When Sex Starts to Hurt After 50: Why “Sandpaper Sex” Happens and How to Heal It Without Shame

If you’ve started flinching when your partner reaches for you—not because you don’t love them, but because sex has started to hurt—this episode may save your intimacy.

Painful sex after 50 isn’t rare. And it’s not “just menopause.” But it is something most women were never warned about.

In this episode of Sexy After 50, I name the experience so many women silently endure: “sandpaper sex." Burning. Dryness. Pain. Avoidance. Shame.

I explain what’s actually happening in your body, including:

• Genitourinary Syndrome of Menopause (GSM) and why it affects up to 50% of women
• Why estrogen alone is not the full answer—and where testosterone fits in
• How chronic stress and a guarded nervous system amplify physical pain
• Why “just use more lube” fails most women over 50

This is women’s health and intimacy education without dismissal, embarrassment, or minimizing your experience.

You’ll also hear a real client story that shows what becomes possible when:

• Pain is taken seriously
• Penetration pressure is removed
• The nervous system is allowed to feel safe again

I introduce The Silk Road, a somatic, non-penetrative intimacy practice that helps retrain the body away from pain and toward pleasure—without forcing desire or overriding your body’s signals.

Because your body isn’t rejecting intimacy. It’s protecting itself.

If sex has become painful, avoidant, or emotionally loaded, this episode gives you a new path forward—one rooted in safety, consent, and healing.Listen now.
Share this with a woman who needs language for what she’s experiencing.
And remember: You are allowed to feel good.

I’m Dr. Juls and this is Sexy After 50.
We don’t normalize suffering here.
We restore pleasure.

Sexy After 50 is a podcast for women over 50 navigating low libido, painful sex, intimacy struggles, sexless marriage, hormonal changes, vaginal dryness, feeling disconnected or unwanted, and loss of desire—using nervous-system–based somatic healing, women’s health education, feminine energy reconnection, and sexual healing to restore pleasure, emotional connection, and confidence.

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Contact Dr. Juls. - info@juliemerrimanphd.com

