Has Sex Become Painful? Here’s What to Do About It

I read a recent survey that indicated roughly 46% of post-menopausal women complain of sexual discomfort or pain during sex. It’s not uncommon, but it’s not the norm, either. So much of what we hear about menopause makes it sound much gloomier than it really is.

There are several reasons why intercourse might feel uncomfortable for an older woman. As we go through menopause, the accompanying hormonal changes can result in a decrease in natural lubrication. During arousal, the vagina lubricates itself; this function helps keep tissues supple and, in the process, makes insertion of fingers, toys, or a penis easier. The amount of wetness varies from woman to woman over a lifespan and could become problematic with menopause. (To learn more, read Sex and Menopause: A Beginning, Not an End.)

Related to the decrease in the body’s production of natural lubrication, our skin and tissues become thinner due to the decrease in estrogen. The combination of a dry vagina and thinning, delicate tissues can produce small tears in the vaginal tissue, which cause discomfort or pain. During arousal, the vaginal tissues begin to swell and lubricate. This increased blood flow helps to keep muscles toned and strengthens vaginal tissues. So, a practice of regular self-pleasuring, and having partnered sex can help keep the vagina healthy. (Plus, it's fun!)

Why Does It Hurt?

If you have discomfort during sex, can you tell what caused it? Was it due to insufficient lubrication? Did the toy or penis feel too large for you? Did you feel like your vaginal opening was too tight? Did you try to change positions and see if that helped? For example, sex in the doggy style position allows for greater penetration; it’s possible that a partner’s penis could be hitting the wall of your cervix. The solution there is to ask your partner to use gentler thrusts or to change positions. A doctor will want to know the answers to these questions in order to help diagnose the issue.

For some women, the discomfort is due to vaginismus, a condition where the pelvic floor muscles contract during penetrative sex. This causes mild discomfort to severe pain. A doctor will refer women with this problem to a physical therapist, who can recommend the use of vaginal dilators to help to stretch pelvic floor muscles.

Don’t overlook the emotional factors that might result in uncomfortable sex. Even when we’re excited about having sex after a long absence, it still requires us to be relaxed and comfortable with intimacy. Tell your partner if you feel any physical or emotional discomfort and talk about ways you can enjoy pleasurable activities again.

What To Do About It

If sex hurts, you don't have to give up your sex life. There are a lot of solutions that can help you continue to have pleasurable sex well into your senior years. Here are a few important avenues to try.

Talk to Your Doctor
The discomfort might be an indicator of a more serious health problem.

Use Lube
Whether you’re 18 or 70, a good lube helps make all kinds of sexual contact feel better. Buy a good quality lubricant, without chemical additives and use it religiously. Use it for self-pleasuring, with fingers, and toys. Use it during intercourse.

Allow Plenty of Time for Arousal
If we rush sex, it can feel dry and uncomfortable. The period of arousal helps prepare our bodies.

Make Sure You’re Comfortable With Your Partner
If you’re nervous or feel embarrassed, it’s difficult to relax and be mentally receptive to sex.

Communicate With Your Partner
Tell your partner if you experience discomfort and want to take it slow. Speak up if it begins to hurt so that you can shift to a different way of pleasuring each other.

Rethink How You and a Partner View Pleasure
Instead of intercourse, consider finger play, sex toys, and oral sex to achieve orgasm for both of you.

Our bodies do change with age. The possibility of painful sex increases when we have less frequent sex or experience other problems. Pay attention to what your body is telling you. Ask partners to respect and support you in finding pleasurable alternatives. Most of the time there is a solution. You just have to be willing to seek out help and talk about your sexual health and needs.