When Sex Hurts! Think Testosterone, Estrogen and the Pill??

When Sex Hurts! Think Testosterone, Estrogen and the Pill?
In young women on birth control pills sex hormone binding globulin may be increased creating a relative insufficiency of estrogen and testosterone, two hormones critical for the health of the tissue around the vaginal opening (vestibule). The medical term is called “Vestibulodynia.”

If you are a pre-menopausal women on the birth control pill and tense pelvic floor muscles, vaginal infections, and skin infections around the vagina have been ruled out bring this to the attention of your doctor. The solution may be getting off the oral contraceptives and being placed on a combination estradiol (.03%) and testosterone (.01%) applied to the vestibular area twice daily.Free testosterone and estradiol levels should be taken along with sex hormone binding globulin. With stopping of the birth control pill and applying topical testosterone and estradiol as outline in Drs. Burrow’s and Goldstein’s article symptoms may improve. Post menopausal women may also   benefit with testosterone and estradiol topical application around the vagina and intravaginally and not only sexual pain might improve but the strength and moistness of he vaginal tissue, sexual desire and urinary “stress” incontinence many times is reduced or eliminated. Other Things You Can Do!
– Don’t eat sugar, processed carbohydrates, all dairy foods, glutinous grains (wheat mainly, all baked goods)  eggs, coffee for 1 month at least.
– Take a good probiotic – Culturelle 2/d; VSL#3 2/d.
– Take vitamin D 5000 IU/d and have your blood level checked in a month

Make sure you see your gynecologist or physician who deals with female issues and bring them each of the reference materials below and ask them if testosterone and/or estrogen insufficiency could be aggravating your  pain.


– The Treatment of Vestibulodynia with Topical Estradiol and Testosterone (full article)

The Effect of Combined oral Contraception on Testosterone Levels in Healthy Women: A Systemic Review and Meta-Analysis (abstract)

When Sex Hurts (book)

International Society for the Study of Women’s Sexual Health

Be and Stay Well,

You can call Kirk for brief health and medical questions at Health Associates Medical Group where he works at (916)489-4400 Monday thru Friday 8-9:00 a.m. PST.

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