Painful bleeding during intercourse after menopause may be caused by hormone reduction, atrophic vaginitis, trichomonas vaginitis and other diseases, and patients need to follow the doctor’s instructions for medication, general measures, and so on. 1. Hormone reduction: usually after menopause, estrogen levels in women’s bodies will gradually decline, and may also appear vaginal dryness, painful intercourse and other symptoms. When the symptoms of pain and bleeding occur during intercourse after menopause, patients can undergo hormone supplementation therapy, which mainly involves taking drugs such as estradiol valerate as prescribed by the doctor. 2. Atrophic vaginitis: patients can apply local estriol ointment or oral tibolone and other drugs to supplement estrogen. Also with local use of metronidazole, norfloxacin and other antibiotic treatment. At the same time, patients also need to develop good living and dietary habits to avoid recurrence of the disease. 3. Trichomonas vaginitis: when elderly patients suffer from trichomonas vaginitis, there will also be pain and bleeding in bed, accompanied by a lot of secretions, foamy and other symptoms, it is recommended that the use of metronidazole suppositories, tinidazole suppositories and other medications, sexual partners also need to be treated at the same time. Postmenopausal pain and bleeding in coitus, it is recommended that patients take targeted treatment under the guidance of the doctor, and do a good job of daily care, so as not to affect the normal sex life.