A Answers (3)
Mehmet Oz, MD, Cardiology, answeredReduced estrogen levels can cause shrinkage of the vaginal mucosa, which results in narrowing of the vaginal opening called the vestibule. This condition is called vaginal atrophy. In this case, pain can occur during initial penetration but often subsides once the penis is deeper inside. About 90% of vaginal pain occurs in the vestibule region.
Jan Shifren, MD, Obstetrics & Gynecology, answeredLower estrogen levels, typically after menopause, cause the vaginal lining to thin and secretions to diminish. The vagina also becomes shorter and less elastic, and the vaginal opening narrows. The result is often dryness and irritation, which can make intercourse or pelvic examinations painful or impossible. . This condition is known as atrophic vaginitis. Thinning of the vaginal lining combined with changes in the pH balance also can make the vagina vulnerable to infection. Urinary tract infections are more common as well, as the urethra also has estrogen receptors. If untreated, atrophy may lead to further thinning of the vaginal wall, narrowing of the vaginal opening, and even bleeding after intercourse.
Boston Women's Health Book Collective, answered
Vaginal atrophy (thinning of the skin of the vulva and vagina due to fluctuating or low estrogen levels) is a frequent cause of itching and irritation in women during the menopause transition and beyond.
Women who are in the menopause transition may notice vaginal dryness, irritation, or pain with intercourse as the very first sign of the transition. Since many women think that hot flashes are the first sign of menopause, we may not even think "menopause" or "perimenopause" when we begin to experience vaginal dryness. While some women with atrophy need treatment, most women with low estrogen levels have some degree of atrophy, but do not require treatment, especially if they are not having sex that includes vaginal penetration.