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We had to repost this from our amazing colleague and former podcast guest ! All about Hormonally-Associated Provoked Vestibulodynia.

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Hormonally-Associated Provoked Vestibulodynia (Ha-PVD) describes pain at the entrance of the va**na (vulvar vestibule) due to irritation and dryness of the greater and lesser vestibular glands (the glands that produce our natural lubrication and keep this skin healthy). These glands can get red and irritated when there is a lack of estrogen and testosterone, coupled with someone having "weak" testosterone receptors that do not bind hormone well.

Here are some indicators that pain with insertion can be related to hormones and vestibular glands:

Menopause- average age of menopause is 51-52. In menopause, the ovaries decrease their production of estrogen and testosterone. This can lead to whole-body symptoms (hot flashes, night sweats), but also local va**nal symptoms (dryness, pain with in*******se, UTI). This is called Genitourinary Syndrome of Menopause (GSM), which is the newer term for vulvova**nal atrophy.

Peri-menopause- describes the fluctuation of s*x hormones that occurs in the 10 years leading up to menopause. Vaginal symptoms can occur during this time as well.

Oophorectomy- removal of the ovaries (which produce a bulk of the estrogen and testosterone) has similar effects to menopause, but more sudden.

Postpartum- estrogen levels are high in pregnancy and drop with delivery. Breastfeeding suppresses o***y function and keeps estrogen levels low in the postpartum period. This can lead to va**nal dryness and pain with in*******se.

Irregular menstrual periods- lack of menstrual period may be an indicator of low estrogen and testosterone, leading to symptoms similar as described above.

Anti-androgen medications- any medications (birth control pills, spironolactone) that lower testosterone or increase S*x Hormone Binding Globulin (SHBG) effectively decrease free, or working testosterone and can lead to va**nal dryness and pain with in*******se. Those with "weak" testosterone receptors are more likely to have these side effects.

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