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Glossary

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Androgens: Male sex hormones. Androgens are produced mainly in the testes. Testosterone is the most important androgen produced by the body. Androgens regulate the male reproductive functions, the development of the male sexual characteristics and have general effects on metabolism. Women also produce small amounts of androgens. 

Anemia: Condition in which the oxygen-carrying blood pigment (hemoglobin) and/or the number of red blood cells (erythrocytes) is diminished. 

Antiandrogens: Antihormones. Synthetic inhibitors (antagonists) of androgens. Some antiandrogens are progestins with additional antiandrogenic effects. Antiandrogens are used for the treatment of acne or hirsutism, for example. Some preparations for hormone replacement therapy contain antiandrogens. 

Arteriosclerosis: Group of arterial diseases that cause thickening and hardening of the arteries. The development of raised patches of fibrous and fatty tissue on the inside walls of the blood vessels leads to narrowing of the arteries. The resulting impairment of blood flow can have serious consequences such as coronary artery disease or stroke. 

Atrophy: Shrinking of tissues/organs which is caused by an inadequate supply of blood or nutrients or lack of use. 

Autonomic nervous system: Vegetative nervous system. Nervous system that regulates the body's vital functions (e.g. digestion, body temperature, respiration) and is not subject to direct voluntary control.

Barrier methods of contraception: barrier methods of contraception prevent sperm from entering the uterus. Some, but not all, barrier methods provide protection against sexually transmitted diseases. The different types of barrier methods of contraception include: the diaphragm, cervical cap, male condom, female condom and the vaginal spermicides.

Birth Control: Family planning, birth control. Measures taken to prevent fertilization of the ovum or implantation of the fertilized ovum in the uterine lining (endometrium). 

Birth control pill: also known as “oral contraceptive,” is one of the most effective reversible methods of birth control. Oral contraceptives contain hormones that prevent the ovaries from releasing an egg. Without the presence of an egg, conception cannot take place. 

Bilateral oophorectomy: an oophorectomy is surgery to remove one or both ovaries; a bilateral oophorectomy involves the removal of both ovaries. 

Bone mineral density (BMD): the amount of mineral (mostly calcium) present in bone. In general, the more BMD, the stronger the bones. 

Bone mineral density tests: use X-ray, photon-beam (light particles), ultrasound and computer-imaging technology to detect osteoporosis at various sites in the skeleton.

Calcitonin: a hormone produced by the parathyroid, thyroid and thymus glands and responsible for increasing the amount of calcium and phosphate deposited on bones.

Carcinoma: Cancer, malignant growth or tumor.

Cardiovascular Disease: describes a group of diseases related to the heart and arteries, including coronary artery disease, stroke, hypertension (high blood pressure), and peripheral vascular disease (atherosclerosis or "hardening of the arteries").

Cerebral: related to the brain.

Cervix: The neck of the uterus. The narrow portion at the lower end of the uterus. The end which opens into the vagina is called the external os, the end which opens into the uterus the internal os. The cervix is sealed with a plug of thick mucus which only becomes thin and permeable for sperm around the time of ovulation. 

Cholesterol: An important building block of the body. It is a component of the cell membrane, a starting substance for the formation of hormones and vitamins and for the production of bile acid. Cholesterol is not soluble in the blood. For transportation through the body it is therefore provided with a water-soluble coat – the so-called lipoproteins. There are various different types of lipoprotein which have different functions. LDL (low density lipoprotein) has the task of supplying the organism with cholesterol. It carries the cholesterol to the blood vessels where it is needed for building the cell walls, for example. HDL (high density lipoprotein) carries the cholesterol from the blood vessels to the liver where it is broken down. HDL is therefore considered a protective factor against arteriosclerosis (hardening of the arteries). Estrogens increase the "good" HDL cholesterol and lower LDL cholesterol.

Climacteric: it is a period of life around the menopause, which is characterized by the declining levels of sex hormones. It includes the premenopausal and the early postmenopausal period.

Combined therapy: In hormone replacement therapy, treatment with both an estrogen and a progestin. The estrogen is given to treat menopausal symptoms and to prevent and treat long-term effects of the estrogen deficiency (such as osteoporosis). The progestin prevents excessive growth of the uterine lining (endometrium) under the influence of the estrogen.

Combined birth control pill: contains an estrogen and a progestogen that prevent pregnancy by inhibiting ovulation. Of the oral contraceptives, women use the combined pills most often.

Constipation:  abnormally delayed or infrequent passage of usually dry hardened feces.

Contraceptives (contraception): a method for preventing pregnancy. This may be done with a medication, device, or by blocking a process of reproduction. Types of contraception include: the cervical cap, condom (male and female), contraceptive diaphragm, implants, injection, Intra-uterine Device (IUD), Intra-uterine System (IUS), natural family planning (“rhythm”) method, oral contraceptives, spermicide, and sterilization. 

Contraindication: A condition or circumstance (e.g. history of a particular illness) in which use of a certain drug or medical procedure is not allowed or not advisable. 

Corpus luteum: "Yellow body". Structure formed in the ovary from the remaining cells of the follicle after ovulation. The corpus luteum produces the female sex hormone progesterone.

Cytology: The microscopic examination of individual cells from body fluids or tissue scrapings. The examination makes it possible to distinguish between benign and malignant changes.

