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When Sex Starts to Hurt: Break the Silence on Vaginal Dryness · The Diva Details

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Welcome to the Diva Detail. Welcome to
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the Diva Detail, where bold,
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confident women embrace life unapologetically.
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From love and sex to wellness and reinvention,
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we keep it raw, real, and powerful.
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No filters, no limits, just fearless
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conversations to help you thrive. Let's dive in with
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Diva Mia and Diva Kat.
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Oh, hello. This is Diva Mia. And I am going to talk
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to you a little bit today about vaginal dryness and pain related to vaginal
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dryness. And then not wanting to have sex because of the vaginal dryness.
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I had several people reach out to me that have had problems
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with vaginal dryness and wanted me to expand upon that because I think it's a
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problem that nobody wants to talk about as one of them when
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you're going through menopause and it can be extremely problematic.
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And then I want to talk about some fixes that actually help because If
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you're having vaginal dryness, you may not have much desire.
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So let's talk about something millions of women
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experience and almost nobody wants to talk about. It's when sex suddenly hurts.
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Maybe it didn't hurt last year and all of a sudden, ouch, it really hurts
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when you have sex. Maybe you need more time and foreplay. I know
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a lot of times in our 40s and 50s, it's, it's kind of repetitive and
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you've been having sex with your partners for a while, but you may need more
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foreplay than you used to before. And if it didn't hurt 6 months ago and
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lately there's dryness, burning, or it's irritated, or you
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even might even have a little bit of blood after sex. Penetration can feel very
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uncomfortable. And a lot of women try to tough it out. I know I was
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one of those women that tried to tough it out for a while. And you
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need more time to get aroused. You may also need that
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hormonal changes. You may need to go talk to your doctors about getting on hormones.
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I, you know, sometimes I would just think maybe I just don't want to have
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sex with him anymore. You know, I'm just not turned on by him. But that
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doesn't mean that everything has to change. There are so many things you can do
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immediately. Everybody jumps to, oh, your libido's just gone and it's
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your hormones must be low, but it's not always. Sometimes it's your testosterone, but sometimes
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it's not. Sometimes it's that you're getting older, but you know what? I don't believe
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in just getting older anymore. There's so many fixes for things
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that we used to assume that, oh, you're getting older. So you have to
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just deal with it. It's broken now. I don't agree with that. But maybe you
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no longer are attracted to your partner. That happens. Just maybe you've lost attraction.
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Maybe you need to spice things up in the bedroom. Maybe you need more fun
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with intimacy or more connection. So hold on. Don't just assume
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that you don't want to have sex with them anymore because of that, because a
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lot of times we think we don't want to have sex because it's painful,
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but it may just mean you need to find ways to make it less painful.
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And when we find ways to make it less painful, then we, our libido returns
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around sex. Those are 2 different problems. I don't want to have sex
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versus I don't want something to hurt are 2 different problems. If every time someone
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offered you dinner, they also punched you in the arm, eventually you might say,
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ooh, I'm done eating dinner. I just want to have lunch. You know? So our
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brain learns to avoid pain and we drive towards pleasure in our
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brain. Pleasure teaches you to come back for more, whereas pain teaches you to avoid
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it. So this is one of the things I think we need to teach more
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kids is that so many kids are always just for the pleasure and they forget
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that, you know, you need to also avoid pain. So today we're going to discuss
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vaginal dryness, painful sex, and the loss of desire that can follow because of
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it. So more importantly, I mean, we're going to talk about the things that can
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actually help too, because many women, we don't discuss this and comfort comes
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before desire and it needs to feel good. Ladies, we're not
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just there as a tool for our men. It needs to feel really good.
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If it doesn't feel really good, you're not gonna have orgasms and orgasms are amazing.
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And honestly, as we get older, a lot of us are more multiple orgasmic
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than we ever were in our lives. The first thing is why did sex suddenly
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start to feel different? Did it happen because of menopause. After menopause,
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estrogen levels decline. You have to realize that as estrogen declines,
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the vaginal tissue and the vulvar tissue, it decreases.
