Pain during sex after menopause

Pain during sex after menopause often relates to reduced lubrication and thinner, less flexible vaginal tissues, but other causes need consideration. Burning at the entrance, dryness, or small cracks can occur with friction. Deeper pain may have a different source, so persistent symptoms deserve an assessment rather than self-diagnosis.

Genitourinary changes after menopause can affect the vagina, vulva, and urinary tract. Symptoms may include dryness, burning, urgency, or discomfort with penetration. Skin conditions, pelvic-floor muscle tightening, infection, medicines, or pelvic conditions can also cause pain. Bleeding after sex is not something to dismiss; a clinician should examine it, especially if it recurs.

Use a water-based lubricant during sex and consider a regular vaginal moisturiser if dryness is frequent. Allow time for arousal, choose activities and positions that feel comfortable, and stop with sharp or burning pain. Avoid douches, fragranced washes, and irritants. A clinician can discuss local or systemic treatment options after reviewing your symptoms, medical history, medicines, and cancer-related considerations.

Book a medical review for bleeding after sex, persistent pain, unusual discharge, sores, itching that does not settle, urinary burning, or pelvic pressure. Seek prompt care for severe pelvic pain, fever, or feeling faint. These features can signal infection, injury, or another condition requiring examination.

Ask whether your symptoms fit genitourinary changes of menopause, whether an examination or swab is needed, and which lubricant, moisturiser, or prescription options suit you. Mention bleeding, urinary symptoms, skin changes, and any history that affects hormone treatment choices.