Why does Sex hurt now?

Pain during sex has a clinical name, dyspareunia, and it is one of the most common things women quietly deal with in midlife, and one of the least talked about. In fact, 1 in 4 people with vulvas develop pain in their lifetime[1]. Cleveland Clinic suggests that its more likely to affect women who are past menopause and often due to a decrease in estrogen.[2]

Types of pain:

There are different types of pain that each have their own causes and treatment options.

Entry pain. Positional pain. Deep pain

What Might Be Behind It

There isn't one single cause, which is part of why it can feel so confusing. Some of the most common contributors during perimenopause and menopause include:

✦   Reduced natural lubrication as estrogen declines

✦   Thinner, less elastic vaginal tissue (part of GSM, covered on our GSM page)

✦   Pelvic floor tension, which can build up over time, sometimes without you realizing it

✦   Endometriosis

✦   Trauma or injury

✦   Emotional factors, stress, anxiety, or simply feeling disconnected from your body after a long gap

 Often it's a combination, not just one thing, which is exactly why a single quick fix rarely solves it on its own

What can you do?
The most important thing is to find a healthcare professional you trust and speak with them. A physical exam may be able to identify the underlying causes. Depending on the cause, a range of treatments are available. Pain is often complicated between physical and emotional so being patient and kind to yourself is important.

Cedars Sinai even suggest  that using a personal lubricant can help alleviate vaginal dryness, infections can be treated with medications, and using a vibrator or medications can help with pelvic floor dysfunction[3].

There are some incredible resources out there and groups that can help. Often just speaking to others experiencing the same thing can help set you in the right direction.

This page is general guidance, not medical advice. A gynaecologist, general practitioner, or pelvic floor physical therapist can give you an assessment specific to you.