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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Painful Intercourse?

I am 63 years old, and after not being sexually active for approx. 18 yrs., I became involved with a man 17 yrs. my junior. Almost 6 yrs. later, we are still together. The first time we had intercourse over 5 yrs. ago, I bled for several days, which did not really surprise me, since it had been so long. I had some trouble with dryness off and on, but nothing we couldn t deal with. Lately tho, it has become painful to have intercourse, in a different way. He is what I consider average size, but it feels like he s hitting bottom and then some lately. Like he s ramming a bruised area where the tip of his penis hits. Obviously, this detracts from our pleasure.
Sat, 3 Sep 2016
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General & Family Physician,  's  Response
Vaginal dryness is a common problem in post-menopausal women. The decrease in estrogen with menopause is the main cause of vaginal dryness, itching, burning, discomfort, and pain during intercourse. Vaginal atrophy is the medical term that describes these changes. Regular sexual stimulation promotes vaginal blood flow and secretions.
Advice
1.     Apply K – Y lubricating jelly before sex
2.     Apply conjugated estrogen 0.625 mg topical cream once daily for 3 months
3.     First involve in foreplay before penetrative sex. Discuss with your partner about this. Foreplay increases vaginal blood flow and secretions
4.     Start pelvic floor stretching exercise to strengthen pelvic floor muscles
5.     Investigation – vaginal smear examination including Gram’s stain, blood sugar (F & PP), USG abdomen & pelvis
Not all vaginal symptoms are related to menopause. Other factors such as fungal infections, allergic reactions, and certain skin conditions can affect the vagina, so consult your gynecologist with above reports if symptoms do not improve with above measures.
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What Causes Painful Intercourse?

Vaginal dryness is a common problem in post-menopausal women. The decrease in estrogen with menopause is the main cause of vaginal dryness, itching, burning, discomfort, and pain during intercourse. Vaginal atrophy is the medical term that describes these changes. Regular sexual stimulation promotes vaginal blood flow and secretions. Advice 1. Apply K – Y lubricating jelly before sex 2. Apply conjugated estrogen 0.625 mg topical cream once daily for 3 months 3. First involve in foreplay before penetrative sex. Discuss with your partner about this. Foreplay increases vaginal blood flow and secretions 4. Start pelvic floor stretching exercise to strengthen pelvic floor muscles 5. Investigation – vaginal smear examination including Gram’s stain, blood sugar (F & PP), USG abdomen & pelvis Not all vaginal symptoms are related to menopause. Other factors such as fungal infections, allergic reactions, and certain skin conditions can affect the vagina, so consult your gynecologist with above reports if symptoms do not improve with above measures. Thanks