7 Ways to Treat Sexual Pain after Menopause

Menopause isn't called the change of life for nothing. Sleep habits change (for the worse), your mood changes (minute to minute), and your hair changes (gets thinner). But perhaps the most unexpected change of all has to do with your sex life. Not only is intercourse downright uncomfortable, but it can actually be painful.

"Pain with intercourse is very common after menopause, and it is usually due to vaginal dryness," says Stacy Tesser Lindau, MD, obstetrician-gynecologist at the University of Chicago.

As a woman ages, estrogen levels drop and the vagina gets thinner and more sensitive, explains Jacques Moritz, MD, director of gynecology at St. Luke's-Roosevelt Hospital in New York City. For some women, it's tempting to just stop having sex altogether. "But it's important to continue to have sex," Moritz says. "That's the best way to prevent pain-related issues. You lose it if you don't use it."

If you're not having regular sex, you can keep your vagina in shape through masturbation,  explains Mary Jo Rapini, LPC, an intimacy/sex relationship psychotherapist. "Masturbating keeps the vagina more flexible and more lubricated," she says.

Get Your Sex Life Back on Track

To enjoy a quality sex life with your partner, there are some strategies to keep you out of pain, in the moment, and feeling sexy.

  • Invest in vaginal moisturizers that you can use every couple of days, Lindau advises. "These are different from lubricants in that they are meant to be 'maintenance therapy,' " she says.  Apply the moisturizer every two to three days, and be patient: they can take several weeks to have an effect.

  • Invest in a vaginal lubricant. While moisturizers are used on a regular basis, lubricants are put into the vagina just before intercourse. Lubricants and moisturizers can be used together, too. (Can't keep lubricants and moisturizers straight? Lindau suggests this trick for remembering: M is for Moisturizers/Maintenance and L is for Lubricants/Love.)

  • Invest in estrogen pills and/or rings. While lubricants and moisturizers can be bought without a prescription, these are by prescription only. Estrogen pills and estrogen rings also make the vagina more moist and supple. The rings, which release a very low dose of estrogen, can be worn for up to three months, Moritz explains, while the pills are small tablets that are inserted into the vagina every couple of weeks.

  • Minimize the use of perfumed soaps, detergents and heavily perfumed moisturizers as these can be very irritating to the vaginal area.

  • Avoid panty liners, since they wick moisture from the vagina.

  • Enjoy more foreplay. Keep in mind that one reason for vaginal dryness is simply be lack of arousal, Lindau says. If you feel dry when you are having sex with your partner, it could just mean that you need to have more foreplay.

  • Start slow. It's totally normal that if you haven't had sex for six months to a year, it can be painful to start up again, Moritz says. Once you're back in the swing of things, though, the pain should lessen and disappear.