Talking About Potentially Painful Sex With a Menopausal Partner

Key Points

• Sex can be painful for women during menopause.
• If it's becoming an issue in your relationship, it's important to talk about it.
• Addressing it with her openly, honestly, and with patience and understanding is crucial.

As you get older, you experience mental and physical changes that impact your sexual performance. For women, a likely cause for these changes in their sex lives is menopause.

Some women face challenges bringing up their difficulties with menopause to their partners, which means no adjustments are made to improve their sexual experiences.

If you notice something's awry with your menopausal partner, it's essential to address your concerns in a way that shows your appreciation for her and your desire to improve your sexual relationship.

What is menopause?

Menopause occurs 12 months after a woman's last period, according to the National Institute on Aging (NIA). The transition to menopause typically happens between the ages of 45 and 55 and can last seven to 14 years.

"[Menopause] is a retrospective diagnosis, when the ovaries enter retirement, essentially, and stop producing the normal amount of estrogen for many organs in the body, as well as a loss of testosterone by at least 50 percent when the ovaries stop making testosterone," said Sameena Rahman, M.D., a board-certified OB-GYN at the Center for Gynecology and Cosmetics in Chicago.

Menopause can affect a woman's sex life. People can expect their partners to undergo emotional and physical changes that impact their sexual health during this point in their lives.

How does sex change during menopause?

Potential changes to a woman's sex life during and after menopause encompass sexual and mental health, sleep, and more.

Vaginal problems

"There is a change in vaginal tissue—thinning, reduction of collagen elasticity, etc.—which can lead to pain as well as decreased arousal and, for many, a longer time to orgasm," Rahman said.

Vaginal dryness, or vaginal atrophy, can cause uncomfortable or painful sexual activity.

Low sex drive

Lower hormones may contribute to a low libido. A low sex drive can make it more difficult to become aroused before sexual intercourse.

Night sweats

A common symptom of menopause, night sweats can disrupt a woman's sleep, leaving her tired and possibly less interested in sex.

Changes in emotions

"There are estrogen receptors in your brain that work with your neurotransmitters. When the hormones decrease, it can lead to more depression, anxiety and brain fog/difficulty concentrating," Rahman said.

With this in mind, a woman undergoing menopause may feel too stressed or irritated to have sex.

Everyday life changes

"Spousal issues, aging parents [and] sometimes dealing with growing kids and career changes [can affect sex lives]," Rahman said.

In many cases, men also undergo hormonal changes while women are experiencing menopause.

"Men also have hormonal shifts, and their testosterone levels also decline, but in a much more gradual way over the course of decades. So if the woman is in a relationship with a man and he, too, is having less sexual desire or is less responsive during sex, they need to also consider the impact of his hormone shifts on their sex life," said Charlynn Ruan, Ph.D., a California-based psychologist and founder of Thrive Psychology Group.

Fortunately, treatments are available to help with the physical and mental symptoms of menopause that may help improve a couple's sex life. However, a good starting point is an open conversation about your sexual relationship.

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Preparing to talk about menopause with your partner

If you believe the changes in your sex life are partially due to your partner going through menopause, it's time to talk about it.

Before initiating the conversation, both parties should educate themselves on what menopause is and its potential effects on their sexual relationship.

"If both partners realize that this is related to biological shifts and not a red flag for their relationship quality, they can start to look at it as an 'us' issue, not a 'me versus you' issue," Ruan said.

How do you start talking about sex during menopause?

Discussing sex with your partner who is dealing with menopause can be difficult. You may be concerned about unintentionally hurting their feelings and making them feel unwanted. Introduce the conversation as respectfully and lovingly as possible.

Some tips for initiating a healthy conversation surrounding menopause and sex include being supportive, making suggestions and listening.

Be supportive

Show you genuinely care for your partner and want to help.

"If there are issues with pain around penetration, orgasm or desire during sex, be supportive and help in the best way possible," Rahman said.

Suggest trying different things in the bedroom

Keep things exciting by exploring different types of intimacy.

"Try new things like intimate massage or tantra, which naturally lend themselves to slower and more sensual sex," Ruan said.

Be an active listener

Good communication is critical but requires letting your partner discuss their concerns. After starting the conversation, allow your partner to share their thoughts and feelings concerning sex by not interrupting or using nonverbal cues and maintaining eye contact.

When should you seek help about painful sex during menopause?

If you and your partner tried to discuss the problem but nothing worked, consider getting outside help.

"Menopause may reveal some communication issues or misalignments that already existed in the relationship, and this can be a chance to spend time with a couples therapist resolving some things that you haven't had the time or space to resolve earlier in the relationship," Ruan said.

It's essential to understand this condition can impact your sexual relationship, so having an open conversation can help improve communication and pleasure.

In conjunction with couples therapy, you and your partner could go to a healthcare provider who specializes in hormones if you both are experiencing hormonal changes in the later stages of your lives.

"If you suspect your partner is being impacted by perimenopause or menopause and you are around the same age or older, suggest you both go talk to a doctor who specializes in hormones and have your levels checked and consider hormone replacement therapy for you both," Ruan said.

The bottom line

Menopause is a natural occurrence in women's lives that affects their health and relationships. As a partner to someone going through menopause, it's essential to understand this condition can impact your sexual relationship, so having an open conversation can help improve communication and pleasure in the bedroom.