Ask the Pharmacist: Maybe it’s Menopause, Maybe it’s More? Women’s Sexual Wellness Edition

September 28, 2023

By: Rachel Noonan, PharmD

According to a study by Northwestern University Feinberg School of Medicine, as many as 84% of women going through menopause and beyond experience vaginal pain during sex. Unfortunately, most of these women never seek help for their sexual wellness concerns and accept painful intercourse as their new, mid-life norm. Many providers – gynecologists included – are not equipped or trained to help perimenopausal and menopausal women get the resources they need to address their concerns.

Additionally, women often don’t understand why they experience pain during intercourse. Here are some common questions about women’s sexual wellness, answered by Belmar’s Rachel Noonan, PharmD.

Q: What’s causing painful intercourse for women?

A: There can be so many physical and emotional pieces at play with painful intercourse. Female sexual problems are complex.

Not all issues are a result of menopause. But for many women in their thirties, forties, and fifties, hormonal imbalances during perimenopause and menopause can be the culprit.

Often when estrogen levels decline, the result can be thinner, dryer vaginal tissue with less natural lubrication. That symptom could be a good indication it’s time to consider hormone replacement therapy.

While the decline in hormones may be expected, you shouldn’t have to suffer with discomfort or avoid sex altogether.

Q: How do I know if it’s menopause or something more?

A: There often isn’t a clear distinction. What is understood to be a natural part of the menopausal transition and a sexual disorder can overlap.

Together, you and your doctor can determine the underlying causes of your concern. It’s true that perimenopause can exacerbate existing issues and bring new symptoms to the surface, but it’s a highly personal experience.

If any of the material in the Discourse About Intercourse articles below resonates with your experience, here are possible explanations for painful sex that may not be solely attributed to menopause:

Q: How do I know when it’s time to seek professional help for sexual discomfort?

A: I would encourage every woman to tune into their body and avoid minimizing their symptoms. Silent suffering isn’t sexy. I recognize reaching out for support can be hard. Don’t forget that intimate moments should be enjoyable, no matter your age or stage of life.

If these thoughts frequently cross your mind, or some of these statements ring true, it might be time to connect with a medical professional:

  • You’re afraid of or avoid intercourse
  • It’s affecting your intimate relationship(s)
  • You feel emotional and physical distress
  • You’re self-diagnosing on the internet
  • Over-the-counter lubricants don’t seem to help
  • You’re ready to identify the source of the problem

Q: I’m worried my provider won’t take my complaint seriously. How do I explain it in a way they’ll understand?

A: Let’s acknowledge that sharing intimacy issues can feel embarrassing or intimidating. Sure, it’s natural to feel uncomfortable discussing private moments, but we owe it to ourselves and women everywhere to normalize these conversations in an honest way. Destigmatize the topic. Rest assured these conditions are real, and options for physical and emotional relief exist.

That being said, who you talk to matters. Ultimately, it should feel right to speak freely about your concerns and be understood. An experienced menopause or sexual wellness provider is accustomed to discussing these issues.

If you already have a provider that you feel comfortable talking to about your health, start there. If you don’t, we can help.

Q: How do I find a provider who understands female sexual wellness and hormone replacement therapy?

Belmar Pharmacy has a referral program where we connect patients to providers in their area who specialize in hormone replacement, understand compounded therapies, and recognize the importance of women’s health. We have relationships with providers in nearly every state in the country. Give our team a call, explain your needs, and we’ll help find a fit for you.