Intimacy After 40: Why Painful Sex During Perimenopause Is More Common Than You Think (And How to Fix It)
- Dr. Tamarah Chaddah, ND
- Nov 24, 2025
- 3 min read
By: Dr. Tamarah Chaddah, ND, MSCP (f. NAMS) | Menopause Practitioner
Follow me on socials @drchaddahnd
If Sex Has Become Painful In Perimenopause… Let’s Talk About It
Perimenopause and menopause bring a wide range of changes including: hot flashes, shifts in mood, sleep disturbance, weight changes, but one area that often doesn’t get enough attention is vaginal health.
Yet it should, because up to 50% of women experience vaginal symptoms during the menopausal transition. You are far from alone.
So, let's talk about why this happens and how you can solve it.
Let's get into it!
Disclaimer:
This content is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, naturopathic doctor, or other qualified healthcare provider with any questions you may have regarding a medical condition or health concern. Never disregard professional medical advice or delay seeking it because of something you have read here.
Why Vaginal Health Changes During Menopause
The vagina contains a high concentration of estrogen receptors. As estrogen naturally declines during perimenopause and menopause, these tissues become thinner, drier, and less elastic. Painful sex during perimenopause doesn't need to be the norm. This isn’t just a comfort issue, it can have a major impact on day-to-day quality of life and sexual wellbeing.
These changes fall under the umbrella of Genitourinary Syndrome of Menopause (GSM). GSM can include:
Vaginal dryness (with or without sexual activity)
Itching, irritation, or burning
Painful intercourse
Recurrent UTIs
Vulvar atrophy that makes sitting, walking, or even urinating uncomfortable
If you’re noticing changes “down there,” please know this is common, treatable, and absolutely worth addressing.
Three Key Products to Support Vaginal Health In Perimenopause
Most women aren’t aware that there are three different categories of products that can make a meaningful difference:
1. Vaginal Moisturizers
Used regularly (not just during sexual activity), moisturizers help improve day-to-day comfort and tissue hydration.
2. Sexual Lubricants
Lubricants reduce friction during intercourse or self-pleasure. Using them is a sign of empowerment and self-care, not a deficiency.
3. Vaginal Estrogen
Topical estrogen therapies can be very effective for GSM. They act locally with minimal systemic absorption and are considered safe for many women. These require a prescription, and I frequently collaborate with family doctors or gynecologists when needed.
One Thing To Remember For Vaginal Health In Perimenopause: Consistency Matters
Vaginal care isn’t a luxury, it’s part of your overall wellbeing. I often tell my patients:
“Vaginal health should be treated just like a skincare routine: high-quality products, used consistently.”
If you’re experiencing discomfort, pain, dryness, or simply something that doesn’t feel like you, please reach out. You deserve support, options, and comfort at every stage of life.
Personalized Support in Ontario
Whether you're in London, Vaughan, Oakville, or Mississauga, working with a licensed naturopathic doctor can help you take a holistic approach to aging, hormones, and fitness.
And if you've been asking yourself, "What is a naturopath?", it’s simple: we use natural therapies, clinical nutrition, lifestyle counseling, and advanced testing to support optimal health at every stage of life.
Around here, I focus on supporting you through your perimenopause and menopause transition. You can book a visit using the button below. I see patients in-person in my clinic in Aurora, Ontario, or virtually, across Ontario!
Follow me on socials @drchaddahnd
