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sex after menopause

When most women think about menopause, they think about hot flashes and night sweats. But few women think about what happens after menopause. As an OBGYN for 40+ years, I’m surprised by how many of my postmenopausal patients feel uncomfortable or embarrassed by bringing up postmenopausal symptoms, such as painful sex.

What women may not realize is that these symptoms are connected to a treatable, medical condition called postmenopausal vaginal atrophy.[i],[ii]  Up to 40% of postmenopausal women experience this condition.[ii] Here’s what you need to know:

What is postmenopausal vaginal atrophy?

Postmenopausal vaginal atrophy is the drying and thinning of vaginal tissues and is caused by a lack of estrogen, which can lead to atrophy, or the thinning of tissue.[i] Common symptoms may include vaginal burning, itching, dryness and painful intercourse.[ii] Other symptoms include urinary symptoms such as urinary urgency and painful urination.[ii]

Are there treatments available to help with the symptoms?

Postmenopausal women experiencing vaginal atrophy need to realize there is no need to suffer in silence – there are several FDA-approved treatments currently available that can help them find relief for their symptoms including a vaginal ring, tablet, cream or an oral pill. If you think you might be experiencing these symptoms, talk to your doctor about finding a treatment option that’s right for you.

What should a woman do who is experiencing these symptoms?

I cannot emphasize enough the importance of women starting the conversation with their doctor. A recent survey of women who experienced vaginal dryness showed that just over half of women had healthcare providers who actively inquired about postmenopausal vaginal atrophy symptoms.[iii] This number is far too low, but it only shows how crucial it is to step up and start the discussion.

Do you have advice for women who are trying to approach this topic with their doctor?

Some women find it hard to talk about. Especially with their doctor. But you don’t have to be embarrassed. Talking about sexual health is a vital aspect of good healthcare. If women are having trouble starting the conversation with their doctor, I encourage them to bring a list of questions or topics that have been a concern. Some people also find that bringing a partner or close friend helps them feel more comfortable. has resources available to help get the conversation started with your doctor.

Experiencing sexual health challenges can be scary or frustrating, but if you ever feel alone during your postmenopausal journey, remember that your doctor is here to help. There are treatments available that can help treat your symptoms, but no matter what – feel empowered to take charge and own the conversation on your health.  

[i] NAMS Menopause Guide 2015. The North American Menopause Society. Menopause Guidebook 8th edition. Mayfield Heights, OH: The North 2 American Menopause Society; 2015.

[ii] Kaunitz Menopause Manag 2001. Kaunitz AM. Sexual pain and genital atrophy: breaking down barriers to recognition and treatment. Menopause  Manag. 2001;10(6):22-32.

[iii] Kingsberg S., Wysocki S., Magnus L., Krychman M. Vulvar and Vaginal Atrophy in Postmenopausal Women: Findings from the REVIVE (REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs) Survey. The Journal of Sexual Medicine. 2013:10(7): 1790-1799.

This post is sponsored by Pfizer.

Dr. Minkin is a nationally recognized obstetrician gynecologist, with a special interest in menopause, and serves as a paid spokesperson for Pfizer to raise awareness and educate about postmenopause.

Dr. Minkin is a Clinical Professor of Obstetrics, Gynecology and Reproductive Sciences at Yale School of Medicine, and practices at her company, Mary Jane Minkin, MD LLC in New Haven and Guilford, Connecticut. She lectures regularly to physicians and medical students, as well as to women directly.

She has published many books, including A Woman’s Guide to Menopause and Perimenopause, and A Woman’s Guide to Sexual Health, and maintains a women’s health website,


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