There’s lots of reasons why sex might be painful after you turn 50. For many women as estrogen levels decline during midlife, their vaginas become much more dry and don’t have the same elasticity or ability to stretch.
What you might notice
- The skin around the labia and vagina feels dry when you wipe
- More irritation with tight clothes
- A slight odor – from sour to fishy
- Feeling that the vaginal opening can’t stretch enough for a partner or a toy to enter
- Pain if the skin is being stretched or even pulled apart with tearing
- Wondering where your normal ability to lubricate went to
- Pain in the area after sex
You’re not alone! In fact about half of women over 35 need to use a lubricant when having sex.
Why this happens
You may be surprised to learn that your genital area has a ton of estrogen receptors, and as they get thirsty for more estrogen than your body is making, the skin gets dry, loses some of it’s elasticity and can shrink.
In addition, without the estrogen to keep the vaginal ecosystem in balance, the normal healthy bacteria that live in the vagina, known as lactobacilli, will go away. These lactobacilli keep the pH slightly acidic, which prevents the overgrowth of yeast and bacterial infections.
All this adds up to a vagina that’s drier, less able to lubricate and which is more prone to infections.
Unlike hot flashes and night sweats in menopause, this condition does NOT get better over time, in fact it gets worse. So if you’re experiencing any of these symptoms, do talk to your provider.
What you can do
There are great resources available from the North American Menopause Society, including a link to help you find a health care provider who is familiar with this. (link: https://www.menopause.org/for-women )
- Do use lubricants – From Olive or coconut oil to Sliquid, KY and Sliquid, there are lots of great options out there. Don’t forget, some are flavored for more fun with oral sex.
- Do talk to your provider about vaginal estrogen – Guess what? Using small amounts of estrogen in the vagina does NOT increase the risk of breast cancer. Really, it doesn’t because it’s all absorbed in the vagina and we can’t detect it in the blood. This helps restore the vaginal estrogen, which makes the skin more able to stretch and lubricate. It also helps the lactobacilli return reducing the risks of infection.
- Consider using Intrarosa® – This is a new FDA approved DHEA vaginal suppository that converts to estrogen in the body. This helps restore the vaginal estrogen, which makes the skin more able to stretch and lubricate. It also helps the lactobacilli return reducing the risks of infection.
- Consider using Osphena® – This is an oral medication that acts like an estrogen in the vagina. This helps restore the vaginal estrogen, which makes the skin more able to stretch and lubricate. It also helps the lactobacilli return reducing the risks of infection.
My book, The Hot Guide to a Cool Sexy Menopause has a lot more information on all aspects of menopause. (link: https://www.amazon.com/Hot-Guide-Cool-Sexy-Menopause/dp/1591203716 )
Disclosure: I do not work for with any of the products listed here. All of the proceeds from the sale of my book go to FAME Hospital in Tanzania. (link: https://fameafrica.org )