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 cause thinning of the vaginal tissue. Thining of this tissue exposes the nerve endings to the skin surface and sensitive to friction and manipulation. Low estrogen levels also decrease the elasticity of the vaginal tissue and reduce the number of vaginal folds causing discomfort during penetration and decreased the ability to accommodate the male sexual organ. Also, prolonged lack of estrogen will result in a reduction of nerve and blood supply to the clitoris which in turn reduce the pleasure response to stimulation.
Another significant effect of low estrogen levels on a woman’s sex life is a reduction in natural vaginal lubrication of the vagina due to a decrease in blood flow to the vagina. Reduced lubrication causes vaginal dryness and discomfort and pain with penetration and during intercourse.
Treatment of low hormonal levels leads to reduced pain and significant improvement in a women’s sex life. Initiating treatment before the onset of these changes has the best results however these changes can be reversed with persistent and effective treatment.