Painful Sex After Menopause

Painful Sex After Menopause (Dyspareunia): Causes and Help

Dyspareunia is the medical name for pain during or after sex. After menopause, the most common cause is vaginal dryness from low estrogen. It can feel like burning, soreness or a sharp pain. Painful sex is common, but it is not something you have to live with. It can almost always be helped.

Please note: This page shares general health information in simple words. It is not medical advice. Every body is different, so talk to a doctor or gynaecologist before you try any treatment.

Key Facts About Painful Sex After Menopause

Dyspareunia means pain during or after sex.
After menopause, the most common cause is vaginal dryness.
Low estrogen makes the skin of the vagina thinner and drier.
Lubricants, moisturisers and vaginal estrogen can help.
Other causes, like infections, also need checking.
Painful sex is common and treatable. Talk to a doctor.

What Is Dyspareunia?

Dyspareunia (say: dis-pa-ROO-nee-a) means pain in the genital area during or after sex. The pain can be:

At the opening of the vagina when sex starts
Deeper inside during sex
A burning or stinging feeling
Soreness that lasts after sex

Some women also notice light bleeding after sex.

Why Does Sex Hurt After Menopause?

Low estrogen is the most common reason. Estrogen keeps the skin of the vagina thick, moist and stretchy. After menopause, the skin becomes thinner, drier and less stretchy. This can make sex rub and hurt.

This is part of a condition called genitourinary syndrome of menopause, or GSM. It often gets worse over time if not treated.

What Else Can Cause Painful Sex?

Other causes include:

Infections, like thrush or a sexually transmitted infection
Skin conditions around the vulva
Tight pelvic floor muscles
Vaginismus, where the muscles around the vagina tighten on their own
Endometriosis or fibroids, which can cause deep pain
Not enough foreplay or arousal
Worry or past painful experiences
Some medicines

This is why it is important to see a doctor, especially if the pain is new.

How Can You Make Sex More Comfortable?

These steps can help:

Use a lubricant every time you have sex. Choose a water-based one if you use condoms.
Use a vaginal moisturiser a few times a week to keep the area moist. Read more about vaginal moisturisers.
Take more time for foreplay. It helps your body make its own moisture.
Talk to your partner about what feels good and what hurts.
Try different positions that let you control how deep and fast.
Avoid perfumed soaps, wipes and douches. They can irritate the area.
Regular sexual activity can help keep blood flowing to the area.

Sirona Products for Comfort

Bleu Bliss Lubricant from Sirona is a water-based lubricant. It can help make sex smoother and more comfortable.
The Sirona Menopause Intimate Cream is a hormone-free cream for the skin around the vagina. It helps with dryness, itching and irritation, and is for outside use only.

These help with comfort. They do not treat the causes of dyspareunia.

What Treatments Can a Doctor Suggest?

Painful sex after menopause usually gets better with treatment. A doctor may suggest:

Low-dose vaginal estrogen. This is a cream, small tablet, gel or ring used inside the vagina. It helps the skin become thicker and moister. It is very low-dose and can usually be used for a long time.
Hormone replacement therapy (HRT) if you also have other menopause symptoms.
Pelvic floor physiotherapy if tight muscles are causing pain.
Treatment for infections or skin conditions.
Counselling or sex therapy if worry or past pain is part of the problem.

When Should You See a Doctor?

See a doctor or gynaecologist if:

Sex is painful, even sometimes.
Lubricants and moisturisers do not help.
You bleed during or after sex.
You have unusual discharge, itching or a bad smell.
You have pain deep in your pelvis.
You have any bleeding after menopause.

Many women feel shy talking about this. Doctors hear about it often, and it can be treated.

Related Terms

Shop menopause care: Sirona Menopause Collection

Sources

NHS. Vaginal dryness. https://www.nhs.uk/conditions/vaginal-dryness/
NHS. Symptoms of menopause and perimenopause. https://www.nhs.uk/conditions/menopause/symptoms/
Harvard Health Publishing. Painful sex after menopause is common and treatable. https://www.health.harvard.edu/press_release/painful-sex-after-menopause-is-common-and-treatable
Genitourinary syndrome of menopause: Common problem, effective treatments. Cleveland Clinic Journal of Medicine, 2018. https://www.ccjm.org/content/85/5/390
Sirona Menopause Intimate Cream product page. https://thesirona.com/products/intimate-cream

Disclaimer: This page is for general information only. It is not a substitute for advice, diagnosis or treatment from a qualified doctor. It was written by the Sirona Content Team using the trusted medical sources listed above. Always talk to your doctor or gynaecologist about your symptoms and before starting any medicine, supplement or product. If you have heavy bleeding, chest pain, trouble breathing or severe pain, get medical help right away.