TABLE OF CONTENTS
How to Navigate
Changes at Midlife
Sexual Problems at Midlife
Causes of Sexual Problems
Reminders & Resources
Frequently Asked Questions
Give Us YourFeedback
Dryness and thinning of the vagina is the most common cause of painful sex at midlife and beyond.
Menopause-related discomfort. As reviewed earlier, the dryness and thinning of the vagina (vaginal atrophy) that follows the drop in estrogen around menopause is the most common cause of painful sex at midlife and beyond. Less estrogen means less vaginal lubrication and a less stretchable vagina. The vagina also may shorten and become tighter at the opening. In some women this can lead to a feeling of vaginal tightness during sex along with pain, burning, or soreness. Inflammation and irritation can also develop (atrophic vaginitis), leading to greater discomfort and sometimes to tearing and bleeding of tissue with any penetration of the vagina.
Discomfort not directly related to menopause. Other types of vaginal discomfort are not directly related to menopause but can and do occur in peri- and postmenopausal women, making sex painful or difficult:
Because vaginal discomfort can arise from so many different sources, persistent symptoms of dryness, irritation, burning, itchiness, or pain should be evaluated by a healthcare provider to determine their cause.