Pain with sexual activity
It’s common to have pain with sex if you’ve been through menopause or have had chemotherapy, radiation therapy, or pelvic surgery. This is partly because of a change in hormones, but also because of changes to the blood flow to vaginal tissues. Support and treatments are available.
After menopause, the ovaries stop making an estrogen hormone (estradiol). Without this hormone, the lining of the vagina gets thinner and the walls of the vagina don`t stretch as well. When you get aroused (turned on), the vagina deepens and the lining makes drops of a clear, slippery liquid. These changes make intercourse more comfortable. After menopause, the vagina may be drier or tighter, even when you feel aroused.
If intercourse is painful, it’s best to stop doing things that hurt. Don’t try to push through the pain. If you do, you may start to expect pain with sex, and you may develop a fear of pain with sex. A fear of pain can affect your desire for and interest in sex.
If intercourse is painful, you should stop doing it for a while. Take a break and try some of the available strategies and treatment options before you have intercourse again.
Let your partner know that you’re experiencing changes to your vagina from your cancer treatment. Remember, there are many ways to be sexual other than intercourse (penetration). You can continue other kinds of sexual activity if you’d like to. You may find that touching of your genitals or oral sex doesn’t cause the same pain. If penetration hurts, try genital caressing. Using a vibrator around the clitoris might also help enhance sexual experiences if you’re not having intercourse. Vibrators can also help if you’re feeling tired.
You may need to ease yourself back into sexual activity after your cancer treatment. You don’t have to start with intercourse. Do things that you’ll enjoy, that feel good, and that will arouse you. Being aroused is a natural way that your body gets ready for sex. If your body has enough time to get aroused, the tissues in the vagina will expand. When this happens, there’s more room in the vagina for a penis, finger, or sex toy. This process of becoming aroused can take up to 20 minutes and can take even longer if you’re post-menopausal.
Treatments to help with pain during sexual activity
To help with vaginal dryness or very sensitive skin on the vulva, using a
lubricant for sexual activity often helps to decrease pain.
There are also other treatments that you can use every day, not just when you’re being sexual. These treatments work well to help keep your vagina healthy after menopause and to stay comfortable when something is put in the vagina, like during intercourse. These treatments include:
Think about using these treatments even if you aren’t planning on having sex, as they can support your future sexual function and also help make pelvic exams more comfortable.
