Intimacy after Menopause

I hear from so many women that after menopause, “everything changes” in their bodies but also that many of them don’t know that pelvic floor physical therapy, along with other strategies, can help improve some of the changes that are more…ahem…unsatisfactory.

One big change is in the vaginal area.  Particularly, intercourse can become painful.  What’s changed?  Estrogen.  It’s responsible for keeping vulvar tissues moist and plump.  Without it (after menopause), these tissues can become dry, thin, and fragile.  Sensation decreases, as does arousal.  Friction or stretching becomes uncomfortable.  As a result, the pelvic floor muscles can tighten and guard, making intercourse even more difficult and painful.  It can be a vicious cycle.  

Solutions?  There are several:

  • Vaginal lubricants and moisturizers
    • Lubricants help to decrease friction during sexual activity and protect the fragile tissues.  Whether water-soluble or silicone-based or oil-based, having that protective layer can ease the discomfort.  Please note: oil-based are NOT compatible with condoms!
    • Moisturizers help to maintain increased moisture in the vagina during regular daily activity (not just sexual activity). 
    • Click here for examples of both types of products
  • Topical estrogen
    • Ask your gynecologist or primary care provider about adding a topical estrogen cream or intravaginal estrogen ring to your routine.  By locally adding back estrogen specifically vulvar tissues, much of the thinning and dryness can be improved.
  • Pelvic floor physical therapy
    • PT is vital to ensure that the pelvic floor muscles are working properly to both contract and relax.
    • By learning how to relax the pelvic floor muscles, you can combat the muscle tightness that can accompany the discomfort of dry vaginal tissues and pain.
    • In fact, research has shown that PT PLUS estrogen is more effective than either treatment alone!

Know that painful intercourse after menopause is common but TREATABLE!  Don’t suffer in silence; help is available!

Leave a Reply

Your email address will not be published. Required fields are marked *