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Those tissues, as estrogen declines, it gets thinner, it's drier,
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it's less elastic. It's not as flexible. It can get irritated if you're having
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a lot of friction in the area when you're having sex, it can be more
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sensitive. Some women experience burning or itching
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as well. They might have a yeast infection. There might be something else
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going on. So notice if you're having pain during penetration, because Sometimes
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urinary urgency is a urinary tract infection. Those happen more often
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as you get older. It can also be that one of the things that my
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doctor told me, cause I was getting urinary tract infections, they go, you need to
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pee right after you're done having sex. It also matters if biome related to your
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sexual organs, if that biome is off with you or with your partner, or if
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your biomes don't get along very well. There's things that can cause urinary tract infections,
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but try to start just peeing after sex. Okay. That's one good way.
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There's also cranberry you can take before sex, which has helped a little
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bit, but pee after sex, that'll help. But most women, the doctors call it,
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it's a syndrome after menopause. Instead of just saying things don't
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feel well right there, you can say, could I have something going on with my
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vaginal dryness or urinary tract area? Because we have a
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very prod— we need to have a productive conversation when we see our doctors,
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because you can't just say it doesn't feel right. You should say, hey, I'm really
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dry, or I keep getting urinary tract infections and I keep coming in for those.
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Is there something else going on? But unlike hot flashes, which usually
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improve over time, vaginal and urinary symptoms, because of estrogen loss, it can get
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worse. It doesn't usually disappear unless you treat it. Don't assume you have
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to wait it out because there's treatments, ladies, for this. Pain is kind of
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a desire loop too. When your libido gets involved,
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imagine sex is very uncomfortable. You think maybe it'll be better
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tonight. This one night it'll be better. Then it happens again. Then the third time
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before eventually you start saying, oh, your brain says, I don't want to have sex
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because you're anticipating the pain. Your pelvic muscle gets tighter. Like, ugh, I don't
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want to have sex. Lubrication doesn't work as easily. Sometimes you can add lubrication,
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but sometimes that doesn't even work. So your body isn't relaxed. It tightens
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up and penetration becomes even more uncomfortable. So now you've created
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a loop of, I have pain around sex. I have anxiety. I create
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tension around this, that increased pain. It eventually drops your desire. That's why
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I want, you know, I want you to stop assuming that every loss of interest
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in sex is a hormone problem, because a lot of times That's not the original
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reason. It can be tissue changes as well. By the time pain though has,
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has been happening for a month or two, you can also have muscular responses
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down there. You can have, it can be triggering down there because your
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body remembers it. It's not a weakness. It's conditioning. It's like Pavlov's
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dog. It's like ringing a bell. You're going to go have sex and now everything
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hurts. And if you're, if you touch a hot stove repeatedly over and over again,
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you're eventually going to stop touching that stove. That's what we learn as people.
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Sex repeatedly hurts, your brain might begin shutting down before
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the sex even starts. So your desire is gone. And a
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lot of times people are like, oh, just use lube instead. But that's not always
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working. Lubricant is, it can be useful. It can be helpful,
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but it's not a vaginal moisturizer. So when you're, the skin
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is getting thinner, it doesn't work so well, guys. And sometimes you
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use, you know, you might have a little frisky sex
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and the lubricant is not working. There are vaginal moisturizers that you can use as
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regular skincare. There's things, there's treatments you can have on the
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vaginal area. And it's important distinction. Many women, you know,
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we, they reach for the lubricant and they, they They already feel dry and uncomfortable,
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and then they get dry right away again. And they use a tiny amount because
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apparently we've decided that lubricant should be rationed or something. I don't know.
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I have a huge bottle next to my nightstand, but a lot of women don't
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want to use a lot of lubricant and you need to use plenty. And there's
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no reason to have extra, not to have extra lubricant. There is no medal
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for surviving sex with insufficient lubrication. If it's dry 5
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minutes in, you can always lubricate. You don't have, it's, It happens.
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Men have erectile dysfunction. Women, we get a little
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dry. I'd rather get dry than have erectile dysfunction. So think about it that way,
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ladies. There's different products work differently. I like water-based lubricants and they're
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easier to clean up. There's silicone-based lubricants, but they generally last longer.
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I just prefer the water-based. Some oil-based can also be good, but it
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can damage condoms. If you're using condoms, be careful with— if you're using oil-based lubricants.
