Why is it painful to have sex during menopause?
Pain during sex can be due to a combination of dryness and tightening of the vagina and narrowing of the vaginal entrance. This is called “vaginal atrophy”.
What causes it?
The hormone estrogen, made mostly in the ovaries, helps keep the vaginal lining lubricated, soft and flexible especially during sex.
Leading up to menopause (when your period stops), there is a gradual lowering of estrogen hormone levels from the ovaries.
Is it common?
Vaginal dryness and painful sex are one of the more common symptoms we manage for menopausal women. Fortunately, most often, the treatment is very successful.
Why is it important to treat.
Having a well lubricated and functional vagina that allows you to be confident of having intercourse or the possibility of intercourse, can be important for your overall wellness and confidence.
If your vagina and the entrance is dry and narrow, it can be more tender or painful when you are being examined for a pap test or pelvic ultrasound.
Vaginal atrophy with resulting dryness and narrowing of the vagina and the entrance does not have to be part of your life forever. If treated, this part of your body can be vital, fulfilled and confident. It also helps maintain a sexual and loving relationship with your partner.
Can I prevent these changes from happening?
By having this managed early on, the success of rejuvenating and maintaining a healthy and functional vagina is much better.
Are there other causes of painful sex in menopause?
Yes, sometimes the entrance is more fragile and thinner and can tear easily causing some bleeding and pain. There are other conditions such as skin changes (Lichen Sclerosis) or inflammation at the entrance (Vestibulodynia). Other rare causes can occur, that’s why an examination is necessary.
How to rejuvenate the vagina?
Options include:
- Applying estrogen into the vagina and to the entrance (unless estrogen is not allowed due to other conditions or risks of disease)
- Hyaluronidase gel or cream into the vagina
- Vaginal dilators, if too narrow,
- Lubrication products, (we recommend natural coconut oil for lubrication)
- Radio frequency laser treatments, however, the results are not clearly confirmed.
- Rarely surgery is required to widen the entrance.