetration, explains Datta. But why does this happen? It can be caused by a combination of physical and psychological issues, explains Corda. Physical causes can include urinary tract infections, sexually transmitted diseases, vulvodynia, skin conditions such as psoriasis or eczema, menopause, and birth trauma.

Psychological problems, on the other hand, can be caused by emotional or sexual trauma. A previous painful experience with sex might make it harder to feel aroused and enjoy touch, explains a spokesperson from Brook Advisory. It can also make the muscles around the vagina and anus clench and make penetration difficult and more painful.

Try this: With the appropriate medical intervention and counselling, the experts share that the problem can be alleviated to enable penetrative sex. Treatment usually involves specialist counselling, pelvic floor exercises, biofeedback training with a womens health physiotherapist and use of medical dilators or a vibrator or dildo to slowly encourage the vagina to relax and open.

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Its Best Not To Ignore Any Changes That Cause You Distress

You may cringe at the thought of talking to your gynecologist about sex. But rest assured, there is no reason to feel awkward. If you’re dealing with these changes and are very much unhappy with them, talk to your doctor. Right now, this may be a conversation that needs to take place via telehealth due to the pandemic. If you feel dismissed, then Dr. Rowen encourages you to consider switching to another provider if at all possible. Go find someone who will listen to you and take your problems seriously, Dr. Rowen says. Together, you can come up with a treatment plan that may help you have a more fulfilling sex life, even after menopause.

All products featured on SELF are independently selected by our editors. If you buy something through our retail links, we may earn an affiliate commission.


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Changing hormones can also mean it takes longer to become aroused or feel in the mood for sex.

Spending more time on erogenous play and non-physical intimacy doesnt just increase your arousal. It can also help you feel more connected to your partner.


These ideas work just as well when it comes to getting yourself in the mood for solo sex, too.

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Talk It Out With Your Partner

Even if it’s just the physical changes of menopause that are making sex painful, talking it out with your partner can help alleviate the stress and anxiety surrounding the topic. If you’re single or your partner isn’t the talky type, your ob-gyn is available to lend an ear. I always encourage women to have a good, trusted gynecological healthcare provider to speak with, Dr. Minkin says. A doctor, nurse midwife, or nurse practitioner can be a valuable source of advice.

You may also want to talk to a sex therapist, who can help you be more open about what you need and want from your partner as well as reminding you that the changes you’re experiencing are perfectly normal.

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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.


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