Pain With Sex During Menopause


Pain before, during, or after sex is, unfortunately, more common for women than many people think. Painful sex, also known as dyspareunia, affects up to 20% of women worldwide at some point in their lives. This number jumps to between 17% to 45% of women who are going through menopause.  

Considering 1 in 5 women, and up to 1 in 2 women in menopause experience pain during sex, you would think that it would be a subject that is more commonly discussed. However, although we live in the 21st century, there is still a stigma associated with the female reproductive system which makes many women uncomfortable discussing such concerns. 

It is important to know that although pain during sex is a common complaint for many women, it’s not something that you just have to live with or endure. If you are experiencing pain during intercourse, there are several natural remedies as well as medications that may be able to help relieve your discomfort. 

You should speak with your doctor if you are experiencing any pain or discomfort during sex as soon as you notice it happening. The longer that you let it continue without treatment, the worse it can get and the harder it gets to treat. 

Talking to Your Doctor About Pain During Sex

If you are experiencing pain during or after intercourse, you should reach out to your gynecologist. While it often feels uncomfortable to talk about such topics, it’s important to remember that they are trained to help with such concerns and that it is a common complaint for up to 50% of menopausal women. 

At your appointment, be sure to tell your doctor when you experience pain – if it’s all the time or only when you have penetrative sex or anywhere in between. It’s also important to describe the type of pain you feel. Is it burning, itchy, sharp, dull, achy? This can help them diagnose the cause of your pain and will help them determine the best treatment option for you. 

In many cases, a simple vaginal moisturizer or the use of lubricants can help significantly reduce or even eliminate pain during sex. In more severe cases, however, your doctor may recommend therapy or medications. 

Why Does Pain With Sex Happen?

Although painful intercourse becomes more common during menopause, it’s something that can happen at any point in a woman’s life. Pain during sex can happen for several reasons, including:

  • Pelvic floor dysfunction due to trauma, age, childbirth, or being overweight or obese.
  • Formation of scar tissue due to trauma, childbirth, or surgeries. 
  • A decrease in estrogen levels is most commonly attributed to aging and menopause. 
  • Certain skin conditions such as eczema, lichen sclerosis, or psoriasis.
  • Being unaroused or not sufficiently aroused when penetration happens.
  • Untreated medical problems such as diabetes, heart conditions, or high blood pressure can all affect sexual arousal and performance

In addition to the above reasons, painful sex during menopause can also be caused by vaginal dryness, vaginal atrophy, or other hormonal changes. In some situations, women can become so anxious at the thought of having sex because of past unpleasant experiences that they develop a condition known as vaginismus. 

It is important to talk to your gynecologist if you are experiencing pain with sex as it may also be the result of a bacterial or fungal infection, or more rarely, ovarian cancer. 



Vaginismus is a condition that affects the vaginal muscles. It most commonly occurs in women who have experienced painful sex in the past. This can cause them to develop anxiety at the thought of having sex which causes an involuntary tightening and constriction of the vaginal muscles which can make penetrative sex impossible. 

Luckily, it is highly treatable and there are several treatment options for vaginismus depending on the severity of your condition. Most commonly, physical therapy is recommended which can include yoga poses, pelvic floor exercises, or the use of a vaginal dilator. 

In other cases, sex therapy, deep breathing exercises, and relaxation techniques may be more effective in treating cases of vaginismus.

Why Is Painful Sex More Common During Menopause?

Our bodies go through significant changes during menopause, so it’s no surprise that a lot of the time, sex is the last thing on our minds. Along with fluctuating hormones and massive changes in our bodies such as hot flashes, mood swings, and insomnia, many women also experience relationship difficulties during this stage of their life. 

In addition, women’s vaginas change as they age. The vagina naturally loses elasticity and the vaginal walls become thinner and more susceptible to damage such as tearing and bleeding.

These changes and relationship difficulties can lead to greater levels of stress, depression, anxiety, worsening self-images, worries about weight gain and aging, and many more things that can affect a woman’s self-confidence in the bedroom. 

Together, all of these things can cause performance anxiety and sexual dysfunction, especially if you aren’t feeling the same kind of love from your significant other that you once did. This can lead to a lack of arousal which can hinder the production of the body’s natural lubrication which directly contributes to painful sex. 

Hormone Changes During Menopause

As we grow and age, our bodies go through dramatic hormonal changes. These changes occur at several key points in our lives such as puberty, pregnancy and childbirth, and the stages of menopause. 

While these changes are completely natural, they can come with some unpleasant side effects. As a result of fluctuating estrogen levels, women who are going through (peri)menopause are more likely to suffer from vaginal dryness and/or vaginal atrophy.

These conditions are more common than you might think, each affecting nearly 50% of (peri)menopausal women at some point. 

Vaginal Dryness/Vaginal Atrophy

Vaginal dryness and vaginal atrophy tend to go hand in hand with (peri)menopause, due to decreased estrogen levels. If you have vaginal atrophy, the inside of your vagina may:

  • Feel itchy constantly
  • Have a burning sensation
  • Have thinner, more fragile, or paperlike skin that tears or bleeds easily during sex. 
  • Feel constantly dry without the use of vaginal moisturizers or lubricants.
  • Become shorter, narrower, and the muscles may involuntarily contract when anything is inserted into the vaginal canal. 
  • Become more acidic which can lead to an increased number of urinary tract infections (UTIs).

