Ask a Doctor:
"Why does sex hurt now?"

By Womaness Editors   1-Minute Read

Welcome to ASK AN EXPERT, a series where we pose your real questions to our menopause experts for the answers you need. Have a question? Post it on The After Party, our private Facebook Group.

Your Question:

“Now that I am in menopause, why does having sex feel painful?”

The Answer:

From Dr. Somi Javaid, board-certified OB/GYN physician/surgeon & founder & Chief Medical Officer of HerMD: “If there's pain involved during sex—a common complaint I hear—we call it genitourinary syndrome of menopause (GSM). Our external and internal anatomy are very dependent upon hormones. I often compare a normal, healthy vagina to an accordion: it has these deep folds called rugae, it stretches, and it's pink. As you age and lose those hormone levels, that tissue starts to get thinner…and when you try to stretch that tissue with intercourse, it doesn't do it as well. It almost becomes like a tube sock, burning and hurting. That's when women tell me sex hurts, or they feel dry or hurt the day after.

The reason we call it genitourinary is because some women have bladder symptoms at the same time. They might be leaking with a cough, a sneeze, or while jumping. These changes are all directly related to hormones declining.

The good news is there are nice treatment options. There are suppositories (usually hormonal) that are locally acting. If you want to avoid that, there's pelvic floor physical therapy. There are surgical options for incontinence. There are lasers and radio-frequency treatments for the dryness and pain. There are also great over-the-counter lubricants and moisturizers. We remember moisturizer for our face, hands, and feet. But a lot of women forget about moisturizing sensitive parts like the vagina and vulva. There are now great products out there that can help keep that skin healthy."