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When Sex Hurts

Sex is supposed to feel good—like, toe-curling, spine-tingling good. But if your vagina feels anything like those of many menopausal women, having sex is downright painful.

sex, painful sex, vaginal dryness, menopause, perimenopause, intercourse

A hush-hush symptom of menopause, vaginal dryness affects as many as 75 percent of postmenopausal women, according to the International Menopause Society. As you probably already know, during perimenopause and menopause, the ovaries produce less and less estrogen. But get this: When your estrogen levels dry up, so can your southern region.

The result: Thinning and inflammation of the vaginal walls, which in some women can mean that any down-there contact will be agitating. Even worse, fragile vaginal walls can suffer small tissue tears during sex that can lead to pain and bleeding, according to the North American Menopause Society. Talk about a turn-off! No wonder many menopausal women would rather mop the kitchen floor than have sex!

But not me! Like the other women of GLAM™ (Great Life After Menopause), I reached out for help when my declining estrogen levels had me losing more than my keys—they had me losing my sex drive because of the dryness and the pain. With the help of my menopause expert, I found relief. (You should know that not all gynecologists are menopause experts; in the US, the North American Menopause Society (NAMS) recognizes menopause experts with the NAMS Certified Menopause Practitioner (NCMP) accreditation.)

 Ready to bring back your pre-perimenopausal and menopausal days? Here’s your multipronged approach toward getting the pain-free sex you deserve:

1. Note Your Symptoms

If you find that you’re more lubed up than a Slip ’N Slide, but sex is still less than pleasant, it’s time to treat the root cause of the pain. So, log on to and use the site’s vagina symptom tracker (like a step tracker, only better!) to take note of your below-the-belt symptoms (think: dryness, itching, burning, painful sex, and bleeding), their severity, and what has and hasn’t worked to relieve them. Hit print and you’ll be ready for Step 2.

2. Visit Your Menopause Expert/Gynecologist

Now that you have a handy-dandy printout of your symptoms, make an appointment with your menopause expert who is trained in the ins-and-outs of perimenopausal and menopausal symptoms, painful sex and vaginal dryness included. Your medical practitioner can perform an examination to determine the culprit. If low estrogen is to blame, treatment options include systemic estrogen therapy, local estrogen therapy (LET), and over-the-counter moisturizers. Remember: There is no one-size-fits-all solution; just as every woman is different, so is every vagina. Not sure what the difference is? Visit for more information on various treatment options available.

If you don’t have a menopause expert, check out the menopause experts listed on the North American Menopause Society Web site, request a referral from any great health care providers you know, or ask your friends to refer you to a health care provider who is helping them find hormone happiness.

3. Have a Heart-to-Heart with Your Partner
The only thing as intimate (or more) than having sex is talking with your partner about that sex. Your connection will be so much stronger once you tell your partner that you are having problems “down there.” Welcoming openness and honesty into the bedroom is the surest way to connect with your partner.

With the wisdom of a few years, the benefit of deep relationships, and strong self-confidence to boot, there’s no reason we can’t take control of our sex lives. Reach out and make painful sex a thing of the past!

Reaching out is IN! Suffering in silence is OUT!

Read more from Ellen Dolgen on her blog, Ellen Dolgen.

Ellen Dolgen

Ellen Dolgen, menopause education is a mission. Spurred by her own experience struggling with the symptoms of menopause, Dolgen has devoted the last ten years of her life to helping other women during this often difficult time. While she’s not a doctor or scientist, she’s “talked the talk” with countless menopause experts, so that she can “walk the menopause walk” and share the keys to this menopause kingdom. Together with her son, Jack, she created a FREE eBook, MENOPAUSE MONDAYS The Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause, a comprehensive guide to all things menopause—the symptoms, the treatments, and the long-range effects on a woman’s health. Dolgen shares the expertise of numerous specialists to replace confusion and embarrassment with medically sound solutions, presented in an entertaining and informative way.

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Ellen Dolgen

Saturday 16th of November 2013

Thanks you for your sweet support, Janie.

Janie Emaus

Saturday 16th of November 2013

Thanks for this info. As always, you are a fountain of wonderful knowledge.

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