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Menopause & Painful Sex

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I have a dry vagina… Intercourse is no longer possible…  Sex hurts…  I am dating again and cannot be intimate with my new partner… My doctor does not have an answer to these problems…

The declining estrogen levels from menopause onward have a profound effect on the vagina, making it thinner, less elastic, drier, less acidic (pH levels above 5), and thus more prone to chafing irritation, infections, and bleeding.  The urinary tract, which lies parallel to the vagina, is also estrogen-dependent and will also become symptomatic by way of increased frequency & urgency, and burning upon urination.  The current medical term for this condition is genitourinary syndrome of menopause (GSM).

Our specialized treatment program for secondary (menopausal) vaginismus and dyspareunia can help you:

  • Our experts will carefully assess your limitations and will tailor a treatment plan specific to your needs
  • We will restore all vaginal penetrations (the hands-on aspect of the treatment)
  • We will address vaginal and urological health
  • We offer sexual counseling and/or sex therapy
  • Emotional support is always included
  • We are available if you want us to counseling you and your partner
  • The course of treatment is relatively short – about 4-7 sessions – and the outcome is positive (read the testimonials, below)
  • The treatment is typically covered by insurance — read our Insurance page for details
  • There is help even if you live far away: we will design a treatment program if you are willing to travel to us a few times, including an overnight stay.  Contact us for more details.


More about menopause:

Not all women will enter menopause the ‘natural‘ way; some may get into menopause

  • Surgically,  the result of the removal of both ovaries (Oophorectomy) that is often a component of total hysterectomy, or
  • Induced, the results of certain medications that stop ovarian (estrogen) production, such as Lupron that is used for the treatment of Endometriosis, or chemotherapy drugs such as tamoxifen that are used to treat breast cancer, or
  • As a result of  pelvic/vaginal radiation for female cancer

The functional outcome of  the menopausal changes include

  • Feeling dry, pinchy, chafe
  • The genital lips may ‘stick together’
  • Insufficient natural lubrication
  • Intercourse is progressively uncomfortable/painful (dyspareunia)
  • Intercourse is no longer possible (secondary vaginismus)
  • Gynecologic exams are progressively difficult or no longer possible (secondary vaginismus)
  • Urinary frequency and urgency — the lower 1/3 of the vagina and the urethra share a common wall that is equally affected
  • Emotional and relationship distress
  • For the single woman – doubts about dating: “who would want me without intercourse?”
  • Loss of sexual interest (libido) – who wants pain when sex should be fun and pleasurable?

Other factors may compound the problem:

  1. Dry indoor heat in cold climates
  2. Insufficient hydration (drinking)
  3. The drying effect of certain medications such as anti-anxiety, anti-depression, antibiotics, anti-fungal (for vaginal infections), allergy
  4. Excessive hygiene, including hot water on the genitals
  5. Prolonged disuse (no partner for intercourse)
  6. Sjogren’s Syndrome

The good news is that these changes are not inevitable!  A sound restorative program should allow most menopausal and postmenopausal women to regain vaginal functions with little or no disruption.  You can liken the aging vagina to an old baseball glove that needs oil rubbed in to restore its shape, softness, elasticity, and function.

The sad news is that medical and public awareness about the menopausal & postmenopausal vagina is poor, forcing women to accept the limitations as inevitable, to suffer in silence, and to experience relationship tensions or breakdowns.

Learn about our proprietary treatment for sexual pain, the DiRoss Methodologysm

We hope that you will not only take care of your vagina during these life phases but also share this webpage with your friends and healthcare provider/s — spread the word!

Contact us for further information, or to schedule an appointment.