Menopause - Why does sex hurt?
What is Menopause
Menopause is a normal period of transition in every woman’s life. For many though, it can come with physical changes that can be unwelcome and unexpected. Most women are familiar with the most common symptom associated with menopause which is hot flashes. Unfortunately, vaginal dryness and/or vaginal atrophy can also happen during this transition.
Our hormones play a major role in every aspect of how our bodies function. During perimenopause levels of hormones that regulate sexual health begin to decline. Many of the changes are can be attributed to declines in these major sex hormones:
- Estrogen
- Progesterone
- Testosterone
As these hormones decline, women may begin to experience one or more of the most common symptoms of menopause; hot flashes, trouble sleeping and fatigue. These hormonal declines can begin as early ten years before the menopause transition begins, meaning many women start to experience symptoms long before they are considered menopausal.
What is Dyspareunia?
Dyspareunia is commonly referred to as painful intercourse. It is pain in the pelvic or genital area during sexual activity. Although there are many possible causes such as underlying disease, trauma and problems with lubrication during the menopausal transition vaginal dryness can occur as a result of decreasing sex hormone production, primarily estrogen.
One of the roles of estrogen is to help keep the vagina and surrounding tissues lubricated. As estrogen naturally declines so does the amount for lubricating secretions released by the glands located in and around the vagina. During intercourse, this decreased lubrication combined with the tissue friction can make sex uncomfortable or painful.
Another common cause of painful intercourse is vaginal atrophy. Vaginal atrophy occurs mostly after menopause in the tissues in and around the vaginal wall. These tissues become thinner, dryer and maybe inflamed making intercourse uncomfortable and/or painful.
Help for Pain During Sex
Vaginal lubrication can help. All lubricants are not the same nor do they feel the same. Sometimes it is a matter of trial and error. There are many choices. Water based products can be used with latex condoms and are non-staining however, they are fast drying and may need to be reapplied. If you have significant dryness, you may need a silicone- based product which offers more lubrication and generally does not dry out during sex. Oil- based lubricants also have staying power but they cannot be used with latex condoms or a diaphragm as oil damages latex making them unreliable for protection during sex. Oil based lubricants also can stain sheets or clothing. Many women also prefer natural lubricants these products are free of some ingredients such as glycerin or parabens, which can be irritating to the sensitive skin in this area.
If you are experiencing discomfort during intercourse because of vaginal dryness, try using a lubricant.
Be sure to consult your physician if you are experiencing continued pain with intercourse.
Don’t ignore your pelvic floor. If you are experiencing any of the symptoms listed above and have experienced regular stress or even have a stressful lifestyle, consider adding deep breathing and stretching exercises targeting the pelvic region to help your symptoms. Of course, if your symptoms persist, are severe or bothersome, consult your healthcare professional for advice.
If you’re struggling with bladder leakage and/or urge incontinence and accidents, I invite you to check out my signature program, STOP WORRYING ABOUT BLADDER LEAKS and schedule your free consultation today. I’ve successfully helped hundreds of women treat urinary incontinence – and can help you discover the tools to stop leaking and start living life again without worry.
Dr. Shelia Craig Whiteman PT DPT CLT
Pelvic Physical Therapist/ Certified Health Coach
