When Sex Hurts

It doesn’t have to. Here’s how you can tackle the issue…

Sex has never really been the easiest subject for you to talk about, and it may seem to be an even more distant topic later in life. Add to that the reality that for many women, sex can be painful at some point in their lives, and the matter can be doubly difficult to discuss.

Dyspareunia (dis-puh-ROOnee-uh), the term for painful vaginal sex, is more common than you might think. Estimates vary, but recent surveys of post-menopausal women not on hormone therapy report dyspareunia in as many as 20 to 30%. Some reports range even higher.

Understanding the pain

Dyspareunia is often divided into superficial pain, deep pain or both. Most women complain of superficial pain, which occurs upon vaginal penetration. Often, the pain has a sharp or burning quality. Deep pain occurs with deep penetration or thrusting. For some women, the problem is temporary. For others, it can become chronic.

After menopause, painful intercourse is often associated with changes due to decreased estrogen levels. The vaginal tissues tend to become less elastic, more fragile and more susceptible to bleeding, tearing or pain during sexual activity or during a pelvic exam. It can make sex painful or even impossible. The loss of estrogen can cause urinary problems, which can also make sex uncomfortable. Lack of sexual activity contributes to loss of tissue health and elasticity.

Sometimes other factors are at play, including:

- Injury or trauma, such as from childbirth, pelvic surgery or an accident.

- Skin conditions, such as eczema or lichen sclerosus, or an infection in your genital area or urinary tract.