Changes in sexual function during menopause are normal, but that does not mean that we have to suffer through it. Learn more about why we experience painful sex in menopause and how we treat it.

Related Symptoms

Vaginal Dryness


Chronic Fatigue

Out of 300,000 respondents who have taken our Menopause Assessment:
experience painful sex in menopause
said that painful sex negatively affect their quality of life in a significant way
years on average that women experience painful sex, usually starting 2 years after menopause

Decreased estrogen during perimenopause causes a thinning in the walls of the vagina and the vulvar tissue, causing a reduction in moisture. The vagina also gets narrower, shorter, and less flexible (“less plump”). The reduction in estrogen causes a reduction in collagen (elasticity) and hyaluronic acid production creates an environment where Lactobacilli bacteria - responsible for maintaining low pH of the vagina and keeping away other invasive bacteria - cannot survive.

These changes can lead to painful intercourse, decreased sensation, general discomfort, and itching.

Women with abrupt changes in menopause (surgery or breast cancer treatment) often have the worst presentation of these symptoms, as well as others.  

The changes in the vaginal and vulva will not reverse or improve over time without active support to prevent the tissues from significantly atrophying over time.

How we treat painful sex:

We'll review your health history and listen to your symptoms.

Every woman's experience of menopause is as unique as she is. Rather than treat just the symptom, we want to learn more about the other potential factors leading to painful sex. That's why we'll review your medical history, family history, and gynecological history.

Then, you'll share your experience with menopause, starting with your quality of life and other symptoms you're experiencing (such as vaginal dryness or anxiety).

We'll discuss evidence-based treatments proven to relieve painful sex, including:

Lifestyle modifications

We'll use cognitive behavioral therapy (CBT) to address the anxiety and other mental barriers around painful sex, including advice on how to have an open dialogue with your partner.

Medical interventions

We'll explain hormonal creams, rings or tablets, based on your health history and family history around cancer.

Feel 100% again and thrive in menopause.

Our doctors and health coaches are by your side, answering your questions and monitor your symptoms. As your hormones fluctuate, your symptoms will change over time. Talk to your doctor about these changes and your Gennev doctor will adjust your treatment plan to match your new needs.

You are not alone.

Talk to our menopause specialists for a custom treatment plan proven to help relieve painful sex and other menopause symptoms.

92% of our patients report symptom relief after the first visit.

Everyone's experience with menopause is unique. That's why our integrated care model offers evidence-based treatments.

Dr. Savage helped remove the veil of mystery, and address the WHY all of these changes are happening. Just having clarity, and a knowledgeable person to bounce ideas and concerns off of is a huge gift. I will be chatting with Dr. Savage at least every 6-12 months to guide me through this journey! Gennev (so far) has filled the massive void that my traditional healthcare has been missing.

Dr. Dunsmoor-su was fantastic. She is very knowledgable and relatable. It was so refreshing to have a physician who does not just say, "that's what happens when you get older or you are middle aged, that's just how it is". She really listens and wants to help.

Related Symptoms

Vaginal Dryness


Chronic Fatigue

Recommended Reading

We've interviewed leading experts in menopause over the years. These articles are a great starting point to educating yourself on this symptom (and others) of menopause.