Amelia Grant

After menopause, painful intercourse is a typical condition. According to study, over 40% of postmenopausal women suffer with the disorder known as dyspareunia. 

Despite this, the majority of women do not seek treatment or even recognize that aid is available. Your sex life, relationship, and self-image may all be affected by the disease.

Reduced estrogen levels after menopause induce dyspareunia, which affects the vaginal tissue, leaving it thin, inflammatory, and dry. And, unlike hot flashes following menopause, the problem isn't going away on its own.

Can lead to UTIs

In fact, if left untreated, the problem may worsen because the tissue is readily inflamed and may even bleed after intercourse. Vulvovaginal atrophy is the general term for the disorder, which is linked to an increased risk of urinary tract infections, overactive bladder, and bladder leaks.

Researchers examined 3,520 postmenopausal women aged 55 to 65 residing in the United States, Canada, Denmark, the United Kingdom, Finland, Norway, and Sweden for the Vaginal Health: Insights, Views, and Attitudes (VIVA) study, which was published in 2012. The researchers discovered that 58% of women experiencing vaginal discomfort were unaware that it was an indication of menopause.

In the Revealing Vaginal Effects At MidLife (REVEAL) study, 80 percent of women who had dyspareunia stated they had just learned to deal with it, and many continued to have sex despite the discomfort.

Over-the-counter and prescription treatments

You can attempt over-the-counter remedies to relieve the pain, at least briefly. Personal water-based lubricants, such as Astroglide or K-Y Ultragel, can make intercourse more comfortable, and they're safe to use with latex condoms and clean up with soap and water. However, because they evaporate faster than other types, reapplication may be necessary on a regular basis.

Replens or Vagisil Prohydrate are vaginal moisturizers that replicate the vagina's natural secretions and can hydrate the vagina for two to three days.

Your doctor can prescribe vaginal or oral estrogen therapy to address the underlying problem of estrogen insufficiency in the vaginal tissue. Low-dose vaginal estrogen therapy is safer than systemic therapy, and vaginal creams, rings, and tablets are quite successful (pills or patches).

Many women are hesitant to take oral hormones because they are concerned about cardiovascular disease or breast cancer. However, a study published in September 2017 in the Journal of the American Medical Association followed more than 27,000 women who took oral hormone therapy for an average of five to seven years and then followed them for an additional 18 years found no link between hormone therapy and increased or decreased death rates.

Another, more recent option is Osphena (ospemifene), a nonhormonal, once-daily medication available only by prescription that acts on estrogen receptors in the vaginal tissue and thickens it. Osphena is a selective estrogen receptor modulator (SERM), the same class of medicine as tamoxifen and toremifene, which are used to treat breast cancer. Daily use of the medicine is well tolerated and helpful in lowering the severity of painful intercourse, according to studies conducted before and after its approval in 2013. On the other hand, Osphena has been linked to an increased risk of stroke, blood clots, and uterine cancer.

Laser therapy is a newer treatment option that has shown promise in studies for treating dyspareunia, repairing premenopausal vaginal tissue, and enhancing a woman's quality of life.

Getting the courage to talk to your doctor

According to surveys, many women are hesitant to discuss painful intercourse with their doctors. They may be embarrassed, thinking there is nothing that can be done to help them, or that their sex life is private and not something they should share with their doctors.

Many people say they hope their doctors would bring up the subject so they wouldn't have to bring it up themselves. Doctors should inquire about it, but if they do not, you should bring it up on your own. It's a common issue, so your doctor won't be startled when you ask.