Painful sex post menopause

by M-Lee
(Western Australia)

I have been post menopausal for 8 to 9 years (turning 60 this year) and first noticed that sex was very painful about 3 years ago. As I hadn't been in a relationship a year or two before that I hadn't noticed it previously. I remember that in the relationship 3 years ago the pain did reduce with patient, sensual sex but the relationship didn't continue. I haven't worried about it until meeting someone a couple of months ago. I ordered the NatPro cream and have been administering it twice daily (vaginally at night). Our relationship has been limited by distance so it was at least 4 weeks after applying the cream before sex. It was so painful that I couldn't endure any penetration. With much patience and trial over several days together we managed a nearly full penetration with bearable pain. However, it was far from resolved as the next try (1/2 hour later) the pain was 10/10 intensity scale.

I have read FAQ replies that the NatPro cream has worked after several months. I realise I have been only using it for 4 weeks and need to wait. My question is about the other remedies such as oestrogen rings, and moisturisers like Replens cream (plumps cells for 3 to 4 days). Would I be better served to use those whilst I wait for the progesterone cream to kick in?

I have also read that regular sex will help as well. This will also be difficult as we live in towns 3 hours from each other. I wondered about using vaginal dilators (or dildos) in between seeing my new partner.

Reference is also made to other conditions that can cause it such as Vestibulodynia, vulvodynia, and vaginismus and wonder if I was checked what treatments doctors would offer for these? Can they tell by observing the vaginal tissue. I am due for a PAP smear so thought I would ask.

I also have very dry skin, dry eyes, mouth and joint pain but a blood test for Sjorgren's Syndrome was negative. I was also told there was nothing that could be done for it other than use moisturiser, eye drops etc.

Other medical/menopausal history: hot flushes for 9 years initially helped with Chinese herbs (a few months) but still get several each day, otherwise mood etc OK. Have IBS, fibromyalgia and did have depression (post miscarriages and infertility in my 30's) and PMT, moods and painful periods especially when teenager. Most symptoms helped by practicing mindfulness, diet and exercise regimes. Possibly hot flushes have reduced since being on NatPro cream.

Thank you

Comments for Painful sex post menopause

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Mar 19, 2018
Painful sex post menopause
by: Joy

Hi M-Lee

Natpro is excellent for dryness when inserted in the vagina but is the pain due to dryness, or is there something else going on? Have you discussed this with your doctor? Ovarian cysts for example, can cause pain during intercourse. Natpro lubricates very well and instantly, so I am not sure why you are experiencing such intense pain. If it is only dryness, then Natpro should help you.

Natpro will help with hot flushes if enough is being used. Usually between 100-200mg is recommended but hot flushes usually require 400-500mg for 4-6 days or until they clear.

Sjorgen's Syndrome is one of those 'autoimmune' conditions which no one knows much about, perhaps excess estrogen has something to do with it, but your other adverse symptoms are due to Estrogen Dominance.

I don't believe that any women needs to take extra estrogen so I don't recommend the estrogen ring, it will add to your adverse symptoms. Try Replens, if it helps then that is great.

How to use Progesterone Cream

Estrogen Dominance


Hot Flushes

Mar 19, 2018
Painful sex
by: Rachel

You may have vaginal atrophy which is caused by depleted estrogen. Are you on Facebook? There is an excellent support group, which is closed and confidential, called Vaginal Atrophy. Most people do well on estrogen cream (weak) applied inside the vagina, or DHEA capsules called hydration cubes, HRT, and a combination of treatments. Feel free to contact me.

Mar 21, 2018
Painful Sex Post Menopause
by: Leona

Hi M-Lee,

I’m just about 59 and developed a vaginal muscle tightness that gave me burning pain that made having sex unbearable.
One day I just had extreme tightness along the back wall that wouldn’t release, after hoping it would go away on it’s own and it didn’t I bought a set of dilators on Amazon.
Only had them for a couple of weeks but I can already feel they’re helping. The burning pain is often reduced to tightness in a short time and much more bearable.
I try to use the dilator daily and can feel more tightness on some days, maybe more stressed out but overall the burning pain is lessening. Also found being on my back with a pillow under my hips to tip my pelvis up is the most comfortable position during sex. Lube is important too. I use the dilator before sex. I don’t feel estrogen is worth the risk.

Mar 22, 2018
Painful sex
by: Rachel

A very small amount of estrogen, bio identical and the mildest form, just inside your V where the receptors are a few times a week to begin with could make the world of difference. There are also hydration cubes available with very small amounts of DHEA that can also help. Atrophy is caused by declining estrogen. It won’t get better without it. And the amount is virtually negligible, not enough to affect your levels overall. Once your tissue begins to respond, you can drop the application to once a week. Like it or not, we need estrogen sometimes.


Mar 22, 2018
Thank you
by: Anonymous

Thanks Joy, Rachel and Leona.

I will look into all advice. Probably follow up all starting with doctor review when having PAP smear done.

I thought about DHEA but I can't get it in Australia (possibly can get it in via post from USA I think). The oestrogen use in small amounts I can understand as we are not producing any now except that released /stored in fat cells. If atrophy is a result of lack of oestrogen then a precursor or micro dose sounds reasonable.

The burning pain sounds similar so I will also try dilating.

Love and light

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