Natural Remedies for Painful Sex After Menopause

Key Takeaways

• Vaginal dryness and tightness are common during menopause, but you don’t have to settle for discomfort (Portman & Gass, 2014).
• Five practical natural approaches can help: lubrication, pelvic floor physical therapy, mindfulness and relaxation, position and timing adjustments, and open communication with your partner.
• When vaginal tightness is part of the picture, dilation therapy can help rebuild comfort with penetration. In a recent clinical study of Milli users, 85% made measurable progress toward intercourse within 90 days and 57% reported reduced anxiety related to sex at 3 months (Materna Medical, n.d.).
• Open communication with your partner is key to maintaining emotional and physical well-being during menopause.

Menopause changes a lot about your body, but painful sex doesn’t have to be part of that. Women’s sexual health is just as important as men’s, and it’s time to stop feeling embarrassed about speaking up about it.

What Happens During Menopause

When your estrogen levels drop, your body undergoes changes that can affect your vaginal tissues, leading to dryness and discomfort during sex (Portman & Gass, 2014). These changes are normal, but they shouldn’t be something you live with. Your sexual health matters and there are tools to help you feel better. For a deeper look at how estrogen affects your body and what GSM actually is, see our article on why sex hurts after menopause.

The Real Impact on Your Life

When sex becomes painful, it doesn’t just affect your body — it can make you feel less confident, hurt relationships, and take a toll on your mental health (Gaspar et al., 2017). If you’re feeling this way, it’s time for a change. You deserve to feel good about yourself and enjoy sex without pain. For more on how chronic sexual pain affects desire and relationship connection, see our article on painful sex and sexual desire.

“In a recent clinical study of Milli users, 85% made measurable progress toward intercourse within 90 days, and 57% reported reduced anxiety related to sex at just 3 months. Consistency is a critical factor — and a tool that reduces the stress of each session makes that consistency achievable.”

5 Simple, Natural Ways to Manage Discomfort

Here are five practical, natural ways to help manage vaginal dryness and tightness:

1. Keep Moisture Where It Matters

Dryness shouldn’t stop you from feeling comfortable. During sex, always use a good, water-based lubricant to make things easier and more comfortable (Kennedy et al., 2022). Look for pH-balanced, glycerin-free, and fragrance-free formulas that are gentle on vaginal tissue (Edwards & Panay, 2016). For a full guide on lubricant types, what to look for, and what to avoid — including what is compatible with Milli’s silicone surface — see our article How to Use Lube With Milli. And if you want to try the lubricant our FemmePharma partners recommend, Milli comes with a 15% discount coupon for Mia Vita Personal Lubricant & Moisturizer.

2. Try Pelvic Physical Therapy

If you’re experiencing ongoing tightness and discomfort, pelvic physical therapy can help (Wallace et al., 2019). These specialists teach you exercises — including Kegels and relaxation techniques — to relax tight pelvic muscles and ease pain. You can combine this with using lubricants and dilators for even better results. For techniques you can start at home today, see our article on how to relax your pelvic floor.

3. Use Mindfulness Practices

Practicing mindfulness, yoga, and meditation can help reduce anxiety and make sex more comfortable (Mira et al., 2022). These practices help you relax and feel more connected to your body. The more relaxed you are, the easier and more enjoyable sex can be. For specific yoga poses and stretches that target pelvic floor tension, see our article on yoga poses and stretches for pelvic floor relaxation.

4. Experiment with Positions and Timing

Sometimes, simply changing positions can make sex more comfortable by reducing pressure on sensitive areas (Faubion et al., 2018). Take your time and find what works best for you and your partner — don’t rush, and make sure you feel comfortable. For more on how to approach intimacy when sex is painful or penetration is currently difficult, see our article on intimacy with vaginismus — many of the approaches there apply equally to menopause-related discomfort.

5. The Power of Open Communication

Talking openly with your partner about what feels good and what doesn’t is key. Communication helps both of you understand each other’s needs and create a better, more comfortable sexual experience (Gaspar et al., 2017). Don’t be afraid to speak up. For more on how to navigate intimacy and relationships when sex is painful, see our article on how vaginismus affects relationships — the communication and connection themes apply broadly to anyone managing painful sex.

Milli: A Tool Designed for You

If vaginal tightness is affecting your sex life, Milli offers a modern approach to dilation therapy. Unlike static dilator sets that require switching between multiple devices at fixed sizes, Milli is an FDA-cleared expanding vaginal dilator that gradually expands while inside — from 15mm to 40mm in 1mm increments — allowing you to control the size and pace entirely. The optional integrated vibration feature can be used on low or high to support muscle relaxation during sessions (Faubion et al., 2018).

Consistency is a critical factor in how quickly dilation therapy produces results — and a tool designed to reduce the physical and emotional stress of each session makes that consistency much more achievable (Wallace et al., 2019). In a recent clinical study of Milli users (Materna Medical, n.d.):

• 85% made measurable progress toward intercourse within 90 days
• 57% reported reduced anxiety related to sex at 3 months
• 68% reported more comfortable intercourse at 3 months
• 80% used Milli’s vibration feature at least half the time
• 85%+ stayed on track with recommended use at 6 months

No prescription is required — Milli is available over the counter and designed to be used at home, independently or alongside pelvic floor physical therapy. For more on how dilation therapy works and what the broader research shows, see our article Do Vaginal Dilators Work?.

