Vaginal Atrophy: Pain and Bleeding During Sex

by Eileen Bailey Health Writer

During and after menopause, your body goes through a number of changes. Some of these are noticeable, such as dry skin, thinning hair and changing body shapes. Some of these changes aren’t physically noticeable, such as vaginal atrophy. Just as lower estrogen levels cause your skin to dry, they also cause your vaginal lining to become dry and thin. Symptoms of vaginal atrophy can include pain and bleeding during sex.

Pain During Sex

When the lining of your vagina becomes dry, it can make sex painful. This can lead to a decreased interest in sex. For some, this creates problems in their relationships, especially if you don’t understand the reasons behind the pain or what you can do to help you better enjoy sex. Luckily, there are a number of things you can do to decrease the pain and increase the pleasure of sex.

Have more sex - This might not sound like the right thing to do, after all it is what is causing the pain, however, sexual activity (with someone else or with yourself), increases blood flow to your vagina. This won’t give you back your estrogen but it will help keep the tissue healthy and promote natural moisture and therefore decrease the pain. Spending more time in foreplay to make sure you are aroused will also help.

Use lubricants - Water-based lubricants (found in your local pharmacy) help. There are a number of different lubricants so be sure to look for one that is water-based. Using a lubricant can make sex more enjoyable, which might lead to you wanting more (see the first point - more sex helps)

If you have tried the previous home-based ideas and are still experiencing pain, it is time to talk to your doctor. Medical treatments, such as topical estrogen or hormone replacement therapy (HRT), can help restore your estrogen levels. These treatments do come with side effects and risks so be sure to talk to your doctor about all your options and what risks each one comes with to help you make the best decision for your health.

Bleeding During Sex

Some women experience bleeding during or after sex. If you are post-menopausal (and are sure this is not your last period), you should talk to your doctor. Bleeding during sex can indicate irritation or infection of your vaginal tissue. If you do have vaginal dryness, friction during sex can irritate the vaginal walls and cause bleeding.

After menopause, you are also at a higher risk for vaginal infections because the acidity levels in your vagina changes. This allows yeast and bacteria to grow and thrive. Infections such as these need to be treated by your doctor.

While pain during sex is more common after menopause because of vaginal atrophy, it doesn’t mean that you need to stop having sex and enjoying intimacy in your relationship. Taking some simple steps, such as extra foreplay and using a lubricant, might be all you need to begin enjoying sex again. But even if that doesn’t work, your doctor will be able to provide you with additional options. You can enjoy sex long after menopause.

For more information on vaginal atrophy:

Half of Postmenopausal Women Face Challenge of Vaginal Atrophy

The Benefits of Vaginal Creams

Entering Menopause Means Making Vaginal Health a Priority

Tips for Talking to Your Partner about Vaginal Atrophy

When Sex is Painful: 5 Possible Causes


Sex is Painful: A Guide on What to do if You Experience Pain or Bleeding During Sex

When Sex Hurts

Eileen Bailey
Meet Our Writer
Eileen Bailey

Eileen Bailey is an award-winning author of six books on health and parenting topics and freelance writer specializing in health topics including ADHD, Anxiety, Sexual Health, Skin Care, Psoriasis and Skin Cancer. Her wish is to provide readers with relevant and practical information on health conditions to help them make informed decisions regarding their health care.