Let’s be honest, at our age, we’re no strangers to a few unexpected aches and pains. A twinge in the knee when we stand up too fast, a stiff back after gardening, or that mysterious click in the jaw that seems to have become a permanent feature. We often brush them off as the inevitable souvenirs of a life well-lived. But there’s one area where a new or unusual pain can stop us cold, filling us not just with discomfort, but with a deep, unsettling worry: during intimacy.
It’s a topic we often shy away from, even with our doctors. There’s a potent mix of embarrassment, fear, and the desire to believe it’s “nothing.” But when a sharp sting, a deep ache, or a burning sensation makes an appearance in the bedroom, it’s your body’s most direct way of waving a red flag. Ignoring it isn’t just a threat to your sex life; it can be a risk to your long-term health. So, let’s put embarrassment aside and talk plainly. That unusual pain could be a messenger, and its message could be that you’ve contracted an infection that needs attention.
First, let’s dismantle the myth that sexually transmitted infections (STIs) are only a concern for the young. Nothing could be further from the truth. In fact, rates of STIs among adults over 50 and 60 have been steadily climbing for years. Why? We’re part of the generation that redefined sexuality, and many of us are continuing to enjoy active sex lives well into our golden years. Furthermore, with divorce and dating later in life more common than ever, many of us are with new partners. But here’s the crucial part: after menopause, a woman’s body undergoes significant changes. The vaginal tissues become thinner, drier, and less elastic, making tiny tears during intercourse more likely. These micro-tears are like open doors for bacteria and viruses, making older women more susceptible to infections than their younger counterparts.
So, what exactly could that pain mean? Let’s break down the common culprits.
The Burning or Stinging Sensation: Could it be Chlamydia or Gonorrhea?
If you’re experiencing a burning or stinging sensation, particularly during urination or intercourse, your mind might jump to a urinary tract infection (UTI), and that’s a valid suspicion. But two common bacterial STIs, Chlamydia and Gonorrhea, often present in a very similar way.
- Chlamydia is often called the “silent” infection because it frequently has no symptoms at all. But when it does speak up, it’s often through a burning feeling when you urinate or a unusual discharge. For women, it can cause pain during sex and even bleeding between periods (or post-menopausal bleeding, which is an immediate signal to see a doctor). For men, it might include testicular pain or swelling.
- Gonorrhea can also cause a burning sensation during urination and increased discharge. What many don’t realize is that it can also cause a sore throat if you’ve had oral sex, or discomfort in the rectum if that’s a site of contact.
The reason these infections cause pain is inflammation. The bacteria irritate and inflame the delicate tissues of the urethra and cervix, turning a normally comfortable act into a painful one. The good news? Both are easily cured with antibiotics. But left untreated, they can lead to serious complications like Pelvic Inflammatory Disease (PID) in women, which can cause chronic pelvic pain and infertility, and epididymitis in men, a painful condition affecting the testicles.
The Painful Sores or Ulcers: The Sign of Herpes
Perhaps the pain isn’t a general burning, but a sharp, localized pain from a specific sore or a cluster of small, fluid-filled blisters. This is the classic, though often misunderstood, signature of the Herpes Simplex Virus (HSV).
It’s essential to know that herpes is a spectrum. Many people who have it experience such mild symptoms they mistake it for an ingrown hair or a pimple. For others, the first outbreak can be severe, with flu-like symptoms and painful sores that make any touch, let alone intercourse, unbearable.
The sores can appear on the genitals, anus, or thighs. The virus then retreats into the body’s nerve cells, where it can lie dormant for weeks, months, or even years before flaring up again. Stress, illness, or fatigue can trigger a recurrence. While there is no cure for herpes, antiviral medications are incredibly effective at managing outbreaks, reducing their frequency and severity, and lowering the risk of transmitting it to a partner. The pain is real, but the stigma is often worse. Knowing your status and talking to your doctor allows you to manage it effectively.
The Unusual Discharge and Discomfort: A Hint of Trichomoniasis
Often overlooked but surprisingly common is an infection called Trichomoniasis, or “Trich.” Caused by a microscopic parasite, it can cause a frothy, yellow-green vaginal discharge with a strong, often unpleasant odor. For women, this can be accompanied by itching, redness, and a burning sensation in the genitals, making sex painful. Men frequently have no symptoms, but they can experience irritation inside the penis, a slight discharge, or a burning feeling after urination or ejaculation.
Like the bacterial infections, Trich is curable with a specific type of antibiotic. The pain and discomfort it causes are direct results of the inflammation triggered by the parasite.
Beyond STIs: The Other Possibilities
While STIs are a critical possibility to rule out, it’s also true that not every pain points to an infection. As we age, other conditions come into play.
- Vaginal Atrophy: For women, the decline in estrogen during and after menopause leads to genitourinary syndrome of menopause (GSM). This can cause the vagina to become dry, thin, and inflamed, leading to pain, burning, and bleeding during intercourse. This is not an infection, but a hormonal change, and it’s highly treatable with topical estrogen therapies and lubricants.
- Prostatitis: For men, pain during or after ejaculation can be a sign of prostatitis, an inflammation of the prostate gland. This can be caused by a bacterial infection (which may or may not be sexually acquired) or by other factors.
- Musculoskeletal Pain: Let’s not forget our faithful companions—arthritis, bursitis, and old injuries. A new position or even the act itself can strain a hip, knee, or back, causing a very different, but very real, type of pain.
The Single Most Important Step: Talk to Your Doctor
Reading this might feel overwhelming, even frightening. But knowledge is not meant to scare us; it’s meant to empower us. The absolute worst thing you can do is to let fear or embarrassment keep you from taking action.
Schedule an appointment with your primary care physician or gynecologist/urologist. Be direct. You can say, “I’ve been experiencing a pain during sex that I’m concerned about. I’d like to be tested for STIs and explore other potential causes.”
A simple blood test, urine sample, or swab is all it takes. It’s confidential, it’s routine for doctors, and it’s the only way to move from a place of fear and uncertainty to a place of knowledge and control.
That unusual pain is not a verdict on your life or your choices. It is a signal, a piece of data from your body. By listening to it, and having the courage to investigate, you are taking a powerful step to protect your health, your peace of mind, and your ability to enjoy intimacy for years to come. Don’t let a moment of embarrassment compromise a lifetime of well-being.