The years of perimenopause and transition into menopause is a profound time period. It is unique for each woman. As our bodies respond to declining and fluctuating levels of sex hormones, women may experience physiologic symptoms and changes of attitude toward intimacy. In particular, painful sex is often a complaint that many women experience and should share with their doctor. In this guide, we will discuss why midlife women may experience painful sex or painful intimate experiences. If you wish to address this concern in your sexual health and well-being, continue reading to claim your right to sexual health and wellness. 

Woman holding hands in front of crossed legs in sign of pain.

Understanding the Whys: Painful Sex After Menopause

Navigating the changes in intimacy, including sexual function, during the menopausal transition and sex life after menopause, often accompanied by symptoms like painful sex or dyspareunia, is a crucial aspect of women’s health which often is left untreated. This multifaceted challenge is also encompassed by the term genitourinary syndrome of menopause (GSM), acknowledging the comprehensive impact on the genital and urinary systems. If you’ve been experiencing discomfort or pain during intimate moments, you’re not alone, and there are effective solutions available. Let’s first understand some physiological factors that can cause sexual pain to arise during the menopause transition and after menopause.

Vaginal Dryness and Thinning Vulvovaginal Tissues

The decline in estrogen levels in both perimenopause and menopause can lead to many symptoms aside from hot flashes and night sweats. Indeed, this change in hormone levels causes a reduction in vaginal lubrication and the thinning of vaginal tissue. As a result, vaginal dryness and discomfort can arise during sexual activity and pain with penetration. These changes in vaginal tissues can make sex painful and overall intimacy challenging, impacting women’s sexual health and experience.

Decreased Blood Flow

The overarching decline in estrogen hormones affects blood flow to the pelvic area, diminishing sensitivity and arousal in the vulvovaginal region. This reduction in blood flow and compromised tissue health contribute to discomfort and pain during sexual activity. In the following sections, we’ll delve into effective solutions to address these challenges and empower postmenopausal women to reclaim a fulfilling and comfortable intimate life.

Happy woman holding leaves in her hands

How Can You Ease Painful Sex Symptoms After Menopause?

Navigating the changes in intimacy and sex,during and after menopause is a crucial aspect of women’s health. As said before, painful sex, or dyspareunia, is a common concern among postmenopausal women, and addressing it is essential for overall well-being. If you’ve been experiencing discomfort or pain during intimate moments, you’re not alone, and there are effective solutions available to relieve pain.

photo of a Estrogen cream tube on a pink background

Vaginal Estrogen Therapy

Some way to find relief or decrease the pain during or after vaginal intercourse is the use of vaginal estrogen creams, tablets, or rings. Topical vaginal estrogen can help restore estrogen levels in the vulvovaginal tissues, promoting elasticity and lubrication helping to relieve dryness. Vaginal estrogen therapy as part of menopausal hormone therapy (MHT) is a targeted approach to alleviate discomfort and enhance overall sexual well-being.

Lifestyle Adjustments

Pandia Health’s expert doctors recognize the role of lifestyle factors in perimenopause/menopausal symptoms. Addressing issues such as weight management through a balanced diet and regular exercise, as well as getting sufficient sleep and stress management techniques can positively impact both overall health and intimate well-being.

Unbranded transparent bottle of Intimate lubricant gel and purple lupine flower frame

Use of Vaginal Moisturizers

Vaginal moisturizers provide a nonhormonal option for managing painful sex. Hyaluronic acid is the recommended ingredient in vaginal moisturizers and can be used alone and with vaginal estrogen treatment. Regular use of vaginal moisturizers can enhance vaginal moisture contributing to increased comfort during sexual activity. Pandia Health doctors also encourage the use of lube when planning to have sex with intercourse. Water-based lubricants are tolerated by most women since some people may be allergic to silicone. 

Educational Resources

Pandia Health empowers women with educational resources to understand the changes occurring during perimenopause and the transition into menopause. Knowledge is a powerful tool, and informed women are better equipped to navigate the challenges and make decisions. 

Websites such as the North American Menopause Society (NAMS), Menopause Matters, and Women’s Health Concern provide valuable information and support for women going through perimenopause.

Tailored Solutions with Pandia Health

Pandia Health’s expert doctors in menopause understand and recognize the varied perimenopausal and menopausal symptoms, which frequently include painful sex. Pandia Health’s team consists of Menopause Society Certified Practitioners (MSCP, previously known as NAMS certified menopause practitioners NMCP) experts in recommending personalized, menopause treatment options and plans to address the unique needs of each woman through an online Consultation.

Pandia Health’s telemedicine platform allows women to connect with expert doctors from the comfort of their homes. The online consultations provide a safe and confidential space for discussing intimate concerns, ensuring that women feel heard and their medical problems are understood.

Comprehensive Assessment

The board-certified doctors at Pandia Health evaluate your health questionnaire taking into account factors such as medical history, other symptoms lifestyle, and individual preferences. Pandia Health’s health questionnaire has been crafted by expert certified MSCP doctors who have years of experience helping women address perimenopausal/menopausal symptoms. That’s why the online questionnaire may seem a bit long since doctors benefit from noting your concerns and the symptoms you are experiencing. After careful review, the right treatment for each unique woman’s case is presented and reviewed. Pandia Health offers vaginal and systemic hormonal treatments that can alleviate symptoms of estrogen decline.


Dealing with painful sex in midlife requires a compassionate and personalized approach, and Pandia Health’s expert doctors in menopause are ready to help and guide you.  Understanding the causes, and addressing concerns and symptoms through online consultations, can provide a tailored treatment plan for the unique needs of each woman, Pandia Health is revolutionizing menopausal care. Women have the permission and the right to sexual and vaginal healthand desired Intimacy in midlife. Sexual and vaginal health is women’s health. With Pandia Health’s support, women can improve their sexual health and well being and restore intimacy back into their lives.