When Intercourse Becomes Painful

When Intercourse Becomes Painful

“I haven’t been sexual with a partner for about nine years. When I was about fifty-four, a very nice man and I got together, but we could not have sex vaginally. The pain was so great, I simply could not. It was like someone rubbing sandpaper inside me - not a turn-on for either partner.” - excerpt from Naked at our Age, “When Sex Hurts: Vulvar/Vaginal Pain”

Vaginal atrophy is when the walls of your vagina become thin, dry or inflamed and can make intercourse painful as well as distress the urinary tract. Otherwise known as genitourinary syndrome of menopause (GSM), this affects a whopping 50-60% of post-menopausal women! Yet, only 25% seek treatment, likely due to shame, embarrassment or misinformation. 

A drop in estrogen levels causes vaginal atrophy. While a reduction in estrogen is most commonly associated with menopause, it can also be caused by breastfeeding, certain medications, removal of ovaries, hormone treatments, cancer treatments, pelvic radiation therapy, and etc. Symptoms of GSM include less lubrication during sex, discomfort or bleeding during or after sex, itching genitals, increased yeast infections, pain or discomfort while peeing and incontinence. 

Many women suffer in silence, remain undiagnosed, and may avoid sex altogether which can exacerbate the problem as vaginal tissue and elasticity will continue to deteriorate without stimulation. Another byproduct of menopause is difficulty in relaxing the pelvic floor muscles which when tight can make penetration painful.

If you suspect you may have vaginal atrophy, do not hesitate to seek out medical diagnosis and help. 

Sex can and should be enjoyed well into our adulthood. You can take ownership of your pleasure and sexual health with these helpful tips from Ellen Barnard, MSSW:

  • Moisturize & Massage - daily application and massage of internal and external vaginal skin will increase blood flow and build up the vaginal skin and layers beneath it
  • Estrogen treatment - a short-time use of an estrogen gel or ring will improve skin elasticity and thickness
  • Orgasm - whether solo, with a toy or partner, you should aim to orgasm at least once or twice a week to maintain nerve functioning and improve lubrication
  • Work those pelvic floor muscles - practice those Kegel exercises and focus on both on contracting AND releasing the muscles
  • Lube up - silicone-based lubricant is more protective of the skin and compatible with condoms. Please note that silicone-based lubricants will break down silicone sex toys.

Photo Credit: Deon Black