Periwell
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Category: GenitourinaryClinical Profile

Painful Intercourse

Sex transitions from pleasurable to painful, ranging from a feeling of 'friction' to severe burning.

Biological Mechanism

Genitourinary Syndrome of Menopause (GSM) drives this. The loss of estrogen causes the vaginal epithelium to thin, lose its elastic rugae, and stop producing transudate (lubrication). Micro-tears occur during penetration, leading to burning pain.

Common Misdiagnoses

Vaginismus, Psychosomatic block, Yeast infection

Evidence-Based Treatments

  • 01Local Vaginal Estrogen

    Gold standard. Directly restores tissue thickness and lubrication.

  • 02Vaginal moisturizers/lubricants

    Symptom management, though they do not reverse the atrophy.