Painful Sex After Menopause is Common and Treatable

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Key Takeaways

• Painful sex after menopause is common. Hormonal changes can affect vaginal tissue, lubrication, and elasticity.
• The most common cause is GSM. Genitourinary Syndrome of Menopause occurs when declining estrogen leads to vaginal dryness, tissue thinning, and structural changes.
• Pain is not “just part of aging.” Discomfort with sex is a medical issue with effective, evidence-based treatments.
• Evaluation matters. A menopause-focused OB-GYN can identify the cause and recommend care tailored to your symptoms and goals.

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Pain during sex after menopause is more common than many women realize, yet it’s rarely discussed openly. For some women, discomfort develops gradually over time. For others, it can feel sudden and confusing, especially if sex was previously comfortable.

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If this sounds familiar, you’re not alone and help is available.

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Why Sex Can Become Painful After Menopause

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The most common reason sex becomes painful after menopause is hormonal change. As estrogen levels decline, the vaginal tissue may become thinner, drier, and less elastic. Together, these changes can make penetration uncomfortable or painful.

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Some women may also experience:

• Increased vaginal sensitivity
• Decreased clitoral sensitivity
• Small tissue tears due to dryness

A common underlying condition responsible for these changes is Genitourinary Syndrome of Menopause (GSM).

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GSM occurs when declining estrogen affects the structure and function of the vagina, vulva, bladder, and urethra. One way physicians describe this is by thinking of the vagina as a rainforest, supported by moisture, healthy bacteria, and constant renewal. With estrogen loss, that environment changes. Lubrication decreases, tissue becomes fragile, and the protective balance is disrupted.

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GSM is commonly associated with:

• Pain during sex
• Recurrent urinary tract infections
• Vaginal or vulvar tearing, irritation, or bleeding

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It’s Not “Just Part of Aging”

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Painful sex is not something you need to accept or push through. While menopause is a natural transition, persistent discomfort with intimacy is a medical concern that deserves evaluation and care.

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Avoiding sex out of fear or discomfort can also affect emotional wellbeing, relationships, and self-confidence. Addressing symptoms early can make a meaningful difference in both physical comfort and quality of life.

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Why Medical Evaluation Matters

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A qualified provider can help determine whether pain during sex is related to menopause or another condition, such as infection, pelvic floor dysfunction, or vulvar skin disorders.

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Proper evaluation ensures that treatment is appropriate, effective, and aligned with your individual health history and goals.

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How Gliss Supports Menopause Care

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At Gliss Wellness, board-certified OB-GYNs provide personalized, virtual care focused on diagnosing and treating menopause-related symptoms, including painful sex.

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Appointments are designed to allow time to listen, review your history, and discuss treatment options thoughtfully. Care is evidence-based, supportive, and free of judgment.

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The Bottom Line

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Painful sex after menopause is common, but it is highly treatable. With the right care, many women experience meaningful improvement in comfort and intimacy.

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If these symptoms feel familiar, you don’t have to navigate them alone.
Learn more about menopause care at Gliss or schedule a virtual appointment to discuss personalized treatment options.

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