Hormonal imbalance, specifically a low estrogen environment, plays a significant factor in pain during intercourse. Long term low dose estrogen birth control use and postmenopausal vaginal dryness due to lack of estrogen production from the ovaries causes thining of the vaginal tissue. Thining of this tissue exposes the nerve endings to the skin surface and senitive to friction and manipuation. Low estrogen levels also decrease the elasticity of the vaginal tissue and reduce the number of vaginal folds causing discomfort during penetration and decreased ability to accomodate the male sexual organ. Also prolonged lack of estrogen will result in reduction of nerve and blood supply to the clitoris which in turn reduce the pleasure response to stimulation.
Another signifcant effects of low estrogen levels on a women’s sex life is reduction in natural vaginal lubrication of the vagina due to decrease in blood flow to the vagina. Reduced lubrication causes vaginal dryness and discomfort and pain with penetration and during intercourse.
Treament of low hormonal levels leads to reduced pain and significant improvement in a women’s sex life. Initiating treatment before onset of these changes has the best results however these changes can be reversed with persistent and effective treatment.