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And it's— if a product burns or stings you, it's causing a reaction.
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Stop using it right away. And you may need to go rinse it out too.
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I had a problem one time where it caused a major irritation and
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you have to rinse it out right away. So you test it on your skin
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first before you insert it internally. I highly recommend that.
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But your body, it's, it isn't obligated to tolerate pain.
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So, you know, it has to say intimate before you use it. I like
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coconut oil, I will say, but I don't know how good coconut oil is with
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condoms. So that's a caveat if you're using coconut oil, but I do like coconut
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oil down there for daily moisturizing as well as a
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lubricant. It's, it's For me, it works very well. And I wish somebody else
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told me about coconut oil when I was younger, because I was like, and then
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I used it. I was like, I'm just going to put this on every day.
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Now it's part of my skincare regimen, but I use coconut oil daily. If there's
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warming ingredients in some of these lubricants, you have to be careful. Cause if you
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have sensitive skin, especially down there, it can cause a problem. Simply having it more
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often is not better. Realize that there's also vaginal moisturizers
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too. So there's different moisturizers that people use that we
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overlook. A vaginal moisturizer isn't necessarily something used
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during sex. It's something you can put on in the morning, noon, and night,
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whenever you want to use it. It's, uh, it can be used several times a
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week depending on the product and what it says on the instructions. But the
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objective is to improve everyday comfort and moisturizing and the moisturizing
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feel and how it's the suppleness of your skin. Basically, if dryness
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is mild, a moisturizer can take the significant
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edge off. It's a, if it's major, and when I say dryness, ladies,
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if it's dry down there and you're walking You can get chafed
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inside your lips, if you will, because it's
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too dry. Realize it can cause other problems as well. And consistency is
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the key word. You wouldn't use facial moisturizer once and expect everything
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to be better. You need to use it consistently and use
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it as directed and give it time. Sometimes things take time to work, but if
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it's burning or dry, you know, go get checked out for a sexually transmitted
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disease too, because sometimes you never know what your man was doing. For some women,
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you know, over-the-counter moisturizers and lubricants are enough. But if
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you're burning or it's completely uncomfortable, you may need to go investigate
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further. When it's causing bleeding or any type of irritation that's
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making it difficult to function. Let's talk about estrogen. We have symptoms
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related to menopause when we decrease our estrogen. There is
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something called low-dose vaginal estrogen. It's an insert. It's a tablet.
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I do use this. It's different than taking systemic estrogen
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for symptoms like throughout the body, but because it— the
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inserts, the tablets that just go in, they— it's just for vaginal
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dryness and it works really well. I think it works well. It works well for
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me anyway. It can come in a cream. Mine's a tablet and it's inserted.
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You can also get a vaginal ring that does the low-dose estrogen.
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The goal is not merely to take, you know, make everything more slippery.
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It's to, it's to treat the estrogen-related tissue changes.
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So it helps the thickness of the vaginal wall. It helps it be more supple.
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And that matters because lubricant, you know, it helps with the
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friction. It may help with the actual sex, but vaginal estrogen
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is going to help long-term. It's going to help recondition the tissue itself.
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I love my vaginal estrogen. I probably don't do it as much as
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I'm supposed to. I'm supposed to do it, you know, every few days, but I
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probably get it once a week, but it's still working very well for me.
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So for most women, you know, moderate symptoms, it can make
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a major difference. It made a major difference for me. And I love my low-dose
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vaginal estrogen. If you have a history of estrogen sensitivity or cancer,
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you need to talk to your doctor before you do any hormones because there are
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estrogen So don't just assume local vaginal
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estrogen is okay. You need to talk to your doctor before you do anything.
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Ask your doctor, get the, you know, actual information and make sure it's not going
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to cause any problems. There's other types of estrogen as well. Anything you're doing
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with estrogen, you always have to talk to your doctor, especially if you've had previous
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medical problems. There's also prescriptions that exist. Vaginal estrogen is the only
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prescription option. If you're doing vaginal estrogen, it's already going to be a prescription,
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but there's other treatments that you can do that are not can be done.
