Painful sex during perimenopause and menopause has a medical name — genitourinary syndrome of menopause (GSM) — and it is extremely common. It is also very treatable. You do not have to live with it, and you do not have to keep avoiding intimacy.

What is happening: falling oestrogen causes the vaginal and vulvar tissues to thin, lose elasticity, and produce less natural lubrication. The vaginal pH also shifts, making tissues more easily irritated. Sex that was comfortable before becomes painful — sometimes sharply so — and avoidance is a completely natural response to pain.

This is a physical, medical condition. It does not mean your relationship has a problem. It does not mean you are no longer attracted to your husband. It means your body’s hormonal environment has changed in a way that affects tissue health.

Treatment that works:

Vaginal oestrogen is the most effective treatment. Applied locally to the vaginal tissue (as a pessary, cream, or ring), it restores tissue health, lubrication, pH, and elasticity with very minimal systemic absorption. Vaginal oestrogen is available in India as a cream or pessary. Applied 2–3 times per week, results are typically noticeable within 4–8 weeks. This is separate from systemic HRT and is generally considered safe even for women who cannot use systemic HRT.

Lubricants help immediately: water-based lubricants for use during sex, and vaginal moisturisers for daily comfort, are available at pharmacies and online.

As for talking to your husband: you can say simply, “My hormones are causing physical changes that are making sex uncomfortable, and I’m seeing a gynaecologist about it.” That is enough. You don’t owe a detailed explanation; you just need him to understand it is physical, not emotional.