It is no secret that sex can be painful during perimenopause and menopause. What's worse however, is that nobody really wants to talk openly about it because they are either a) embarrassed or b) feel isolated. Therefore, painful sex may go unaddressed or even untreated. As a result, your libido can decrease, and your sex life —nonexistent. Sorry for the bad news. The good news however, is that you are not alone (if that is actually considered good news) and there are several options to help improve your situation. But first, let's try to understand why it happens and then explore ways to make intimacy less painful ---perhaps enjoyable, and hopefully your libido/desire will also return.
So, why does sex hurt during this stage of life? The number one contributor is the diminished amount of estrogen that the body is producing. The result is genito-urinary symptoms, in other words dryness, burning and pain in the vagina as well as urgency and frequency in the lower urinary tract --almost feeling like you have a UTI. The lack of estrogen causes the vaginal tissues to thin and become drier and this results in less elasticity and natural moisture to this part of the body. If something hurts, then a natural instinct is to not seek it out a.k.a. not have sex. The problem then becomes compounded. Sex becomes less frequent, and the painful repercussions can be even worse. In addition, the emotional relationship can suffer due to lack of intimacy. We know by now that It takes the perfect set of events to make things happen in the bedroom and here are V. ways to help improve your sexual outcomes during menopause.
i. Communication. If it has been a while since you have had sex due to pain and/or lack of libido, now is the moment to reconnect. Take the time to talk it through and let your partner understand what you are experiencing both physically and emotionally. You need to be able to communicate with your partner and trust that they will support you during this challenging time. And remember, your partner may be experiencing their own challenges as well.
i. Stimulation. Yes, stimulation without penetration may be a great way to start to wake things up again. This can be manual, oral, internal or outer-course stimulation. With or without the use of sexual devices, recognizing that you can still feel good can absolutely help with desire and libido.
iii. Lubrication. Try something to reduce the physical friction. Lubricants may not fix the [long term] problem, but they certainly can help improve the immediate situation. Whether the lube is water based or oil based, it can help with the glide factor, making things easier. Experiment with a few and see which works best for you. We’re partial to all-natural, oil-based lubricants like Voilà.
iv. Relaxation. Physical therapy (PT) specific to the pelvis can also be enormously helpful. Believe it or not, the pelvic floor muscles are super strong. If the brain tells the body that something is going to cause pain, then a natural defense mechanism sets in. The vaginal muscles can then tense and you will experience vaginismus which is the body's automatic reaction to the fear of some or all types of vaginal penetration. So, whenever penetration is attempted, your vaginal muscles tighten up on their own. You have no control over it. PT can help a woman learn how to engage and relax these muscles to help reduce if not eliminate pain with intercourse. It also lets her regain some control of her body.
v. Medication. Local estrogen therapy is also a great option for many. Estrogen can be applied to the vagina, either via cream, tablet or capsule and used on a regular basis to help restore the elasticity and secretory capacity of these tissues. The result can be very helpful in relieving the genitourinary symptoms commonly experienced by many perimenopausal and menopausal women.
Voilà does not provide medical advice, diagnosis, or treatment and is not a medical provider. Discuss all/any menopause symptoms, questions or concerns with your personal doctor.