When you go through menopause, and post-menopause, you might discover that sex does not feel as good as it used to, or it might even be painful. Between 17 percent and 45 percent of postmenopausal women report having painful sex. The cause is often vaginal dryness or thinning. Other factors can impact how sex feels as well. Some women may think they are too old to keep having sex or have to live with the pain. In this article, we will look at some of the causes of painful sex during menopause and steps a woman can take to minimize pain during sex.

Having Less Estrogen

Menopause causes estrogen levels to drop, which lowers the blood flow to the vagina. This can make the vaginal tissue thin, fragile, or dry, causing painful sex. The inside of the vagina might feel itchy or dry, and the skin outside of it might be irritated.

If you’ve given birth in the past or had any surgeries, you may have scar tissue left over, which can become more sensitive during and after menopause.

Feeling Less Aroused

When you are aroused, the tissue around the vagina will fill with blood, which triggers lubrication. With less estrogen post-menopause, you might not become aroused as quickly as you did before or your vagina might require extra lubrication.

Painful Sex Associated with Menopause

Pelvic Floor Dysfunction

The grouping of muscles around the vagina is known as the pelvic floor. Menopause can cause dysfunction in this area, with the muscles contracting too much during sex, making it painful. If the pelvic floor is dysfunctional, your bladder or your uterus can push on the vagina, making sex even more painful.

What You Can Do

There are many solutions to help make sex more comfortableThere are many solutions to help make sex more comfortable for you during and post- menopause; check out a few of them below:


You can try using a lubricant during sex to counter the dryness you are experiencing. There are tons of brands of silicone and water-based lubricants out there, and what works for one woman doesn’t always work for the next. Review the product labeling before use.


There are vaginal moisturizers that can help ease dryness. These are different than lubricants in that they can be used not just in preparation for penetrative sex, but for daily comfort as well.

Pelvic Floor Therapy

You can talk to your clinician about seeing a pelvic floor therapist, which can help strengthen your pelvic floor muscles if pelvic floor dysfunction is the cause of your pain.

Vaginal Dilators

If you are experiencing vaginismus, dilation therapy may be a treatment option for you. Vaginismus is a condition where the vaginal walls contract tightly, which can cause penetration to be difficult or painful. The Milli Vaginal Dilator is a tool intended for controlled dilation of the vagina. It can be used for dilation for an examination, in preparation for a surgical procedure, or to help relieve the symptoms of vaginismus and related dyspareunia. A vaginal dilator can gently train your vaginal muscles over time to help make sex more comfortable. You can include it in foreplay with your partner.