What should you know about menopause sex hurts?

Lower oestrogen after menopause can make vaginal tissue thinner, drier, and less flexible. This may cause burning, stinging, soreness, or pain with penetration, and discomfort can continue briefly afterward. Pelvic floor muscle tightening can add to the pain, especially after an earlier painful experience.

Pain is not something you have to accept as a fixed part of menopause. Thrush, skin conditions, urinary problems, infections, endometriosis, pelvic organ prolapse, and some medicines can also cause discomfort. An examination helps identify the cause rather than relying on symptoms alone.

Pause if pain starts and talk openly with your partner about pressure, pace, and positions. Allow more time for arousal, use a generous amount of lubricant, and consider a vaginal moisturiser for ongoing dryness. Avoid fragranced washes, douches, and products that sting.

If pain continues, a clinician may discuss local vaginal treatment, pelvic floor physiotherapy, or another option suited to your symptoms and medical history. Intimacy does not need to involve penetration while you are healing; touch and other forms of closeness can reduce pressure.

Arrange medical care for repeated pain, bleeding after sex, unusual discharge or odour, sores, itching, pelvic pressure, urinary symptoms, or pain that is worsening. Seek urgent help for severe pelvic pain, fever, heavy bleeding, fainting, or sudden illness. Tell the clinician where the pain occurs and whether it is superficial or deep.

Could dryness, pelvic floor tension, infection, or another condition explain this pain? Would a vaginal moisturiser, lubricant, or prescription treatment help? Could pelvic floor physiotherapy be appropriate? What bleeding or discharge should I report promptly?