Menopause and Painful Sex don’t have to go together!

Menopause and Painful Sex don’t have to go together!

We can feel good and enjoy all stages of life without the stress of pain. Understanding the issues and solutions can bring back the pleasure we deserve.

Painful sex, before, during or after intercourse (Dyspareunia) can happen for women at some point in their lives. It is a frequent problem for postmenopausal women.

20 to 30 percent of postmenopausal women surveyed, not on hormone therapy, report dyspareunia. Dyspareunia occurs in the pelvic area causing sharp or intense pain while having sex. It may cause women to experience severe or acute pain and can happen during intercourse and possibly before or after. For some women, dyspareunia is temporary. For others, it can become chronic.

During menopause, painful sex links to a decrease in estrogen levels. Losing estrogen can cause urinary problems, and discomfort with sex; however, lack of sexual activity itself contributes to loss of tissue health and elasticity. The vaginal tissues become less elastic, more fragile, and more susceptible to bleeding, tearing or pain. There are treatment option so keep reading.

Other Factors

Other factors are sometimes at play, including injury or trauma, childbirth, pelvic surgery, or an accident. Skin conditions like eczema, lichen sclerosis, or an infection in your genital area or urinary tract also can cause sex to be painful. Involuntary spasms of the vaginal wall muscles (vaginismus) can make attempts at penetration painful or impossible.

Vagina Coach, Kim Vopni

Certain medications, such as antidepressants, high blood pressure, and others, can contribute to vaginal dryness. In addition, stress, fear of intimacy, and concerns about body image or relationship difficulties can make pleasurable sex challenging.

Pain associated with deep penetration or certain positions may cause inadequate relaxation of pelvic muscles or conditions that affect the pelvic area, such as pelvic floor dysfunction, endometriosis, and uterine fibroids. Scarring from pelvic surgery or treatments such as pelvic radiation can cause changes that can make sex painful.

Painful Sex Treatment

Many women with painful sex do not require medical treatment. If sex hurts, especially if it hurts to the point that you are avoiding it or want to stop, it’s time to find a pelvic floor physical therapist and get help. They may ask when your pain began, where it hurts and if it happens every time, you have sex. They may ask about your history of surgery, childbirth, and sexual relationships.

Vaginal lubricants can help decrease pain during sex and can be applied as often as needed. Vaginal moisturizers that contain hyaluronic acid can help maintain vaginal moisture and even heal already dry irritated tissue. Vaginal estrogen is considered the gold standard and can relieve discomfort and help improve the condition of the vaginal tissues.  There are different forms such as creams, pellets and a ring that delivers the estrogen over a period of time.  Your doctor or naturopath can help you decide which option is best for you. It is also recommended to read the book The Estrogen Fix and Estrogen Matters to help understand the confusion surrounding hormone therapy.

Skin conditions may worsen the symptoms of dryness associated with decreased estrogen levels. Topical creams treat skin conditions such as lichen sclerosus. These creams, which may include topical steroids, are prescribed after a detailed exam and diagnosis by your health care provider.

Vagina Coach, Kim Vopni

Pelvic Floor Physiotherapists

Pelvic floor physical therapy can help address the muscles and may relieve pain when tight.

Pelvic floor physical therapy can relax the pelvic floor muscles and help improve blood flow and circulation. If you are unfamiliar with dilators, they are a tool you insert into your vagina to help it open up and relax. Over time, you may notice improved bladder control, less abdominal pain, and more pleasurable sex. Additionally, you’ll get some “homework” to do on your own, involving practicing breathing exercises, finding ways to manage stress, and even possibly using dilators at home.

Recommended Program

The Buff Muff app includes essential education, an exercise library of effective movements, whole body workouts, meal plans, access to my vagina village - progressive and passionate experts - and a weekly LIVE coaching call with me.

It is free to download, and you can enjoy a 2-week free trial to explore all of the content.

Vagina Coach, Kim Vopni

In the Recommended Resources section, I recommend pelvic health products and devices. I only promote and endorse products I have tried myself. There are lubricants and devices such as the vSculpt (vFit), designed by Ob-Gyns to improve a women’s intimate wellness, sexual function, and confidence. There are suggestions for products to manage pelvic pain, painful sex, supplements for urinary tract infections, and pelvic floor training. Most of these have a special discount available to members of the Buff Muff community. Available on iPhone and Android.


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