After menopause, some women find that they still enjoy sex, but it’s different than it used to be. For some people, it can hurt when it didn’t before. Often this is because estrogen levels drop after menopause. This can cause your vagina to become less elastic and more likely to tear during sex or to bleed afterward. Having less estrogen can also make you more prone to urinary tract infections that can cause discomfort in the vaginal area.

While this isn’t welcome news for most people, it’s certainly not all bad. Regular sex is one of the best ways to keep this area healthy after menopause. It increases blood flow to the vagina, which helps it maintain elasticity. Research has shown that people who are sexually active -- whether by themselves or with a partner -- have milder symptoms of menopause than those who aren’t.

If you’re still interested in sex but have issues with pain, you may want to try some different positions.      If you change the angle of your body or pelvis, it can make penetration (if that’s what you want) easier and more enjoyable. Trying different positions may also offer relief or support for stiff joints, another symptom of menopause.

1.  You sit on top. Some postmenopausal people complain of pain deep in the vagina near the cervix during sex. When you sit on top during sex, you can keep penetration to the point at which you feel comfortable. If you don’t want that, grinding your pelvis against your partner in this position can feel good, too.

Your partner can lay flat while you sit on top. They can also sit up with their legs slightly bent in what’s called the lotus position. Some women like it because it lets you to hold onto your partner for a more intimate experience.

2. Doggy style. This position lets either of you stimulate your clitoris during intercourse, which can make things more enjoyable. You may need a bit of arm strength, but you can support yourself with pillows under your stomach or elbows if necessary.

3. Missionary with an assist. If dryness and pain upon entry is your main concern, try a variation of the missionary position. Lie on your back with a pillow or two under your lower back. This raises your pelvis to make insertion a little easier. Lots of lubrication will help, too. 

4. Oral sex is still sex. If penetration is too painful, why not stick to oral sex? If your partner is willing, it can give you enjoyment without the discomfort of penetrative sex. You can take turns giving and receiving. Or one of you can switch around so you’re facing head to toe (“69”) to pleasure each other at the same time.  

5. Lie on your side. Lying on your side lets you control how deep your partner can go, which helps if you have deep vaginal pain. This can work whether you’re face-to-face with your partner or have your back to them (bend your legs a bit if entry is from the back). The entry angle can vary, so this may not work if you have pain at that point. 

6. Standing from behind. Stand and lean forward over a plush chair, a countertop, or with your hands against a wall. Your partner stands behind you to enter you from behind, like with doggy style. Either of you can stimulate your clitoris. And you can control the depth of entry to avoid pain from deep sex.

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