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When Sex Hurts: Practical Solutions for Women Over Fifty · Doing Marriage Well

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  Doing Marriage Well for April 16, 2026 When Sex Hurts, Practical Solutions for
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  Women Over 50 On Tuesday, I discussed some ways age brings about sexual challenges
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  for men. Today, the ladies.
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  Her intimate tissues need estrogen, and levels of estrogen fall at menopause.
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  This causes tissues to thin, which can make sex uncomfortable.
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  The easy solution is topical estrogen, in the form of creams, rings, or tablets.
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  Your doctor will decide what is best for you Topical estrogen has been shown
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  to restore tissue thickness, increase elasticity,
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  improve lubrication, and lower vaginal pH In addition to reducing or eliminating
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  painful intercourse, these changes also help to prevent recurring urinary tract infections,
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  As the estrogen is applied to the genitals, it does not change blood levels significantly.
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  Because of this, it is generally considered safe for women who have had breast
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  and reproductive cancers.
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  Your doctor can tell you more if you are in that category.
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  Medication is a good first step, but sometimes the body needs a little extra help.
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  Without regular intercourse, the post-menopause vagina can atrophy,
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  making intercourse uncomfortable, painful, or impossible.
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  Estrogen will help, but it might take more. Careful stretching will restore the vagina.
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  One way to do this is to have him insert his well-lubricated penis and remain still.
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  Work up to a couple of minutes. If you can't do this, start with a finger or two.
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  Men, if you do this for your wife, self-control is a must. If you become overly
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  enthusiastic, you risk injuring her and causing her to lose trust.
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  Women, if he does this for you, offer to finish him by hand when he feels the
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  need. And of course, ask him to do the same for you.
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  If intercourse is not possible or too uncomfortable, there is an option that
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  Laurie and I call pseudocourse.
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  After foreplay, he lays on his back and lubricates the underside of his penis.
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  He holds his penis up against his body and she straddles him as if to have intercourse.
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  She presses her genitals against his and then moves her vulva up and down along his penis.
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  This is strongly stimulating for both and will lead to orgasm for both.
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  As this method provides clitoral stimulation, she can orgasm even if she never has from penetration.
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  You can control how much stimulation he receives by adjusting the amount of
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  rubbing on the glands of his penis.
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  If she starts near the base, he will enjoy it, but won't climax quickly.
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  More stimulation of the glands will get him to orgasm faster.
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  This is Paul, and there are ways to keep doing sex well.