Painful Intercourse and Menopause

Painful Intercourse (dyspareunia) after menopause: its causes and treatment options

Painful intercourse – or dyspareunia – is persistent or recurring pain in the genitals that can strike just before, during, or immediately after sexual intercourse. Another medical condition is vaginal atrophy (atrophic vaginitis).

Vaginal atrophy is thinning, drying, and inflammation of the vaginal walls that may occur when your body has less estrogen. Vaginal atrophy occurs most often after menopause.

Sexual pain as a category of female sexual dysfunction is relevant at any age. Women dealing with vaginal dryness as a result of estrogen deficiency, it may well be the dominant issue.

Treating Painful Intercourse in Menopause

When determining the cause of a sexual problem in a postmenopausal woman, put dyspareunia caused by vaginal dryness (as well as its psychosocial consequences) at the top of the list of possibilities.

Millions of women experience pain before, during, or after sexual intercourse—a medical condition called dyspareunia. Dyspareunia, a sexual dysfunction, is known to have a variety of causes, both physical and psychological, which is why it is important to visit your women’s health care provider for an examination and diagnosis and to discuss the best treatment options.

Is Painful Intercourse During Menopause Normal?

For many postmenopausal women, dyspareunia is caused by inadequate lubrication resulting from low estrogen levels. Often, this can be treated with topical estrogen applied directly to the vagina. The vaginal tissues tend to become less elastic, more fragile, and more susceptible to bleeding, tearing, or pain during sexual activity or a pelvic exam. It can make sex painful or even impossible. The loss of estrogen can also cause urinary problems.

It’s fairly normal for women going through menopause to experience pain during intercourse. The most likely cause is a lack of lubrication from lower estrogen levels. For those entering perimenopause or menopause, you may experience:

• Pain in a normally pain-free sex life
• Pain at entry (initial vaginal penetration)
• Pain at each instance of penetration, including inserting a tampon

If these symptoms are present, you may be suffering from vaginal dryness, which is often also a symptom of menopause. Over-the-counter lubricants can help make intercourse more comfortable. However, other treatments can provide additional relief.

Why It Happens

At menopause, you’re most likely to have pain from:

• Hormone changes. Dwindling estrogen due to menopause is the No. 1 reason for sex pain at midlife and beyond. Hormone shifts make the tissues in your vagina become thin and dry. Dryness can add friction during sex. Your vagina also stretches less, which makes it feel tight.
• Fear and worry about pain. Once painful sex happens, you may dread its return. Fear can make your muscles tight and add dryness.
• A health problem. Other issues not due to menopause may be at fault, like chronic pain syndrome in the vulva, the area around the entrance to your vagina. Or you may have a urinary tract, yeast infection, or skin problem. Being stressed or depressed, problems with your partner, or past sexual abuse can also make sex painful.

What Are Some Other Causes for Concern?

Not all causes of dyspareunia are due to menopause. If you’re experiencing:

• Deep pain upon thrusting
• Stinging or burning
• Throbbing pain that persists hours after sex

It may be a red flag for a more serious underlying issue. Please visit your gynecologist to discuss this and to explore all treatment options.

Don’t be shy about getting help. Don’t think sexual pain is just part of menopause. Sex should never hurt. Be prepared to answer honestly and openly about your sexual health. You should have your health evaluated. We, as gynecologists, are here to help you determine the cause of your pain, not to judge or embarrass you. Improving your quality of life and health is our goal.

Why choose Dr. Aliabadi?

Highly trained and honored by the medical community, Dr. Thais Aliabadi is certified by the American Board of Obstetrics and Gynecology and a Diplomat of the American College of Obstetrics and Gynecology. She implements the most advanced, state-of-the-art technology and treatment options. Dr. Aliabadi specializes in up-to-date, minimally invasive surgical techniques, promising her patients shorter recovery times, reduced pain, and the least interruption to their daily lives.

Supported by her warm, professional team, Dr. Aliabadi treats women through all phases of life and cherishes the special one-on-one relationship between patient and doctor.

We also invite you to establish care with Dr. Aliabadi. Please click here to make an appointment or call us at (844) 863- 6700.

The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center are conveniently located for patients throughout Southern California and the Los Angeles area. We are in Beverly Hills and near West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.

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