A woman’s sexuality often reaches a new level of satisfaction during and after menopause. Without the worries of pregnancy and birth control sex can be more spontaneous than in the past. Plus many women begin to make peace with their bodies and see their sexuality in terms of a complete package and not just in terms of looks. But just when things should be heating up, sexual intercourse can be uncomfortable and even painful for some women.

Painful intercourse (the medical experts call it ‘dyspareunia’) is pain that can occur before, during or after having sexual intercourse. While in some cases painful intercourse can be a symptom of more serious health issues, for this article we will concentrate on the connection to menopause.

The pain itself can be mild or severe interfering not only with sex but with day to day life to the point where using tampons is uncomfortable. Sex should be a pleasurable part of life and a personal choice; it should not be something that is ‘taken away’ from you without your having a say in the matter.

The constantly fluctuating hormones during menopause affect the natural lubrication in the vagina. Lower estrogen levels can occur after childbirth or if you are breastfeeding, causing vaginal dryness. This leaves the inner walls of the vagina prone to increased friction and small tears. Along with the physical pain during sex, many women develop anxiety due to feelings of inadequacy or losing their sexual abilities.

Some medications can contribute to vaginal dryness. If you are currently taking antihistamines, high blood pressure pills, birth control pills, or antidepressants you may be more vulnerable to additional discomfort.

The most important thing is to discuss your symptoms with your doctor. Unfortunately this is not the easiest topic for many women to discuss with their partners, let alone their physicians. But the sooner you can understand what is causing painful intercourse, the sooner you can find a suitable treatment to help combat the discomfort. Your doctor will discuss your personal health history and your sexual life to discover why you are having pain. This discussion may involve details of your sexual history which can be difficult to reveal. Do not let embarrassment stop you from getting the treatment you need.

Your doctor will also perform a pelvic exam to look for any irritation, swelling or signs that something unusual is happening. In the past painful intercourse was simply dismissed as being ‘all in your head’ and ‘the change’ and women’s concerns were not taken seriously. Today doctors are becoming more understanding, realizing that painful intercourse is real and can be treated – it cannot be ignored in the hopes it will just go away.

To deal with painful intercourse, your doctor may recommend any number of the following treatments for sexual intercourse and day to day life:

*Using water-based sexual lubricants will make penetration easier.

*Trying sexual positions that put less pressure on your body, such as the woman on top position can help ease discomfort. This gives women woman more control and greater freedom to find a more comfortable way to accommodate penetration.

*Engaging in longer foreplay, perhaps using those lubricants can help you by giving you and your body time to get ready as feeling rushed can lead to greater frustration with sex.

*Speak up and let your partner know what is happening to your body and discuss what might help you sexually. Some women find this difficult and resort to ‘showing not telling’ to communicate their preferences with their partners.

*Estrogen therapy may be prescribed to help alleviate vaginal dryness and other menopausal symptoms. Alternative therapies may be suggested for women who do not want to take traditional hormone replacement therapy.

Women hit their sexual peak during their late 30s and into their 40s, only to have menopause make things difficult. Painful intercourse does not have to be another of those menopause symptoms that we have to endure. We can take the embarrassment out of sex and bring our self-esteem and our mojo back.

Looking for more advice about painful intercourse? Log onto www.mayclinic.com/health or www.menopauseexpert.co.uk for addition information that you can print off and bring to your next doctor’s appointment.