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How to Prevent Painful Sex after Menopause

Painful Sex After Menopause?

Most of us would say we are well-informed about a wide range of topics. We read nutrition labels, follow current events, and read the best sellers. We may know a fair bit about medications and overall health. But how much do we know about sexual health and how menopause changes our bodies, especially when it comes to painful sex after menopause?

Many women feel uncomfortable talking to their doctors about sexually related issues. That reluctance can leave some women suffering through painful intercourse, not talking to health care providers or partners. A recent study found that between 17% and 45% of postmenopausal women report sex is painful. The condition is called dyspareunia, and ranges from milder issues like dryness to vaginal thinning and in more serious cases—vagina atrophy.

The underlying cause of painful intercourse can be due to non-menopausal related issues so reporting any concerns to your doctor is very important. Second in importance is talking to your partner. We forget that our partners often don’t understand menopause.

You are not alone if you feel awkward or embarrassed in talking about sexual needs and intimate issues. If you and your partner don’t normally talk about sex this may feel difficult. But, it’s more important than ever that you communicate to help your partner understand the issue.

Sari Cooper, a certified sex therapist, notes, “One piece that often doesn’t get integrated is the partner. Many women feel obligated to have sex with their partner. Sometimes there is a domino effect. The male partner may develop an avoidance tactic because he doesn’t want to hurt his partner or they want to rush through it and he develops an erectile disorder.” (Source)

What you can do to avoid painful sex

 Don’t try to hide your discomfort from your partner. Menopausal changes can directly impact how penetrative sex feels and they may not be aware of that, so it’s up to you to educate them. You and your intimate partner can talk about what feels good and what doesn’t.

Suggestions to reduce discomfort during sex might include:

  • going slower when initiating sex,
  • not penetrating as deep as usual,
  • using lube,
  • and in general exploring what feels good for you.

Consider alternatives to penetrative sex that allow both of you to feel pleasure and achieve a climax, if desired. Mutual pleasuring, oral stimulation, the use of fingers and toys can all substitute or supplement intercourse.

Change the focus of sexual activity after menopause.

I think we can get into this routine around sex. Sexual intercourse is typically very goal-oriented, it’s about who comes and who doesn’t.  To focus on pleasure, in a broader sense, expands possibilities and avoids those feelings of being cheated out of your orgasm. Or like a failure for not being able to come during sex.

This idea often requires men to rethink sex—to look at what might give a female partner pleasure regardless of what that act looks like for them.

Try and push through the discomfort of having these conversations as the alternatives: tolerating the pain or avoiding all sex are not acceptable alternatives for either of you. This article on communication skills for intimate relationships may be helpful.

What to do first if you are experiencing pain during sex.

Please consider seeing a doctor. Your specific issue may require more than lube and a different approach to intimacy. Many times a doctor can offer a treatment that helps to eliminate or lessen the pain.

Gynecologists who specialize in midlife issues would be the most knowledgeable. They may suggest you a treatment plan or refer you to a physical therapist specializing in women’s pelvic health.

But don’t just ignore it and hope it will go away. Painful sex is often avoidable and nothing to feel embarrassed about.

Useful resources on sexual health:

Sex: Painful or Uncomfortable

Sexual Problems at Midlife

Remedies for the Midlife Mind and Body 

Causes of Vaginal Discomfort 

Walker Thornton

We are delighted to have Walker Thornton as our Women’s Sexual Health columnist. After working for over 10 years in the field of sexual violence against women, Walker is now enjoying a new career as a freelance writer, public speaker, and sex educator with an emphasis on midlife women. Her blog, was ranked #5 by in their top 100 Sex Blogging Superheroes of 2014. You can connect with her on Facebook and Twitter For questions about sexual health, write her at

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