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Transcript

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If you've started flinching, when your partner reaches for you, not because you don't love them, but because your body has started screaming no before, your brain can say, yes, this episode might save your sex life and possibly your relationship. Sexy after 50, improve sex and intimacy by healing your nervous system so you finally feel turned on and coughed in. Again, I'm Dr. Jules and we're waking up but never left desiring and fire. Listen, I know this topic is uncomfortable. But there are three reasons you need to stay with me for the next 28 minutes until the very end one. I'm gonna tell you the medical term your doctor probably didn't use GSM and share brand new 2024 research proving that testosterone, not just estrogen, is the missing piece of the puzzle. Two, I'm teaching you about your root chakra, the energy center that governs whether your body feels safe enough to experience pleasure. And three, I'm giving you a practice called the Silk Road of full body pleasure exploration you can do with a partner or solo that completely removes penetration from the equation. Because here's the secret, your body doesn't need more pressure. It needs permission. So girl, grab your coffee, silence your phone, and let's talk about the thing that's been making you wince because you deserve better than sandpaper. Well, I wanna start by telling you something that a client, highly educated well. Sophisticated woman shared with me recently. I need to tell you something that a client recently shared with me, and bear in mind, this is a very sophisticated woman. She said she was in bed with her partner and for the first time in her adult life, she said, stop. I can't, it hurts too much. And then bless her heart, she cried. And it wasn't really because she was sad. Well, no, that wasn't it at all. It's'cause she was terrified. You have to understand this client is a sex therapist and felt like she was supposed to have this stuff figured out. Yet there she was over 50 lying in bed in the dark, wondering if this was it. If her body. Had just, well shut down for good. If you've ever had that moment, that split second where you think, huh, is this just my life now? I see you because painful sex in midlife doesn't announce itself. It creeps up on you first. It's just a little friction. Maybe I need more lube. Then it's burning. Maybe I'm not turned on enough. Then it's actual pain, and you start going to bed earlier or later and you develop mysterious headaches and you become fluent at deflection. And deep down, you start to believe that your femininity dried up along with your tissues. Okay girl. What's happening to you? Has a name and it's an awful genital urinary syndrome. Of menopause. GSM, which is a terrible name. I know it sounds like something you'd catch on a discount cruise, but it's real, it's physical and it affects up to 50% of postmenopausal women. So let me break down what's actually happening. When your estrogen level drops during perimenopause and menopause, your vaginal. Your vaginal tissues, those beautiful stretchy self lubricating tissues start to thin out and they lose elasticity. The medical term is a trophy. Imagine the soft, moist lining inside your cheek. Now imagine that lining turning into tissue paper. Thin, fragile, dry. That's what's happening to your vagina walls. Of course. Friction hurts. My God. Of course it does. Course penetration feels impossible, and it's not anything you've done wrong. It's just a biological reality, and I think if you're anything like me, this is gonna piss you off. Only about 25% of women who experience GSM. Ever seek treatment. Why? I mean it, it's probably because they're embarrassed. You know? We think it's just part of aging because our doctors, when you do mention it, say things like, oh, well that's normal at your age and hand you a sample pack of lube. I want you to get angry about that because normal doesn't mean acceptable. Common doesn't mean inevitable. You wouldn't accept chronic pain in your knee without treatment. Why the hell would you accept it in your vagina? Now here's the research that really makes things interesting. A 2024 study published in Menopause, the journal. Of the North American Menopause Society found something shocking. GSM isn't just about estrogen. It's also about testosterone, which also drops at menopause and plays a critical role in your vaginal tissue health, blood flow, nerve sensitivity, and arousal. So women with load testone experience more severe vaginal, a trophy, more pain during sex, lower genital sensation, and decreased natural lubrication. Your vagina is not a one hormone show. So when your doctor runs labs and says, well, your estrogen is fine, they're only looking at half the picture. So let's dig in a bit more and explore why lube isn't fixing it. I think that's the biggest mistake I see smart, capable, highly intelligent women making when dealing with painful sex. Thinking that slapping on some lube right before intercourse is gonna solve the problem, but I want you to listen to me very carefully. Lube is for the event, moisturizer is for maintenance. Here's an analogy that changed everything for one of my sweet clients. If your face is chronically dry and cracked, you