What hormonal changes cause dyspareunia?
Hormonal changes—especially falling oestrogen levels during menopause, after childbirth, or while breastfeeding—can cause dyspareunia due to thinning and dryness of vaginal tissues.
Detailed Medical Explanation
Low oestrogen can cause the vaginal lining to become thin, dry, and less elastic (atrophic vaginitis), making intercourse painful. These hormonal changes occur most commonly during the menopause transition, but can also affect women after childbirth or during breastfeeding. Some contraceptives and cancer treatments may also lower oestrogen and cause similar effects. NHS: Vaginal Dryness.
Clinical Context
Hormonal-related dyspareunia is particularly common in women aged 45 and above or those experiencing premature ovarian insufficiency. Identifying hormonal causes allows for targeted treatments, such as vaginal oestrogen.
Evidence-Based Approaches
NICE and British Menopause Society recommend oestrogen therapy for menopausal vaginal symptoms. Lifestyle changes and non-hormonal lubricants can also help. BMS Factsheet.