Menopause and Pain During Intercourse

Patient

Q: My wife is 66 and I am 59. She has gone thru menopause (12 yrs ago) and has suffered with vaginal dryness since. She still has hot flashes and is not on any hormones due to the "Risk Factor". She uses a lube but penetration is extremely painfull and so is the exit. Climax is the only pain free time during sex. I am a normal (6 inch) guy. She describes the pain as being stuck with a knife.

Doctor

A:   I do understand your concern. Pain during sex or dyspareunia is a common symptom during menopause. usually due to a fall in female sex hormones. treatment is usually with hormone replacement pills, hormone creams or ordinary lubricants. Since you have mentioned that your wife cannot take hormones due to risk factors, using a estrogen vaginal cream, tablet or ring may be more effective for your wife. I would suggest that your wife consult her gynecologist for further evaluation. Her doctor may may do an internal examination, blood-work and imaging studies to rule out condition like endometriosis, lichen sclerosus, uterine retroversion or pelvic organ prolapse that may cause similar symptoms. Treatment will depend on the cause. I hope the information helps.

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