Are menopause symptoms making sex painful? Relate, the UK’s largest provider of relationship support, has worked with Health & Her to develop advice to help you and your partner work together to understand why painful sex can become a problem at menopause, and how you can put things right together.
Why can sex become painful at menopause?
Painful sex can start during the menopause because of a drop in oestrogen levels, this causes vaginal tissues to be thinner, less elastic and drier. This makes sex less comfortable and sometimes painful.
As well as being uncomfortable sex can be further complicated by vaginismus – this an automatic reaction to the anticipation that sex will be painful, causing you to clench up. It can make penetration harder for your partner too and so he may find sex uncomfortable.
At around the same time women go through the menopause men can also start to experience problems getting aroused and keeping an erection. If penetration is uncomfortable for them they can find it difficult to keep an erection – these problems can feed on each other and create a vicious circle. Gradually couples can find they start having less and less sex until their sex life has all but disappeared.
A time to try new things…?
Despite all the problems it can cause, discomfort during sex is a very treatable condition. It’s essential to use a lubricant once you’ve been through menopause and take into account that your bodies have changed – what used to work well for you probably needs to be rethought.
How does painful sex affect relationships?
A dwindling sex life is likely to start to change how you feel more generally about your relationship. Both of you will probably be unsure about why your sex life isn’t what it used to be but be unsure what to do.
Your partner might misinterpret a lack of sex as a sign that you are no longer attracted to them and may start to withdraw from the relationship.
Unpicking these misunderstanding in sex therapy – or through a series of honest chats – is key to getting an enjoyable sex life started again.
What can help with painful sex during menopause and post-menopause?
There’s lots that can be done to help with both of the physical and emotional issues. For advice on why you might be finding sex painful and how you can take action to resolve physical issues, this video with Consultant Gynaecologist Anne Henderson is helpful. You might also be interested in GP Shilpa McQuillan’s overview article here.
Reframe: great sex isn’t all about penetration
Try lots of different ways to feel sexy and build up your desire –flirting, kissing, and massage can all enhance desire and mean your sex life is about a lot more than intercourse. When you are in bed spend much more time on foreplay, you could try role play or sharing fantasies, it’s about trying new things so you don’t feel under pressure to have sex in the ways you used to.
Understand that you may be under or over sensitive to touch
It’s not unusual for you to respond differently to touch after you go through menopause, being under sensitive to touch is the most common response. This happens because the vagina changes and the vaginal walls, which are often only a few cell layers thick, become thinner. The vagina also becomes shorter and narrower as a result of hormonal changes which occur at menopause. All these changes mean you need to relearn touch and what is enjoyable for you.
Avoid mindreading and explain how you feel
Find a way of talking about how menopause has affected your relationship. Your partner might be assuming that you’re not attracted to them because you don’t want to have sex.
Telling them that you’re going through menopause and this has affected how you feel about sex can go a long to avoiding arguments and feeling you are drifting apart. It doesn’t have to be a big discussion you could point your partner in the direction of some websites that give them more information about your symptoms. Try not to pretend that everything is the same and hope things will improve, vaginal dryness is a symptom that won’t go away over time.
Consider sex therapy.
If a lack of sex is putting your relationship under strain, a sex therapist can help you overcome any specific issues you have with painful sex and rediscover your sex life. They understand that these problems can be complicated and will listen sensitively to your problems. Many people find once they start therapy they find it surprisingly easy to be open about their problems.
Don’t put up with painful sex
Whatever you do though, don’t let embarrassment stop you getting help with painful sex. It’s a common symptom of the menopause and often something as straightforward as using a good lubricant can make a huge different to your enjoyment of sex. If you feel that problems with your sex life are leaving you feeling stuck and dissatisfied with your relationship many couples find seeing a sex therapist gives them the support they need to address the issues underlying painful sex.
Relate is the UK’s largest provider of relationship support, and last year they helped over two million people of all ages, backgrounds, sexual orientations and gender identities to strengthen their relationships.