Hot flashes, weight gain, and difficulty sleeping – these are all commonly discussed issues that women encounter during perimenopause and menopause. Painful intercourse is something women may be a bit more hesitant to discuss, but it shouldn’t be because it’s a problem that many women experience during this transitional time in their life.
The fact is, as we age, our skin collagen decreases and this can lead to less cushioning between the skin and our pelvic bones as well as a decrease in lubrication. Our skin also thins and is more easily irritated. These changes can cause discomfort with penetration and sometimes external friction during sexual relations. The good news is that there are several ways to help decrease pain during intercourse and improve your satisfaction:
- Maintaining regular sexual activity with a partner or through self-pleasure is important for promoting adequate blood flow to the genital area. More activity, therefore, can actually help decrease discomfort.
- Moisturizing lotions designed specifically for the vagina can help improve skin health, and there are many different types available at your local pharmacy or grocery store. Similar to facial and body moisturizers, vaginal moisturizers are best absorbed after a shower or bath and can be used as often as needed.
- Vaginal lubricants can help decrease friction which can cause pain during sexual touching and penetration. There are 3 main types of lubricants and many different options available within each type. It is important to experiment and find the one that works best for you.
- Water-based lubricants feature easy clean-up from sheets and clothing and a low chance of skin irritation, although different additives like preservatives may be irritating to some people. Water-based lubricants can dry out and may require additional water (or saliva) to reconstitute.
- Silicone-based lubricants are the most slippery; therefore, only small amounts are needed, and you are less apt to need additional applications. Note that silicone-based lubricants should not be used with silicone vibrators because they can cause a reaction that will deteriorate the vibrator.
- Oil-based lubricants are the most likely to be irritating to sensitive skin, but many women enjoy using plain old olive or coconut oil that they have on hand in their kitchen cabinet.
- Hybrid moisturizers/lubricants are often made with hyaluronic acid which is an ingredient used in wrinkle creams. These work by drawing fluid into skin cells to increase skin thickness and softness.
If these at-home remedies don’t work, it’s time to consult your primary care provider or gynecologist, who can perform a careful examination to rule out other causes of pain including infection, non-hormonal skin problems, or pelvic floor muscle injuries. Your provider may recommend a prescription for vaginal estrogen to help rebuild some vulvar and vaginal skin pliability and natural lubrication. These come in the form of creams, pills, or rings, and your provider can discuss these options with you.
For women who are experiencing physical challenges that are interfering with their quality of life during menopause, Atrius Health offers Menopause Consultation Services to our patients at our Kenmore and Chestnut Hill/West Roxbury practices.