Painful Sex After Menopause

As Vulva Doctors explain to their patients, once they have reached menopause, women often experience painful intercourse. This is frequently linked to reduced oestrogen levels. “The vaginal tissues tend to become less elastic, more fragile, & 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 oestrogen can cause urinary problems, which also can make sex uncomfortable; & lack of sexual activity contributes to loss of tissue health & elasticity [1]

Moreover, in addition to the aforementioned, there are a number of other factors that contribute to painful sex after menopause. Vulva Specialists frequently help patients who are suffering from:

• Trauma or injury (including: an accident, pelvic surgery, or giving birth)
• Skin conditions (such as lichen sclerosus, or eczema)
• An infection in the urinary tract or genital region
• Certain pharmaceuticals (e.g., high blood pressure medications and antidepressants), can add to vaginal dryness
• Fear of intimacy
• Stress
• Worries about body image
• Relationship difficulties
• Pain linked to deep sexual penetration
• Pain brought about by suboptimal relaxation of the pelvic muscles
• Particular conditions which impact the pelvic region. (Examples include: uterine fibroids, endometriosis, and pelvic floor dysfunction)
• Scarring derived from pelvic treatment or surgery. (Pelvic radiation is a good example)
• Vaginismus (involuntary spasms generated by the muscles in the vaginal wall)
• Vulvodynia [1]

When you have an online or in-person consultation with a Vulva Doctor, they will be vigilant to all the aforementioned, on top of the declining oestrogen factor. To that end, they will arrange for any necessary exams, tests or scans.

Did You Know?

“Vulvodynia is a leading cause of painful sex & affects up to 3.2 million women in the UK, yet it is often misdiagnosed & under-reported. It affects the vulva – the area surrounding the entrance to the vagina, including the labia & clitoris” [2]

The Low-Down on Vulvodynia

“Despite having been first described in the 19th century, vulvodynia is still not widely acknowledged. [With the exception of Vulva Doctors], many providers are unaware of this condition, missing opportunities to help these women who have a substantially impaired sexual life and quality of life in general” [3].

Getting a Vulvodynia Diagnosis

When someone who is concerned that they may have vulvodynia, consults a Vulva Doctor: after reviewing their medical history, the next step that the Vulva Specialist takes, is to exclude other important factors. These comprise:

• Vaginal pathology
• Vulva pathology
• Urological pathology, and
• Musculoskeletal pathology [1]

Unfortunately, the management and diagnosis of vulvodynia are often disregarded by GPs. “Both can be more challenging in postmenopausal women, among whom vulvar dermatoses (e.g. lichen sclerosus) and oestrogen deprivation are common, and the symptoms of these can resemble and overlap those of vulvodynia. Vulvodynia often is assumed to be “psychological” or “psychosomatic”, or “vaginismus” in younger women, while it is often considered to be a consequence of low oestrogen levels or vulvovaginal atrophy in the older population” [3]

Getting Your Post-Menopause Sex Life Back on Track

The good news is that there are a number of proven viable solutions which your Vulva Doctor can help you with. Once you have had your initial consultation with a Vulva Pain Specialist, and after they have conducted any necessary tests, they will provide you with an accurate diagnosis and a Holistic Personalised Treatment Plan which you can get started on right away.

References

[1]. Sparks, D. (2018). “Why is sex after menopause sometimes more painful?” Mayo Clinic.

[2]. Jarvis, S. (2018). “Understanding vulvodynia and why it causes painful sex.”

[3]. Vieira-Baptista, et al.”Diagnosis and management of vulvodynia in postmenopausal women.” Science Direct.https://www.sciencedirect.com/science/article/abs/pii/S0378512217309568#:~:text=Highlights&text=Vulvodynia is vulvar pain or,estrogen resulting in vulvovaginal atrophy.