Reviewed by Dr. Kenton Bruice, MD
Reading time: four minutes
Menopause often brings significant changes that can affect the sexual health and overall quality of life of many postmenopausal women.
Vaginal dryness, decreased estrogen levels, and other menopausal symptoms such as hot flashes and night sweats can contribute to discomfort and pain during sexual activity. This can be distressing and affect both the physical and emotional aspects of a woman’s life.
In this blog, we will explore the topic of painful intercourse during menopause and how bioidentical hormone replacement therapy (BHRT) can help alleviate symptoms and improve sexual health.
Table of Contents
What Causes Painful Intercourse?
Pain during sex, also known as dyspareunia, can be caused by a variety of factors.
During menopause, the decrease in estrogen production leads to a thinning and drying of the vaginal tissues (vaginal atrophy), making them more susceptible to pain and tearing during sexual activity. This is known as atrophic vaginitis.
Understanding Changes to Your Genitalia During Menopause
Declining estrogen levels trigger several changes in the vulva and vagina:
- The labia majora (outer) lose their fat pad, reducing volume and size, which removes a layer of protection.
- The labia minora (inner) can thin and shrink, producing fewer protective secretions.
- The clitoral hood may thin out or fuse, exposing the sensitive clitoris to irritation and discomfort.
These changes leave the delicate structures of your vulva more vulnerable to chafing, irritation, and trauma, which can make sexual activity painful and decrease sexual desire.
Your Vagina
Internally, your vagina also undergoes significant changes due to reduced estrogen levels.
The vaginal lining, which consists of multiple layers, relies on estrogen to stay thick, elastic, and lubricated.
During your reproductive years, healthy estrogen levels allow the vaginal tissue to:
- Stretch and recover easily during sexual activity and childbirth.
- Maintain natural lubrication, making sex comfortable and reducing the risk of injury.
As estrogen levels drop, the vaginal walls may experience:
- Thinning and dryness (known as vaginal atrophy), leading to less natural lubrication.
- A loss of elasticity, making the vaginal tissue less flexible and more prone to tearing during sex or routine pelvic exams.
- Narrowing of the vaginal opening, further increasing discomfort during intercourse.
These changes can make sex painful, cause irritation, and even lead to small tears in the vaginal tissue, reducing intimacy and sexual interest.
If you’re experiencing painful intercourse, consult with a healthcare provider to explore the best options for your needs. There’s no need to feel embarrassed! This is a normal part of aging, and effective treatments are available to help you feel comfortable and enjoy intimacy again.
Finding Relief with BHRT
Bioidentical hormone replacement therapy (BHRT) can offer relief for women experiencing painful intercourse during menopause.
BHRT involves using hormones that are structurally identical to those naturally produced in the body, and they are administered through various forms such as creams, patches, pellets, or pills.
Hormone replacement therapy can help restore vaginal tissues and improve moisture levels, reducing uncomfortable symptoms and making sexual activity more enjoyable. Testosterone therapy may also be beneficial for improving libido and arousal.
Hormone Testing
Dr. Bruice specializes in balancing hormones with bioidentical hormones.
Here is what you can expect from a consult with him at our hormone clinic in Denver, CO:
- Comprehensive hormone testing to determine individual hormone levels.
- Personalized treatment plan tailored to address specific symptoms and needs.
- Regular follow-ups and adjustments as needed to ensure optimal results.
Other Ways to Manage Painful Intercourse
Along with BHRT, there are other effective treatments to manage painful intercourse during menopause. These include:
- Use vaginal lubricants before and during sexual activity. Oil-based lubricants and water-based lubricants can provide relief and reduce friction.
- Engage in longer foreplay to increase natural lubrication.
- Try different positions that may be more comfortable.
- Communicate openly with your partner about any discomfort or changes in libido.
It is important to address any underlying issues, such as infections or pelvic floor dysfunction, with the help of a healthcare professional.
Find Relief and Reclaim Your Sexual Well-being
Painful intercourse during menopause is a common issue that can significantly impact a woman’s quality of life.
With BHRT and other management strategies, women can find relief from discomfort and enjoy a fulfilling sex life.
If you are suffering from painful intercourse or other symptoms of menopause, consult with Dr. Kenton Bruice to discuss your options and find the best treatment plan for you.