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Pain with Sexual Relations in Older Women

Pain with intercourse is common in older women. At first it may be a problem just once in a while, but it can become a more frequent and serious problem. You might like and want to have sex but avoid it because it hurts.

The medical term for painful sex is dyspareunia.

How does it occur?

You may feel pain at the opening of your vagina or in the vulva, which is the area around the vaginal opening. Even a gentle touch in this area may cause pain.

A number of different things can cause pain during sex. Some of the physical causes of pain during sex are:

  • Menopause: The decrease in hormone levels at menopause causes changes in vaginal tissues. The tissues may become thinner and less elastic. Your vagina may feel dry and may have less vaginal wetness even when you are sexually aroused.
  • Medical problems such as infection; bowel problems; growths on the uterus, tubes, or ovaries; or arthritis
  • Scarring of tissues torn or cut during childbirth or surgery
  • Having intercourse after a long time of not having sex
  • Irritation by spermicides, soaps, or other chemicals

Many older women are faced with circumstances that affect their sexual response and may make sex more painful, such as:

  • Either you or your partner may be ill or frail. In such cases, sex may not be a priority or may be avoided because of a fear of hurting or being hurt.
  • You may lack privacy and sexual freedom. This may be because you share a home with relatives or are living in a retirement home that does not offer privacy.
  • If you are not married, you or your partner may not be comfortable with the idea of sex outside of marriage. (Widows and widowers may be reluctant to remarry because of financial problems, such as a reduction in Social Security benefits.)
  • You may be taking medicine that affects your sex drive.

How is it diagnosed?

Your healthcare provider will ask about the pain. You may have a pelvic exam and tests to look for infection or other problems.

How is it treated?

Treatment depends on the cause of the pain.

  • Vaginal lubricant

    Your healthcare provider may recommend use of a vaginal lubricant. The lubricant can prevent the pain caused by lack of vaginal moisture during sex. You and your partner can use a lubricant in a way that makes it a part of lovemaking. Lubricants can be purchased at a drugstore. Ask your provider what product might be best for you. Benefits of using a lubricant are:

    • You will have less irritation, less pain, and fewer tears of vaginal tissue.
    • Your partner will have less irritation or discomfort. It will be easier for the penis to go into the vagina.
    • Because sex will be less painful, you will have less fear of pain during lovemaking.
  • Hormone therapy

    You can use hormone medicine to replace some of the estrogen hormone that decreases after menopause. Hormone therapy may reduce or get rid of the symptoms of menopause that cause painful sex, such as vaginal dryness. There are some risks with hormone therapy. For example, it may increase your chances of getting some forms of cancer or heart disease. Discuss the benefits and risks of hormone therapy with your healthcare provider.

  • Treatment of other causes
    • Treatment of other medical problems, such as infection of the vagina, bladder, or urethra, can lessen pain.
    • You may have fibroids or genital warts that need to be treated.
    • You may need to stop using spermicides or douches that cause allergic reactions.
  • Counseling

    If the reason for painful sex is psychological, ask your healthcare provider to refer you to a psychologist, sex therapist, or other counselor for help.

Written by James P. Semmens, MD.
Published by RelayHealth.
Last modified: 2010-09-06
Last reviewed: 2010-03-13
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2011 RelayHealth and/or its affiliates. All rights reserved.
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