How to Treat Vaginal Dryness In Menopause By Margaret Polaneczky, MD, Heather Rupe DO, Arefa Cassoobhoy, MD, MPH "Sex is supposed to be fun, and it’s definitely not supposed to hurt. But one of the consequences of menopause is vaginal dryness, which for many women means painful sex. With the loss of ovarian estrogen, vaginal walls that were once elastic, expandable, supple and sturdy can, over time, become tightened and fragile. The vaginal walls can become as thin as tissue paper, unable to withstand the manipulation that occurs with sexual activity, and can tear and even bleed with intercourse. “Use it or lose it” When sex becomes painful, the natural response is to begin to avoid intercourse. But without continued sexual activity (masturbation counts, too), the vagina becomes even smaller and tighter, making a bad problem even worse. Add in a partner with erectile dysfunction and it’s not unusual for a woman to present to me not having had sex ...