Menopause-If sex turns from pleasure to pain
Did you know that pain with sex – dyspareunia, is one of the most frequently reported symptoms of menopause?
If sex is painful, women commonly have a reduced desire for sexual intimacy or reduced arousal too. Many women accept this as part of aging and just avoid having intercourse. However, there are ways to improve dyspareunia and to start enjoying sex again.
Why can sex become painful after menopause?
A common reason sex can become painful after menopause is due to the drop of the hormone Oestrogen. Oestrogen is important in the vagina and vulva to keep the tissues soft, lubricated and elastic.
When Oestrogen lowers, the tissues can become more fragile and dry, this sometimes causes too much friction during vaginal penetration and the tissues get irritated.
In some women, the pelvic floor muscles that surround the vagina and the vaginal opening tighten as a protective response to try and prevent further penetration. This tightening response can cause further discomfort, and if the muscles stay tight they can become sore from being over-active. If this continues women can develop anxiety or fear about having intercourse (sometimes this occurs on more of a subconscious level) and the nervous system can also become sensitised.
If you have pain during intercourse it is essential that you consult with a doctor familiar with women’s health problems so that any other causes of pain such as infection, skin conditions and irritations can be checked. Your doctor may also prescribe a local oestrogen treatment to help improve the integrity of the vagina and vulval tissues.
What can physiotherapy do to help during menopause if sex is painful?
A physiotherapist will collect a thorough history and perform an assessment to help determine why you are experiencing pain. The physiotherapist may also provide education and treatment including:
- Advice on vulval care such as avoiding using soaps and scented personal items on the vulval tissues
- Use of lubricants
- Advice about sexual positioning and building arousal and desire again
- Desensitisation of the tissues and the nervous system
- Education on pain science and why your pain may be persisting
- Teach relaxation – whole body and of the pelvic floor muscles
- Help gently release tight pelvic floor muscles
- Provide you with self-management strategies
- Refer you to other appropriate health care practitioners
Our team of myPhysioSA for her Women’s Health Physiotherapist’s are here to help you through menopause If sex is painful there are many strategies that can help. Call 1300 189 289 to book now!
Leanne Slater, myPhysioSA for her Women’s Health Physiotherapist