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You have options. I mean, that's what this whole episode is about, that you have
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options. We've talked about vaginal dryness, um,
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as a physical thing. You can use lubricant, but there's, you know, you can't spend
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the next 5 years constantly having lubricant when you have the medical— there's a medical
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treatment plan that can be used to actually fix the problem. I think that's the
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goal, is we need to learn to start fixing problems instead of just masking the
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symptoms, because lubrication alone, it's just going to mask the symptoms. It's going
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to make intercourse a little less painful, but it still may be painful. So if
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you, if it's still painful with lubricant, you need to talk to your doctor.
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This is, you know, it's a fact. It may affect your entire sexual relationship,
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specifically symptoms, you know, that produce better medical conversation.
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It's embarrassing. I understand that, but you need to talk to your doctor.
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All right. Pelvic floor may also be part of the problem. Here's something
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that a lot of women don't realize. There's a lot of physical therapy now.
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There's specific machines that can actually help you tighten your pelvic
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floor. The pelvic floor helps keep
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your bladder in, helps with bowel and sexual function. And people often assume that
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the pelvic floor therapy is only for women who leak urine, and it's not.
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The pelvic floor also can help you become a little
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bit tighter. And sometimes the pelvic floor muscles are too tight.
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So there's that as well. If your muscles are involuntarily tightening in response to
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anticipating pain, because you're having pain during sex, it's going to
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become more painful. A pelvic floor physical therapist can evaluate evaluate what's
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going on down there. Treatment, it can involve relaxing the muscles. There's a
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chair that actually helps with pelvic floor, is a little bit costlier expense.
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There's breathing techniques, there's stretching, there's exercises.
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Not every pelvic floor needs more Kegels, just so you know.
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Some of us don't need any more Kegels. Sometimes women are squeezing that
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muscle that actually needs to learn how to relax because sometimes it's too
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tight. Just realize that, ladies, when it's too tight, that can cause pain.
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So just realize Just because you've been doing 100,000
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Kegels this week, you might have actually caused the sex pain that you're having.
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There's another very inexpensive treatment that couples ignore
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is just slow down. Women's bodies are not a pounding machine
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at the same speed they were in their 20s. So arousal may take longer.
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Lubrication may take longer. Foreplay may need to take longer.
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And it's okay. It means that the runway just needs to be a little longer
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to get you to your final destination. Sometimes, you know, as a couple, you still
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are, you know, you're doing the exact same thing and routine that you did in
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your 30s and You need— you had 3 minutes of initial infection followed by let's
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go, and your body's saying, wait, I'm not even turned on yet.
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So you're going to need a little bit more preparation,
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more kissing, touching, stimulation, potentially oral sex,
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relaxation, and communication. Just takes your time. Sex should
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be pleasurable for both people. And ladies, if you're not having good sex, then you
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need to really fix this because sex can be amazing. And frankly, it's necessary
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to talk to your partner about this because this should not be
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a negative experience for you. Sex becomes— when it's less rough, and more intentional,
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it's better for you and it's better for them. Hopefully you have a partner that
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cares about your satisfaction as well. Otherwise you probably need to find a different partner
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if you have a boyfriend relationship. If you have a marriage, go talk to a
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therapist. That's why I always recommend first, but stop pushing through the pain. This one
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needs to be said clearly. I was in a marriage where I was having a
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little bit of pain from sex and I pushed through the pain a lot.
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I should not have done it because it makes it less enjoyable
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for you and it doesn't make you happy. And I don't think it really makes
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your partner happy either. Because if you're having painful sex, you really need to
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go talk to your doctor. But here's the thing. Nobody told me that. I just
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thought it was part of aging, part of menopause, and there wasn't a fix.
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And when I talked to my doctor, I heard the same thing. I needed a
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different doctor. Painful sex should not be that way. And then you start
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avoiding intercourse because of the pain, and then you've lost your sex
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and you've lost touching and cuddling and your closeness. And, and you're
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exhausted in any way. There's lots of reasons not to have sex, but pain is
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such a big one. So if something hurts, stop and let them know, hey,
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that hurts. It did not feel good. And if you have a partner that doesn't
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care, you're probably with the wrong partner. All right, moving on. And then expand your
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definition of sex. Here's another place couples get stuck. Sex does not just equal
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penetration. Nope, nope, nope, nope, nope. Sex— sexual intimacy
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is much broader than just penetration. If penetration hurts, then try treating the cause.
