Can genitourinary syndrome of menopause cause pain during sex?

After menopause, lower oestrogen can reduce natural lubrication and make vaginal tissue thinner and less flexible. Friction may then cause stinging, burning or soreness during penetration, with discomfort sometimes continuing afterwards. Pelvic floor muscle tightening can add to the pain. Other causes include infection, skin conditions, endometriosis, pelvic disorders or medicines, so pain during sex does not by itself establish the cause.

Allow more time for arousal, stop when pain begins and use a generous water-based lubricant. A vaginal moisturiser used regularly may help ongoing dryness. Avoid perfumed products inside or around the vagina. A clinician can assess the tissues and discuss local hormonal treatment, pelvic floor therapy or another approach based on your symptoms and medical history.

Book an assessment if pain is new, recurring, worsening or affecting intimacy. Seek prompt care for fever, pelvic pain, foul-smelling discharge, sores, heavy bleeding or bleeding after menopause. A clinician may examine the vulva and vagina and test for infection or other causes before recommending treatment.

Could tissue changes explain the location and timing of my pain? Would a lubricant, moisturiser, local hormonal treatment or pelvic floor therapy be suitable? Do I need testing for infection or another condition? How should I manage pain if it returns?