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Mehmet Oz, MD, Cardiology, answeredIn your twenties and thirties, the vaginal walls are bathed in hormones, making them strong and robust. But as you enter your forties, hormone levels, namely estrogen, gradually start to decline. This causes the walls, which are comprised of mucous membranes (vaginal mucosa), to become less resilient and more susceptible to trauma. Inflammation or tears are more likely to occur, which can cause pain during sex.Helpful? 8 people found this helpful.