Why Genitourinary Syndrome of Menopause Can Cause Pain During Sex

After menopause, reduced oestrogen affects the vulva, vagina and nearby urinary tissues. The vaginal lining may become thinner, produce less natural moisture and stretch less easily. Friction during penetration can then cause burning, soreness or pain at the opening or deeper inside. Small areas of irritation may keep discomfort going after sex. Urinary urgency, burning or recurrent urinary symptoms can occur alongside these changes.

Pain during sex can have other causes too, including infection, skin conditions, pelvic-floor muscle tightening or another pelvic problem. A clinician can separate these possibilities by asking where the pain occurs, examining the tissues and reviewing medicines and menopause symptoms.

Pause or change sexual activity when pain begins. A water-based or silicone-based lubricant can reduce friction, while a regular vaginal moisturiser may help ongoing dryness. Allow more time for arousal and use positions that let you control depth and pace. Avoid perfumed washes and douching, which can irritate sensitive tissue.

If symptoms continue, discuss local vaginal oestrogen or other prescription options with a qualified clinician. Pelvic-floor assessment may help when muscles tighten in response to pain. Do not assume every episode is caused by menopause, especially if symptoms are new or changing.

Arrange a medical assessment for persistent, worsening or new pain, pain with bleeding, unusual discharge, sores, fever, pelvic pain or urinary symptoms. Seek prompt care for severe pelvic pain, heavy bleeding, faintness or fever with feeling very unwell. Pain that prevents intimacy or examination also deserves treatment rather than being accepted as an unavoidable part of menopause.

Ask whether the pattern fits Genitourinary Syndrome of Menopause, whether an examination or infection test is needed, and which lubricant, moisturiser or prescription treatment suits your health history. Mention bleeding, urinary changes, medicines and the exact location of pain.