How to Talk About Painful Sex After Menopause

Medically Reviewed by Traci C. Johnson, MD on January 30, 2020
From the WebMD Archives

Your vagina changes when you go through menopause. You may notice dryness and irritation. Without treatment, sex can start to hurt. Thankfully, there are a lot of things you and your doctor can do to make intimacy more comfortable.

There’s one part of the pain puzzle that may be awkward. That’s sharing your concerns with the person you’re intimate with. If you’re nervous about bringing it up, you’re not the only one. Research shows that about half of women don’t tell their partners that sex is painful. And that’s not good for your pleasure.

“So many people are uncomfortable talking about sex, whether they’re 18 or 67,” says Laurie Mintz, a sexuality psychologist and author of A Tired Woman’s Guide to Passionate Sex. “But you can’t solve a sexual problem without talking about it.”

It’s normal to shy away from sensitive topics, especially if you’re worried about upsetting your partner. But if you stay silent about it for a long time, you can start to dread or avoid intimacy. Your symptoms can get worse if you continue despite your discomfort.

Schedule a Chat

Tell your partner you’d like to talk about your sex life. More importantly, let them know you’d like to find new ways to have fun together. Make sure you agree on a time and place where neither person feels rushed or pressured, Mintz says. That means don’t bring it up during lovemaking or when you’re on a date.

You may want to jot down your thoughts beforehand. That way you won’t forget what you want to say. Let your partner know it’s OK for them to ask you questions.

Use “I” Statements

You don’t want your partner to feel like they’re to blame. So you may want to start off by mentioning menopause. Talk about how it can affect your sex life. It’s fine if you’re not sure how your body will change. Just be honest about how you feel and what you need. Ellen Barnard, co-owner of A Woman’s Touch, a sexuality resource center in Madison, WI, shares how that conversation might go:

“I want to let you know what’s going on with me. You’re not doing anything wrong. But I need a lot longer time to warm up. And I’m really dry, so I’m going to need to use some lubrication. And let’s go pick that together. I need to let you know what feels good, so I’m going to do that when we’re playing.”

You should tell your partner that you may have to stop if intercourse hurts, Mintz says. If you come up with a plan before you’re intimate, you won’t catch them off-guard.

Focus on Pleasure

It’s easy to point out what feels bad. But Barnard tells her clients to pay more attention to what brings pleasure. You may prefer one position over another. If it feels good when your partner massages your clitoris, tell them that. If you’re not sure what you like, try “practicing solo first,” suggests Barnard.  

You may also need to ask for more foreplay. That’s because your vaginal blood flow may not respond as quickly after menopause. That can affect your mental and physical arousal. A lot of sexual pain comes from having intercourse before you’re ready, Mintz says.

Explore a Sex Shop, Together

There are a lot of different kinds of lube. And it can be sexy to pick one out together. You may worry that your partner won’t think you’re turned on if you need extra wetness. But vaginal dryness from menopause doesn’t mean your attraction is gone.

Extra lubrication can enhance pleasure for people who have no sexual problems. “There’s no shame in using a lubricant,” says Alyssa Dweck, MD, a gynecologist who focuses on sexual health in New York. “You’ve got 20-year-olds using lubricants because it’s fun.”

If you’re comfortable with the idea, you can pick out some toys in your local sex shop. Things like vibrators, dildos, or masturbation sleeves can give you more options for pleasure, Barnard says. They’re also a good way to add novelty to things between the sheets.

Explore Intimacy in New Ways

Some menopause treatments can take a while to restore your vaginal health. During that time, you shouldn’t take part in sex that causes pain. That means you might need to take a “vacation from penetration,” Barnard says. But you can still have fun through other types of intimate play. That includes kissing, oral sex, or stimulation with hands or vibrators.

Remember that there isn’t a “normal” way to make love. All that matters is that “you and your partner are having pleasure together and not at the expense of one of the other,” Barnard says.

Visit a Couples Therapist

Your love life can thrive if you keep communication open. But what if you don’t know how to get the conversation started? Or what if your partner gets defensive? What if you don’t know how to spice things up?

That’s where a therapist comes in. A marriage and family counselor can give you a safe space to work through relationship tension. A sex therapist can address your sexual issues specifically. And there’s no shame in getting help.

“If the couple’s goal is to have a wonderful deep connection through sexual pleasure, it’s completely valid to ask for help getting there,” Barnard says. “We don’t grow up in a culture that teaches us how to talk about sex. And it doesn’t teach us how to ask for pleasure.”

You can find a sexuality specialist at the American Association of Sexuality Educators, Counselors and Therapists (

Intimacy Outlook

Once you treat your sexual pain, it can be fun and exciting to find ways to adapt. Intimacy just might take a little more effort than it did when you were younger. “You can plan for great sex together, even if it’s different,” Barnard says. “You may have to work it at, just like we have to work at everything when we’re older.”

Show Sources


Laurie Mintz, PhD, sexuality psychologist; professor, department of psychology, University of Florida.

Ellen Barnard, MSW, certified sexuality educator; co-owner, A Woman’s Touch Sexuality Resource Center, Madison, WI.

Alyssa Dweck, MD, gynecologist, CareMount Medical Group; medical consultant, Massachusetts General Hospital.

Pain Research and Management: “Dyspareunia in postmenopausal women: A critical review.”

The Journal of Sexual Medicine: “"Fulfilling His Needs, Not Mine": Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States.”

Journal of Sexual Medicine: “Predictors of task-persistent and fear-avoiding behaviors in women with sexual pain disorders.”

National Vulvodynia Association: “Overcoming Challenges in Your Intimate Relationship.”

Harvard Health Publishing: “Yes, you can have better sex in midlife and in the years beyond.”

© 2020 WebMD, LLC. All rights reserved. View privacy policy and trust info