don't just splash water on it right before you take a selfie and call it good, right? Hell no. You use high quality daily moisturizer to repair skin barrier all the time. Your vaginal tissue deserves the same, probably actually more care than your face. Because unlike your face, your vaginal tissue is supposed to lubricate, stretch, and accommodate friction. So here's your four part protocol. Part one, daily vaginal moisturizer, not lube moisturizer. You need to use it two to three times per week, whether or not you're having sex. You need to look for products with hyaluronic acid.'cause this molecule holds 1000 times its weight and water. I mean, it's magic. It needs to have vitamin E and lactic acid that's gonna help maintain a healthy pH. Specific products I recommend Reverie. It's a hyaluronic acid suppository replens, long lasting vaginal moisturizer, or good clean love, restore moisturizing vaginal gel. Ladies, these are designed to hydrate and repair tissue over time, not just provide a temporary slip. And part two, high quality lubricant. Part two, high quality lubricant for sexual activity. Water-based. Go with water-based if you're using toys or condoms. Try like liquid or uber lube. Those are good. You wanna go with silicone-based or wet platinum. A good sex store can guide you to these lubes as well. Oil-based. If you're not using latex and want something natural, organic, coconut oil is gonna work great, but you wanna avoid. Anything with glycerin'cause that Fiji yeast, parabens, warming sensations or fragrance girl, your vagina is not a bath and body works candle. So we wanna keep it as organic and natural as possible. In part three, there's vaginal estrogen therapy and. This is where women get scared because of all the HRT fear mongering from the early two thousands. But remember, it's recently been taken off the black list, and I wanna be crystal clear. Local vaginal, estrogen cream, tablets, or rings, stay local. They do not enter bloodstream in significant amounts. Think of it like this. It's like watering your garden exactly where it's dry. You're not flooding the entire neighborhood. Right? A 2023 systematic review in JAMA Internal Medicine, y'all. It looked at thousands of women and confirmed. Vaginal estrogen is safe, effective, and does not increase your risk of breast cancer, blood clots, stroke, or heart disease. It's literally just giving your tissues what they're missing. You've got options that include an estradiol cream, estradiol tablets, or an estradiol ring, and here's the game changer. For some women, adding a low dose to Testone cream applied to the vulva can improve sensation, blood flow, and arousal. This is not commonly prescribed, but research shows it works. And as the podcast progresses, y'all, I'm gonna have experts on here. Who are gonna talk to y'all in depth about these things. I just need you to know that you need a menopause informed doctor for this, and I'm gonna have them on this podcast. You don't go to just any old gynecologist. You need someone who specializes in menopause medicine and there's excellent ways to find one. You can go to menopause.org. Or like I said, I'm gonna have some folks on this podcast and I'm sure they will have some ideas for you as well. So, part four, the use it or lose it principle. So blood keeps flow. So part four, the use it or lose it Principle, blood flow keeps tissues healthy. Gentle stimulation, whether that's through self pleasure, pelvic floor therapy, or even just external massage helps maintain tissue elasticity. The more you completely avoid the area, the faster atrophy sets in and progresses. But here's the critical distinction. Use it does not have to mean penetration. It means blood flow, touch, sensation, aliveness, and that's exactly what we're going to practice. But first I wanna tell you about Renata. Renata walked in to my office at 59 years old. She was again, impeccably dressed, blazer, heels, the kind of woman who commands a room. But when she sat down, her whole body crumpled and she said, I haven't had sex with my husband in 14 months. Not because I don't love him, not because I don't want to, but because I hurt so badly. I cry, and she paused. Then she said, the thing y'all that broke my heart, I feel like I'm failing him. I feel like I'm not a real woman anymore, and let me stop right here and say this. If you ever felt like you're failing someone because your body hurts during sex, that is not on you, that is on a medical system that failed to educate you in a culture. That taught you your value is tied to sexual availability. Now, y'all, Renata had tried seemingly everything, more lube didn't work, relaxing, impossible when you're anticipating pain. Glass of wine before sex just made her dizzy and in pain. When I asked if she talked to her doctor. She said that he told me it's normal at my age and to just use more lube. It's not right. Makes me angry. This has gotta change y'all. Here's what we did. Instead, I sent her to a menopause specialist. I have a great one. Of course. I'm in Texas. Mine is in Fort Worth. But absolutely an amazing specialist. Her specialist prescribed vaginal estro, estradiol, which I know I'm slaughtering these words. I'm doing the best I can. Um, tablets twice a week, within three weeks, she reported the tissues feel less angry. It's