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The Role of Hormones in Vulvodynia

Hormones play an integral role in many of the body's daily functions such as metabolism, reproduction, growth, mood and sexual health. They act as the body's chemical messengers and are responsible for regulating and controlling your body's development.

As with most things in life, too much of one thing is never good (same goes for too little!). Hormones are no exception. If the body produces too much or too little of a hormone it needs to function properly, it can lead to illness and cause can or amplify the symptoms of a pre-existing medical condition.

In this case, we are exploring the role that hormones play in vulvodynia. Vulvodynia is defined as chronic pain or discomfort around the opening of the vagina (vulva) that persists without an identifiable cause. Patients who suffer from vulvodynia often experience symptoms such as burning, soreness, stinging, rawness, pain with sex, throbbing, itching and may even notice some swelling.

There are two ways in which hormones can lead to vulvodynia. The first way is due to a decline in Estrogen during Perimenopause (the transition period to menopause).

Sexual responses, as well as genital pain, are modulated, in addition to neural pathways, by circulating levels of gonadal hormones. Therefore, low estrogen levels could lead to vulvodynia and dyspareunia. The decline in estrogen levels can occur naturally or be medically induced such as in the case of a hysterectomy. The most common cause of low estrogen levels in women is menopause. Other natural causes include anovulation secondary to lactation, anorexia, hypothalamic amenorrhea, hyperprolactinemia, and excessive physical activity or physiological stress. In this situation it is advisable to consult a MD who is well versed with vulvodynia and has an experience in hormone prescription which can greatly benefit and can aide with Pelvic Floor Physical Therapy treatment.

The second way hormones can play a role in vulvodynia is due to the use of hormonal contraceptives (birth control). Combined hormonal contraceptives lead to a reduction in serum estradiol and free testosterone by decreasing ovarian production of estrogen and total testosterone. This in turn can cause changes in the vulvar tissue, thus increasing its vulnerability to mechanical stress (gyno exams, tampon insertion, sex, etc.).

If you or someone you know is struggling with vulvodynia and wish to seek help or discuss treatment options, simply click the button below to contact us.


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About Dr. Bhavti Soni 

Founder & CEO, Pelvic Health Specialist

Dr. Soni is a pelvic health expert and has been practicing pelvic physical therapy since 12 years and has been a PT since 15 years. She has extensive education in pelvic health and has been  part of expert panels, global conferences and pelvic health courses where she teaches other Pelvic PTs.  She worked in New York City with leading pelvic pain specialists for 4 years before moving to NJ in 2018 to raise a family and started her own premier Pelvic PT practice. She lives with her husband and 3 year old son.

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