Luckily, vaginal atrophy is highly treatable, most commonly through the use of a vaginal or vulvar moisturizer such as our VMagic Vulvar Balm

Is it Common for Sex to Be Painful with Menopause?

Unfortunately, yes. As our bodies age and change, our hormone levels fluctuate significantly, which can cause drastic changes in our bodies. During (peri)menopause, estrogen levels dip significantly and our bodies stop producing as much of it. 

This leads to a decrease in the elasticity of the vagina which causes a thinning of our vaginal walls, vaginal dryness, and tightening and shortening of the vagina. Altogether, these symptoms can make intercourse extremely painful for some women. As many as 45% of (peri)menopausal women find sex to be painful at some point. 

How to Relieve Pain During Sex

In most cases, pain and discomfort during intercourse can be relieved through the use of lubricants or vaginal moisturizers and through open communication with your partner. In more severe cases, your doctor may recommend sex therapy, physical therapy, or prescription medication to help relieve and reduce your symptoms.  

Communicate With Your Partner

One of the most important things that you can do when it comes to painful sex is communicate with your partner. Let them know that foreplay is more important than ever now, as being fully aroused can significantly help with natural lubrication which will make sex more pleasurable for both of you. 

You may also wish to discuss using lubricants or changing positions to help make sex more pleasurable. Certain positions, such as being on top, can allow the woman to better control the pace and depth of penetration which can help make things more comfortable. 

Finally, if penetrative sex is painful or uncomfortable, consider oral sex or using toys to still have those feelings of intimacy without having to worry about pain or discomfort from penetrative sex. 


Vaginal estrogen, in the form of a pill, ring, or cream that is inserted directly into the vaginal canal, is commonly prescribed for women with severe vaginal dryness or vaginal atrophy. These estrogen supplements are typically a low-dose option that is generally considered safe.

Other women may be prescribed a vaginal suppository consisting of estrogen, testosterone, and DHEA that is also inserted directly into the vaginal canal. 

Be sure to tell your doctor of any other medications you may be on, supplements you may be taking, or other health conditions that you may have as any of these could interact with the medication they are planning to prescribe you.  

Sex Therapy & Physical Therapy

In most cases, pain during sex is caused either by a physical cause that can be treated, such as vaginismus or pelvic floor dysfunction, or a psychological cause that leads to a reluctance to engage in intercourse. 

For physical reasons, your doctor may recommend that you try physical therapy to help strengthen the vaginal muscles. Pelvic floor therapy can also help give you greater control and awareness of these muscles, which can be beneficial in cases of vaginismus. This control can help you learn to relax your vaginal muscles when you feel them tightening. 

Some of the most common physical therapy options for sexual dysfunction include certain yoga poses, pelvic floor therapy exercises, Kegel exercises, and in certain cases, the use of a vaginal dilator. 

Have More Sex

When sex is uncomfortable, trying to have more of it is probably going to be the last thing on your mind. Increasing how often you have sex can be just what the doctor ordered when it comes to relieving pain during sex.

It sounds contradictory, but the more frequently you have sex, the more your body will expect it and grow used to it. Being frequently aroused helps to increase lubrication to the vaginal canal which in turn can make sex more pleasurable. 

At first, it can help to masturbate or use toys such as a vibrator to reintroduce your body to having sexual intercourse. Self-pleasure can help increase arousal and improve blood flow to your genitals which in turn will increase lubrication.

This is also part of why foreplay is so important when having sex at all stages of life, but especially during (peri)menopause. Taking a few extra minutes to “warm up” can make all the difference in having a pleasurable experience. 

Be open and honest with your partner about what feels good and what doesn’t, and take time to have oral sex, and be intimate with your partner before getting straight to the deed. 

Hormone Free, All Natural Treatments

For many women, topical or oral estrogen or other hormone therapies are a last resort when it comes to dealing with their symptoms of menopause. Because of this, many doctors will recommend a vulvar moisturizer or a vaginal lubricant to help make sexual intercourse more pleasurable. 

Vaginal Lubricants

In many cases, a vaginal lubricant may be enough to help make sexual intercourse more pleasurable for (peri)menopausal women. Generally, water-based lubricants are recommended over glycerin-based ones for several reasons. 

Primarily, water-based lubricants are less likely to cause vaginal irritation, they can be used more frequently and they can be used safely with condoms and toys, and they do not carry the increased risk of yeast infections like glycerin-based lubricants do. 

Vulvar Moisturizers

Our VMagic Vulva Balm is a proprietary, hormone-free, all-natural vulvar moisturizer that is the perfect solution for relieving occasional or chronic vulvar dryness and irritation. It is made with all-natural ingredients including our honey and propolis blend, extra virgin olive oil, and organic sea buckthorn.

This moisturizer can be applied liberally and as often as necessary, and it can help to provide soothing relief from vulvar dryness due to (peri)menopause or breastfeeding, irritation from shaving or chafing from tight clothing, and discomfort from friction caused by sex. 

When used daily, 79% of women in a clinical study felt immediate relief from their discomfort, while 92% saw a reduction in dryness in as little as two weeks. 


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