like they're not screaming at me anymore. I mean, what a win. Step two. We added the hyaluronic acid vaginal moisturizer every other night. Step three, and this is the part that changed everything. We took penetration completely off the table for six weeks, full stop, not allowed, banned. She looked at me like I had lost my flipping mind, but. Won't that make it worse? Will I lose him? I mean, that really scared her. And I said, no. What you're going to do is take the pressure off your nervous system so it can stop bracing for pain for, so here's what they did. For six weeks, she and her husband explored intimacy in every other way. Oral, manual stimulation, toys, full body massage. Sin sensation play, zero penetration. And guess what happened? The pressure disappeared. Her body stop clenching in anticipation of pain. Her nervous system learned touch can be saved. Intimacy doesn't have to hurt when they eventually tried penetration again. Slowly with generous amounts of lube and zero expectation, it didn't hurt. And she texted me after I forgot what this felt like, this tear me up. Um, I forgot. I could feel good. I mean, how amazing is that? And then. I am sorry y'all. That's really tearing me up. Hmm. And then she told me something. Well, it made me cry. It's making me cry now. I forgot I was allowed to feel good. Hmm. Let me say that again for everyone in the back. You are allowed to feel good. Your pleasure matters. Your comfort matters. Your body deserves care. Okay. Oh, I'm sorry that. But I mean that I'm passionate about this. Now let's talk about why Renato's nervous system was bracing for pain in the first place. And y'all, this all comes down to your root chakra, this energy center located at the base of your spine and pelvic floor governed safety, grounding, physical foundation, survival instincts, and trust in your body. When and if your root chakra is open and balanced, man, you're gonna feel safe in your body. Grounded and present, trusting of physical sensations connected to pleasure, but when it's blocked or depleted, you're not gonna feel safe in your own skin. You're gonna feel very disconnected from physical sensation. You're gonna be anxious, ungrounded, ungrounded, that floating business. And it's gonna be like you just can't trust your body to support you. Does any of that sound familiar? Here's what happens when sex becomes painful, your nervous system learns this activity equals pain, and pain is a survival signal. Your body's job is to protect you from pain. So your root chakra, your body's safety center. Starts guarding the gates. Before touch even happens. Your pelvic floor tightens, your breath gets shallow, your mind dissociates and your body braces. It's not conscious, it's protective. Your root chakra is essentially saying, we are not safe here. Lock it down, and once that pattern is set. It doesn't matter how much you want to want sex. Your nervous system has veto power. It's got the veto power, man. Oh, but here is the good news. You can reestablish your root chakra. But here's the good news. You can reestablish safety in your root chakra. Through grounding practices, intentional breath touch, that has nothing to do with penetration or performance. See, when you reconnect with your root chakra, you are telling your body, sweet body, you are safe, you are supported, you are allowed to feel pleasure again, and that is what allows desire to return. Okay. Not from force, but from trust. Okay. Big deep breath. We're gonna move into your practice. And again, it's called the Silk Road. Just envision that. Oh, it's beautiful. This is a sensual full body exploration that completely removes penetration from the equation. You can do this with a partner or solo with a toy. The non-negotiable rule, the vagina is off limits. Revolutionary, right? But it's here. But here's why this works. You're nervous system needs to learn that intimacy doesn't automatically equal pain. That touch can feel good. And that your body is safe to inhabit. So here's the setup with a partner. You're going to take turns being the receiver and the giver. The receiver's only job notice and receive. No performing, no reciprocating, just feeling the giver's job. Explore and pleasure without any expectation of penetration or finishing solo. You're going to use your hands, a vibrator or massage oil to explore your own body everywhere except the vagina. So you set the scene, you dim the lights, you put on some music you love. Nice warm room, lock the door and start the practice. I need you to think of your body as a landscape. You're traveling the scenic route, not the highway. You stop. Stop one. The scalp and neck. About three to five minutes. Start here. Slow, intentional touch fingertips, running through hair, gentle scalp massage, using circular gentle scalp massage using circular motions, light pressure on the neck and shoulders. Why this works. The scalp and neck are incredibly sensitive and often neglected. This activates your parasympathetic nervous system, your center of rest and relaxation, and immediately signals safety to your body. Notice what sensations arise. Tingling, relaxation, goosebumps. Just notice. Be curious. No judgment. Stop. Two the arms and hands, two to three minutes. Move slowly down the arms. Trace the inner forearm. Trace the inner forearm, which is