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Sex Health and Aging for Women

As a woman goes through menopause, vaginal changes might make sex difficult.

At menopause, a woman’s ovaries stop producing eggs and she no longer has menstrual periods. Her body also produces less estrogen, a hormone important to female reproduction.

Estrogen helps keep vaginal tissues healthy, flexible, and lubricated. But when estrogen levels drop at menopause, the vaginal walls become thinner, dryer, and more rigid. For some women, the vagina may become shorter and narrower, especially if they haven’t had intercourse on a regular basis.

Many women develop atrophic vaginitis, an inflammation of the vagina that causes redness, discharge, and irritation. Some women find that they aren’t lubricated enough for sex, making intercourse uncomfortable or even painful.

Treatment for atrophic vaginitis depends on how severe the symptoms are. Some women find that using a water-based lubricant is all they need. Others benefit from prescription estrogen, which is inserted into the vagina.

Hormone replacement therapy (HRT) can help women who have other menopausal symptoms, like hot flashes, in addition to atrophic vaginitis. With HRT, estrogen is delivered through a pill or a patch on the skin.

It’s important to note that vaginitis isn’t always caused by drops in estrogen. Sometimes soaps, condoms, or tampons irritate the vagina. If you’re having symptoms, see your gynecologist to rule out these possibilities.

Not all women experience menopause the same way. Some may have more severe symptoms than others. But vaginal issues can usually be treated easily, keeping sex pleasurable as women get older.