Hello, The most common reason for painful sex in women who have had a hysterectomy and/or gone through the menopause is insufficient lubrication. This can be caused by falling oestrogen levels or with a lack of foreplay and it’s important to remember that you need less foreplay the younger you are and more as you get older to stimulate the glands around the vagina which help to produce the lubrication necessary for sexual intercourse. Medication such as anti-depressants, anti-histamines and sedatives can also play a part in reducing the ability of the body to lubricate itself. The most common way of dealing with painful sex post hysterectomy that is caused by the menopause is with a low dose of HRT (hormone replacement therapy) inserted directly into the vagina. Non-hormonal vaginal products include vitamin E vaginal suppositories, lubricants such as Hyalofemme, Sylk or even natural oils such as grapeseed oil, coconut oil, sweet almond oil and sunflower oil. If you do decide to use oils make sure you go for an unprocessed organic produce where possible. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Prabhash Verma, General & Family Physician