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You can kiss, you can touch, massage, use hands, you can have oral sex.
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Have orgasms without penetration. Be affectionate. Be playful. For me,
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oral sex is a huge part of sex. If I have no oral sex,
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it's not as pleasurable for me. I will say stay physically connected.
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This can be especially important while you're rebuilding confidence with your
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sex, especially if you were going through a lot of painful sex. Your brain needs
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to experience this and say intimacy feels good. You need to rewrite
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or rechange those pathways in your brain so that you're like,
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Not saying here comes the pain again. So you're enjoying your sex and
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your partner needs to understand this. If you're partnered with somebody that doesn't understand you
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sexually, it can be very frustrating. Explain to them what happens. You need to
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have them go to the doctor with you so they can hear from the doctor.
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Don't do it while you're in the middle of having sex and have a clinical
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discussion. That kind of kills the mood. Just saying, have the conversation outside
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the bedroom. Say, my body has changed and intercourse has started hurting.
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I will, I still want closeness with you, but It hurts. Can we slow down
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the pace or can we, you know, do more foreplay or more
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oral sex? Or can I have an orgasm before we have sex? That way you
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don't have to deal with the pain during sex. Stop using products as well
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that irritate you. If you're using some type of product,
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even perfume wipes, that was one of the things I was interested in
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is like a lot of people use those wet wipes now. And sometimes that
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can cause irritation or dryness. Bubble baths can, sometimes a deodorant
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spray douches. But if you have odor coming from down there, or if it smells
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like piña colada, saladas, or, um, I don't know what you're doing.
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You shouldn't have a strong odor coming from there. So check that out with your
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doctor too, because sometimes that's, that can be a disease or
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STD or a urinary tract infection. So make sure you track all
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that out. And then sometimes you just need to change your soaps or your detergent
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or just different personal hygiene products. So don't assume every
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burning sensation is menopause. Then dryness, um,
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can cause burning and irritation, but so can other conditions like
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yeast infections, bacterial infections, STDs,
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urinary tract infections can cause problems, but so can also the pelvic floor.
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So talk to your gynecologist or doctor, and if the symptoms
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keep getting worse, you need to get examined, especially if you're experiencing
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bleeding after intercourse or, you know, postmenopausal bleeding that you
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thought you went through menopause and now you're bleeding, or you get a weird discharge.
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That's a, that's a red flag, red flag. Go get that checked out.
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Or if you have any sores or lesions, you may need to get checked out
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for all kinds of different things. Any odors, pain, or discharge,
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those are 3 key things that you need to get checked out for.
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And urinary pain is significant, ladies, and UTIs are
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significant. So you need to go get a culture run if you're having urinary pain
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of any kind. The next thing I wanted to talk about is just UTIs,
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and UTIs are urinary tract infections. It's, it's when you get an
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infection inside your urinary tract, which can go to your kidneys. You have
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to be careful of that. A lot of times when you have estrogen-related
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changes, it can affect the bladder region and the urethra.
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Urethra. Some women, we notice it because we have to pee more often.
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It might be burning. If I, when I, I, I, I didn't really get
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UTIs until I turned 45. And then if I had sex where I wasn't really
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lubricated well, I was more likely to get a, a, um, a bladder infection.
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And then I, and then I didn't know I had to pee after every intercourse
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thing right away. Cuz if you pee right away, that does help. So any urinary
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symptoms, you know, it's not necessarily menopause. It can be an infection of
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another kind, but But definitely get it checked out. And now let's kind of COVID
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the final thing I want to talk about, which was desire. I don't want to
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have sex. When you think that over and over again because of pain
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that you've experienced, it changes your mindset.
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It also changes your lubrication down there. But if sex is hurting,
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it's going to make you more dry anyway. And then it's kind of a repetitive
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cycle. So your desire still, if it's not returned after
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you get wetness back and it's not returned after you've addressed any sleep or
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mental issues related to your partner or your stress levels,
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then you may have a libido issue. There's sleep, stress,
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hormones, quality of relationship, all that stuff we went over before,
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medications, all those things can affect your sleep.
