Painful Sex After Menopause: Is It Changing Your Desire?

Painful sex after menopause can impact far more than bedroom activities. Pain—or even the anticipation of pain—during intimacy can impact how comfortable you feel being touched, how easily you become aroused, and whether you even desire intimacy.

Sound familiar?

If so, welcome back to the main theme of this series: just because you think you have lost desire doesn’t necessarily mean you want to stop being intimate.

Your body may just be saying it hurts.

When Pain Impacts Your View of Intimacy

Don’t touch that stove! You burned your hand on it last time.

The next time you walk by a hot stove, your body is going to remember that burned hand and urge you to be careful. Your body is smart like that. It learns from painful experiences.

Intimacy should be no different.

If you’ve experienced repeated burning, pulling, irritation, or pain during penetration, your body may start to expect that pain before penetration even happens. You might tense up instead of relaxing. You might even avoid sex altogether.

Pain → anticipation → tension → difficulty becoming aroused → less lubrication → more pain → avoidance

This avoidance can become a cycle. And the longer it goes on, the easier it is to believe:

“I just don’t want sex anymore.”

But what if the better question is:

Would I want sex if it didn’t hurt?

That’s an entirely different conversation.

Why Does Sex Hurt After Menopause?

Asking “Why does sex hurt?” is like asking “Why are you hungry?” There can be many answers.

Lower estrogen levels during perimenopause and menopause can cause vulvar and vaginal tissues to become thinner, drier, and less elastic. Natural lubrication may decrease as well.

However, those aren’t the only reasons sex might hurt after menopause.

Painful sex can also be associated with pelvic floor dysfunction, infections or skin conditions, certain medications, prior surgeries or medical treatments, and other conditions.

That’s why pain that persists or causes significant discomfort isn’t something you should simply try to push through.

Your Body May Need More Time

Welcome back again to our earlier discussion of responsive desire.

As many of you learned in that article, your body may require more time to become physically aroused than it used to. During arousal, increased blood flow to genital tissues contributes to swelling and lubrication.

So give yourself time.

Kissing, touching, massage, clitoral stimulation, or whatever else feels good to you can give your body an opportunity to respond before penetration begins.

And no, this doesn’t mean following some Pinterest-recommended course of foreplay.

There is no magic number of minutes that determines when your body should be ready for penetration. Paying attention to how your body responds during intimacy can help you recognize when you actually feel ready.

What Is Your Body Trying to Tell You?

This is where I want to leave you today.

If your interest in intimacy has changed, don’t immediately assume you’ve simply “lost your sex drive.”

Ask yourself a few different questions:

Does intimacy hurt? Am I worried that it’s going to hurt? Am I giving my body enough time to become aroused? Would I feel differently about sex if it were comfortable again?

Your answers may tell you far more about your desire than you expected.

Because sometimes your body isn’t saying “I don’t want intimacy.”

It may simply be saying “I don’t want intimacy that hurts.”

And that’s something worth listening to.

Coming Next

Now that we understand how discomfort can affect desire, let’s talk about what you can actually do about it.

In my next article, we’ll look at lubricants and vaginal moisturizers, why penetration doesn’t have to be the goal, when it’s time to talk with your healthcare provider, and ways to start making intimacy comfortable again.