During menopause, a majority of women experience a slew of symptoms: hot flashes, night sweats, heart palpitations, interrupted sleep, and irritability—to name a few. While many women learn about these hormonal side effects before they arrive, board-certified OB/GYN Maria Sophocles, M.D., FACOG, NCMP, says one set of symptoms catches her patients off-guard the most: vaginal dryness and painful sex. And, they’re even more surprised by how long the symptoms can last.