Intercourse during menopause: what to know

Vaginal tissues may become thinner and less lubricated, so penetration can cause burning, soreness or small areas of bleeding. Desire may also change with sleep disruption, mood changes, hot flushes or relationship concerns. Pain is not something you have to tolerate, and it can reduce interest in sex over time.

Menopause is a stage of reproductive transition, not a reason to stop intimacy. Non-penetrative intimacy, longer arousal and positions that allow you to control depth may be more comfortable. Pelvic floor tension or pelvic organ prolapse can also affect sexual comfort.

Take time for arousal and use a water-based or silicone-based lubricant during sex. A regular vaginal moisturiser may help ongoing dryness, while a clinician can discuss local vaginal oestrogen or other options when symptoms persist. Stop if pain increases, and talk openly with your partner about pace and pressure.

Keep a note of pain, dryness, bleeding and other symptoms. A clinician can check for infection, skin conditions, pelvic floor problems or another cause rather than assuming every symptom is menopause.

Arrange an assessment for repeated pain, bleeding after sex, new discharge, sores, urinary symptoms or symptoms that interfere with daily life. Seek urgent help for severe pelvic pain, heavy bleeding, faintness or fever. Bleeding after menopause deserves medical assessment even when it is light.

Ask whether vaginal dryness, pelvic floor tension or another condition could explain your symptoms; which lubricant or moisturiser suits you; whether local treatment is appropriate; and whether bleeding needs an examination.