Want to Go Deeper? More Resources

This article covers five practical starting points. For more on any of these topics, here are the most popular resources in our menopause and painful sex library:

• Why Does Sex Hurt After Menopause? — the full explanation of GSM, the pain-tension cycle, and where dilators fit
• Maintaining Sexuality After Menopause — how to reclaim intimacy and sexual connection during and after menopause
• What Is Vaginal Dryness? — causes, symptoms, moisturizers, lubricants, and the FemmePharma partnership
• How to Relax Your Pelvic Floor — breathing techniques, stretches, and exercises to reduce pelvic floor tension
• Yoga Poses and Stretches for Pelvic Floor Relaxation — specific poses recommended by pelvic floor physical therapists
• How to Use Lube With Milli — lubricant types, what to look for, and what is and isn’t compatible with Milli

FAQs: Common Questions About Painful Sex After Menopause

How can sex be less painful after menopause?

Start with the practical: a good water-based lubricant (Kennedy et al., 2022), more time for arousal and foreplay, and adjusting positions to find what feels comfortable. If tightness or muscle guarding is part of the picture, pelvic floor physical therapy and vaginal dilation therapy can also help (Wallace et al., 2019). For a full overview of options including hormone therapy, see our article on why sex hurts after menopause.

Are there non-hormonal treatments for vaginal dryness?

Yes. Moisturizers and water-based lubricants can reduce vaginal dryness without hormones (Edwards & Panay, 2016). Pelvic physical therapy and vaginal dilators like Milli help manage the muscle tightening that often accompanies dryness (Wallace et al., 2019). Vibration may also facilitate natural lubrication (Faubion et al., 2018). For more on what to look for in a lubricant and moisturizer, see our article on vaginal dryness.

What exercises can help with painful sex?

Kegel exercises and stretches that target the pelvic floor muscles can help reduce pain during sex by improving strength, flexibility, and relaxation (Wallace et al., 2019). Yoga poses like child’s pose, happy baby, and yogi squat are particularly useful for releasing pelvic floor tension. For a full guide with video demonstrations, see our article on yoga poses and stretches for pelvic floor relaxation.

Can vaginal dilators help with menopause-related painful sex?

Yes — especially when tightness, muscle guarding, or discomfort with penetration is part of the picture. Dilators help the body gradually rebuild comfort with insertion at a pace you control. In a recent clinical study of Milli users, 85% made measurable progress toward intercourse within 90 days (Materna Medical, n.d.). For more on how dilation therapy works, see our article Do Vaginal Dilators Work?.

How long does it take to see results with dilation therapy?

In a recent clinical study of Milli users, 85% made measurable progress within 90 days — and most women who practiced regularly noticed progress within 3 months (Materna Medical, n.d.). Consistency is the most important factor (Wallace et al., 2019). For guidance on building a consistent routine, see our article on the Milli Use Plan and Progress Tracker.

You don’t have to settle for pain or feel embarrassed about talking about it. You deserve to feel good in your body and enjoy intimacy. With natural solutions and tools like Milli, you can take back control and find the relief you deserve. Your sexual health is important, and it’s time to prioritize it.

Sources

• Wallace, S. L., Miller, L. D., & Mishra, K. (2019). Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology, 31(6), 485–493.
• Edwards, D., & Panay, N. (2016). Treating vulvovaginal atrophy/genitourinary syndrome of menopause: How important is vaginal lubricant and moisturizer composition? Climacteric, 19(2), 151–161. https://pmc.ncbi.nlm.nih.gov/articles/PMC4819835/
• Faubion, S. S., Larkin, L., Stuenkel, C. A., Bhupathiraju, S. N., Manson, J. E., Shifren, J. L., & Kingsberg, S. A. (2018). Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: Consensus recommendations from The North American Menopause Society and The International Society for the Study of Women’s Sexual Health. Menopause, 25(6), 596–608. https://doi.org/10.1097/GME.0000000000001121
• Gaspar, A., Addamo, G., & Brandi, H. (2017). Genitourinary syndrome of menopause: Epidemiology, physiopathology, clinical manifestation and diagnostic. Gynecological Endocrinology, 33(2), 1–5. https://pmc.ncbi.nlm.nih.gov/articles/PMC9580828/
• Kennedy, C. E., Yeh, P. T., Li, J., Gonsalves, L., & Gabrysch, S. (2022). Lubricants for the promotion of sexual health and well-being: A systematic review. Sexual and Reproductive Health Matters, 29(3), 1–27. https://pmc.ncbi.nlm.nih.gov/articles/PMC8942543/
• Materna Medical. (n.d.). POMPOM clinical study results (Data on file, KEY0054 and supporting references KEY0050–KEY0053).
• Mira, T. A. A., Buen, M. M., Borges, M. G., Yela, D. A., & Benetti-Pinto, C. L. (2022). Pelvic floor physical therapy and mindfulness: Approaches for chronic pelvic pain in women — A systematic review and meta-analysis. Journal of Psychosomatic Obstetrics & Gynecology, 43(3), 345–352. https://doi.org/10.1080/0167482X.2022.2045879
• Portman, D. J., & Gass, M. L. S. (2014). Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Menopause, 21(10), 1063–1068. https://doi.org/10.1097/GME.0000000000000329