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It can affect your libido. Libido is such an interesting thing because
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vaginal discomfort for women is such a— it's going to put a brake on sex.
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It just will. But libido can be affected by so many different things.
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It doesn't necessarily push the accelerator when you fix it. But removing
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the pain helps. And that's the key idea is sometimes women,
20:53
we try to create more libido while the body says, hey,
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everything hurts. Let's stop for a little bit. It's, it's like you need a sexual
21:01
reset. When that happens, just say not tonight. If it's painful,
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you're going to have to fix that. You're going to have to realize maybe I
21:08
need to get some vaginal estrogen, or maybe I need to figure out what's going
21:10
on down there. You may need to talk to your doctor. This vaginal
21:14
dryness is a talk to your doctor, talk to your doctor, talk to your doctor
21:16
thing. You can't just skip that step. Because there's so many treatments out there
21:20
that you really need to address it because it can get really painful and a
21:24
lot of things can cause irritation. And doctors are used to having the
21:28
conversation, especially if it's an OB-GYN, they're used to having this conversation.
21:31
Intimate hygiene products you can use, but get examined if it
21:35
hurts in any way. Also kind of consider your pelvic floor. You may need to
21:39
do some work on that, but take penetration off the table. If it hurts,
21:42
create intimacy around other things until you can get this resolved.
21:46
There's other ways to have sexual pleasure without having intercourse.
21:49
And then take your time. Don't rush so much. Make sure you communicate with your
21:53
partner and tell them how you feel. What you can do is you can gradually
21:56
reintroduce penetration as it feels better. It's comfort first,
22:00
not performance. Don't feel like you're going to destroy your boyfriend's ego
22:03
if it hurts you. I mean, that might boost his ego. Oh yeah, I'm a
22:06
big man. So just realize if you're having pain, you may need
22:10
to discuss it. If you've experienced any of these symptoms, Make sure you start talking
22:14
to a doctor. Make an appointment if the dryness or the pain gets really bad,
22:17
or if you're bleeding or have any unexpected infections or pain.
22:21
I want women to remember from today's episode that painful sex
22:25
is not something you have to accept because you're getting older.
22:28
Lubricants, vaginal moisturizers. I love my coconut oil.
22:33
Lubricant reduces— it just reduces friction. Make sure you're not allergic
22:36
to coconut oil, by the way, but moisturizer is used greatly. And regularly
22:40
for vaginal dryness, as well as inserts. If over-the-counter
22:45
products aren't enough, then talk to your doctor about a prescription. If there's any dryness,
22:48
you should be talking to your doctor. You should also talk to your doctor if
22:51
pelvis floor dysfunction could be a possible issue, but don't
22:55
force yourself to have painful sex because it's going to make you not want to
22:57
have sex. And then it's going to cause more friction in your relationship. You may
23:01
not hate sex. You just hate what's going on related to sex currently. And this
23:05
is completely different problem and can be solved.
23:08
Determine what the true issue is, and then you can actually treat it.
23:11
So ladies, there is no prize for quietly suffering through painful sex.
23:15
I will say I tried and I tried to take it and you need to
23:18
get it resolved. You don't get extra bonus points because you smiled and
23:22
pretended everything felt fine. Speak up, use lubricant,
23:25
use enough of it, use extra lubricant if you need to try moisturizer,
23:29
try coconut oil if you're not allergic and talk to your gynecologist. Vaginal estrogen
23:33
helps me tremendously. I will say, as well as coconut oil. If you
23:37
tell your partner what you need, hopefully they will listen and you guys can work
23:40
it out together. Because the objective here isn't simply to have more sex. It's to
23:44
have pleasurable sex. It's to feel good. It's to enjoy it. Once it feels
23:47
good and comfortable again, I will say, ladies, in your 50s, your libido may go
23:51
into overdrive. So sometimes desire didn't leave. It's just waiting
23:55
for you, the pain to leave first so that you can come back to reality
23:59
and enjoy sex again. If this helped anyone, please forward it to a friend.
24:04
I look forward to hearing all your comments after this one. Take care.
24:08
Have a wonderful week. This is Diva Mia. Stay strong, stay happy,
24:12
and enjoy your sex. Ciao ciao.
24:15
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24:20
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24:24
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24:30
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