Painful sexual intercourse after menopause

After menopause, lower oestrogen may reduce natural lubrication and make the vaginal lining more delicate. Entry pain may suggest dryness or involuntary tightening of pelvic floor muscles; pain deeper in the pelvis can have a different cause. Irritation, infection and pelvic organ prolapse are other possibilities. The symptom itself cannot tell you which explanation applies.

Use lubricant during intercourse and a fragrance-free vaginal moisturiser for ongoing dryness. Extend arousal time, use gentle pressure, and try positions that limit depth. Agree on a signal to pause, and do not push through pain. A doctor may offer local vaginal treatment, investigate infection, or recommend pelvic floor physiotherapy. These choices depend on your medical history and other medicines.

Book a review for pain that continues, changes, or interferes with intimacy. Contact a clinician promptly for bleeding after menopause, new discharge, fever, genital sores, severe pelvic pain or urinary difficulty. A pelvic examination and selected tests may be recommended, particularly when symptoms are new or do not improve with lubrication.

Ask what location and timing of the pain suggest, whether dryness or pelvic floor tension is present, which treatments fit your health history, and how soon you should return if symptoms persist.