Medically reviewed by Dr. Tamara Neuhaus MD
That’s it. I’m giving up on sex. At least, intercourse. I was able to find some lubricants to help with the dryness. But now it feels like my uterus or something has become a punching bag during sex. No orgasm is worth this. - Tyra, 49
Sex can become painful during perimenopause for a couple of reasons. One very common reason is that your vaginal tissues may start to lose lubrication, and become thinner and less elastic. The other reason is that your uterus, bladder, or rectum may start to bulge into your vagina, where they can get jousted and jostled during intercourse. This phenomenon is called prolapse.
We’ll focus on prolapse in this article, as we go into detail on vaginal dryness here. Prolapse can also happen for a couple of reasons. Fluctuating estrogen levels in perimenopause can cause the muscles and ligaments that normally hold your uterus and bladder in place to weaken. And as they weaken, the organs shift south. Pregnancy, childbirth and hysterectomy can also increase your odds of experiencing prolapse.
There are some exercises that you can do to strengthen the muscles that hold your pelvic organs in place. We recommend working with a gynecologic physical therapist to learn to do them the right way. Because doing them the wrong way could make matters worse. Another other option is to have surgery to secure the wayward organs back in place. So definitely start with physical therapy.
Our menopause specialists can create a personalized care plan to help make sex more enjoyable for you. Learn more.