Painful Intercourse After Menopause

Lower oestrogen after menopause can reduce natural lubrication and make vaginal tissue more delicate. This may cause burning, tightness, soreness during penetration, or aching afterwards. Pain can also involve pelvic-floor muscle tightening, irritation from products, infection, or a condition such as pelvic organ prolapse. Menopause symptoms may occur alongside vaginal dryness, including hot flushes, night sweats, mood changes, or low sex drive, but painful sex should not be dismissed as something you must tolerate.

Use a water-based or silicone-based lubricant during sex and a vaginal moisturiser regularly if dryness is ongoing. Allow more time for arousal, choose positions that control depth, and stop if pain starts. Avoid fragranced washes and douching. A clinician can examine the tissues, check for infection or prolapse, and discuss local or other treatments suited to your health history. Mention any medicines, previous cancer treatment, or bleeding.

Arrange medical review for pain that continues, recurs, or affects intimacy. Seek prompt care for bleeding after sex, unexpected vaginal bleeding, sores, unusual discharge, fever, a new pelvic lump, or difficulty passing urine. Severe pain with faintness or heavy bleeding needs urgent help. The cause may be treatable, but examination is needed to identify it.

Ask whether your symptoms fit vaginal dryness, infection, pelvic-floor tension, or prolapse; which lubricant or moisturiser is appropriate; and whether local hormone treatment or pelvic-floor therapy could help. Tell the clinician where the pain occurs and whether bleeding follows intercourse.