surprisingly an erotic zone. Massage the hands, fingers, wrists, pro tip, use oil or lotion. The glide creates a completely different sensation than dry touch. I highly recommend warmed coconut oil or a body safe massage oil. And notice, does one arm feel more sensitive than the other? Do you want more pressure or less? Your body will tell you if you listen and stop three the chest breasts. And belly five to seven minutes. This is where you can introduce more intentional pleasure. Breasts, nipples and the belly are packed with nerve endings, so use hands, lips, or vibrator on the lowest setting. Not to turn yourself on, but just to explore sensation, let sounds come out. Size, hums, moans. Let your body express. What it's feeling, why sound matters? Vocalization activate your vagus nerve, which signals to your nervous system that you're safe and allowed to experience. Pleasure, and then stop four your thighs and feet about three to five minutes. Inner thighs are a gold mine of sensitivity and so are feet if that happens to be your thing. Slow teasing touch. The key is to build sensation and arousal without heading straight for the genitals. You're teaching your nervous system. That pleasure can exist in your whole body, not just your genitals, and you're expanding your, and you're expanding your erotic map. And then stop five. The external vulva and clitoris. This is optional, but if you do about five to seven minutes, and this is only if you feel ready and I mean genuinely ready, not I should be ready. You can explore external touch. Use the high quality lubricant or oil touch, the clitoris, the labia, the per perineum. All externally, zero pressure to go inside. You can use fingers with lube, a vibrator, try the dame palm or the wee vibe tango. A partner's mouth the rule. If at any point it starts to hurt or feel uncomfortable, you stop. No pushing through, no trying to make it work. No, it'll get better once I'm turned on. Pain is information. Listen to it. Then there's the debrief. After your Silk Road journey, you take a moment and you ask yourself or share with your partner, where did pleasure surprise me? Where did I feel the most alive? Where did I feel numb or disconnected? What did I learn about my body's capacity for pleasure? Outside of penetration, I want you to write this down. I want you to track it. You need to notice patterns. See, you're grounding your root chakra. By reestablishing safety and trust in your body, you're proving to your nervous system. That touch doesn't have to lead to pain. You're expanding your pleasure beyond penetration. A study in 2023 in the Journal of Sexual Medicine found that women who engage in regular non-penetrating sexual activities reported 42% over overall sexual se reported 42% higher overall sexual status. God reported 42% higher overall sexual satisfaction, significantly lower pain scores, greater body confidence, and more orgasms. Yes. Really you are retraining your nervous system to associate touch with pleasure instead of pain. And here's the beautiful part. Once you've done this practice multiple times, penetration might start to feel less scary. Not because you forced it, but because your body learned. Touch is safe pleasures, touch is safe. Pleasure is allowed. I don't have to brace. Okay, let's bring this home. Here's what we covered today. GSM is real, physical and treatable. It affects up to 50% of postmenopausal women. It's tissue atrophy caused by low estrogen and low testosterone. Research from 2024 proves testosterone matters more than we thought. This is not something you just live with. Second, you need a four part protocol, not just lube. You need a four part protocol, not just lube, daily vaginal moisturizer, high quality lubricant, local estrogen, and possibly testosterone therapy. And gentle, regular blood flow to the area. Talk to a menopause informed doctor. Use the find provi. Use the find a Provider tool@menopause.org or continue listening to this podcast. I'm gonna get you some on here. And third, your root chakra must feel safe before pleasure can return. Girl, when sex becomes painful, your nervous system. Learns to guard against touch. The Silk Road practice helps you rebuild trust, expand your pleasure, map beyond penetration and prove to your body that intimacy can feel good again. Here's what I want you to do. Write. Now step one, if you're experiencing painful step, step one. If you're experiencing painful sex, make an appointment with a menopause specialist this week, not next month, this week, order a vaginal moisturizer, two day. Start using it tonight. Try the Silk Road practice this weekend, solo, or with a partner. Give yourself permission to explore pleasure without penetration, and here's what I need you to hear. Your beautiful body is not failing you. The medical system failed you, but not preparing you for this. Your pleasure matters. Your comfort matters. You are allowed to feel good. Do not settle for sandpaper when you deserve silk. I am Dr. Jules, and I'll see you next week. Is your body saying yes. This is what I've been needing to hear. Download the Desire and Fire reset while that spark is still flick. It's free and it's the exact nervous system practice that brings sex and intimacy back from shutdown. The link is in the show notes. Your fire never left. Let's wake it up.