Cytotoxic drugs: Drugs that inhibit the growth of malignant tumors.

Dual-energy X-ray absorptiometry (DEXA): a bone mineral density test used to diagnose osteoporosis. Regarded as one of the most effective imaging tests for bone density, DEXA can detect bone loss with a precision of 2 - 4 % in the spine, hip and total body. 

Dysmenorrea: menstrual pain.

Dyspareunia: pain during sexual intercourse.

Dysuria: pain during urination.

Endometrial hyperplasia: an overgrowth in the uterine lining (endometrium). It can cause abnormal menstrual bleeding and can become precancerous. 

Endometriosis: Gynecological disorder in which endometrium (uterine lining) grows outside the uterine cavity (e.g. in the fallopian tubes, ovaries or abdominal cavity). The disorder can not only lead to severe pelvic pain but can also produce infertility. 

Endometrium: The lining of the inside of the uterus. In each monthly cycle the endometrium thickens to prepare itself for implantation of a fertilized ovum. If fertilization does not take place, the surface layer of the endometrium is shed during menstruation. 

Estradiol: The most potent natural estrogen. Estradiol is produced particularly in the maturing ovarian follicles during the reproductive phase of a woman’s life. 

Estrogen monotherapy: (Estrogen Replacement Therapy - ERT) Form of hormone replacement therapy (e.g. for treatment of menopausal symptoms or prevention or treatment of osteoporosis) in which estrogen is administered alone without the simultaneous administration of a progestin. Estrogen monotherapy is only suitable for women who have had a hysterectomy. For woman with an intact uterus, a progestin is added (Combined Therapy). 

Estrogens: Estrogen hormones. Female sex hormones. The most important estrogens produced by the body are estradiol, estrone and estriol. During the reproductive years estrogens are produced mainly by the maturing ovarian follicles. They are responsible for development of the female sexual characteristics and regulate the female reproductive functions together with progesterone. Estrogens also have important effects on organs outside the reproductive system. They help the body to build up bone mass. They have a positive influence on blood fat and, thus, prevent arteriosclerosis which can later lead to heart disease. In addition, they have a positive influence on general well-being, support the immune system and preserve the elasticity of the skin. After menopause only small amounts of estrogen are produced, particularly the weaker estrone. This is produced primarily in the adrenal cortex and in the fatty tissue. The estrogen deficiency can lead to menopausal symptoms and severe disorders such as osteoporosis.

Fallopian tubes: Female reproductive organ. The fallopian tubes take up the mature ovum after ovulation and carry it to the uterus. The fallopian tubes are the site of fertilization. 

Fertility: The ability to produce children. In women fertility begins with the menarche and ends with the menopause. In men, fertility lasts from the first spontaneous ejaculation up to an advanced age (with wide individual differences). 

Fibroid: a noncancerous growth of the smooth muscle on the uterus. It appears firm, round, and gray-white. Multiple growths of this kind develop most often in the wall of the uterus. They usually occur in women between 30 and 50 years of age.  

Fluctuations in sexual desire (loss of libido): for some women the loss is so great that they actually find sex repulsive, in much the same way as they felt before puberty. What hormones give, loss of hormones can take away. See also vaginal atrophy.

Follicle: Structure in the ovary consisting of the ovum surrounded by a group of cells. The maturing follicles produce estrogens.

FSH, Follicle Stimulating Hormone: a hormone secreted by the pituitary gland that stimulates - among other effects - the release of estrogens by the ovaries. 

FSH test: a test to determine the blood level of follicle stimulating hormone (FSH). 

Genital tract (Uterus): Reproductive system. Term referring to all internal and external sex organs in men and women. 

Gonads: Sex glands. In women the ovaries, in men the testes.

Gonadotrophins: a collective term for follicle stimulating hormone (FSH) and lutenising hormone (LH).

Hirsutism: Development of male-pattern hair growth in women. Caused chiefly by increased production of male sex hormones (androgens). 

Hormonal contraception: The most effective reversible (non-permanent) method of birth control. Hormonal contraceptives are available as pills (oral contraceptives), as one-month or three-month injections, as implants or as intrauterine system (IUS). 

Hormone replacement therapy (HRT): The use of hormone preparations to treat hormone deficiency states. In women, the administration of estrogens (usually in combination with progestins, combined therapy) for the treatment of menopausal symptoms and for the prevention and treatment of the late consequences of the hormone deficit (e.g. osteoporosis). 

Hormones: Chemical messengers, produced by the body or synthetically, which transmit information between cells (or between the components of a cell) and regulate metabolic functions in their target cells. Many hormones can be produced synthetically and used as drugs. 

Hot flush/Hot flash: Unpleasant, temporary sensation of heat in the skin, particularly in the upper part of the body. The face becomes flushed and sweating may occur. The duration and frequency of hot flushes can vary considerably: from a few seconds to as long as 30 minutes, from several times an hour to only a few times in a month. The hot flushes are often accompanied by a racing pulse. As they frequently occur at night, affected women complain of sleep disturbances. Hot flushes are caused by the menopausal estrogen deficit. 

Human Papilloma Virus (HPV): Wart virus. Viruses that cause benign tumors of the skin and mucous membranes. Some types of HPV are transmitted particularly by sexual intercourse and are held responsible for the development of cervical cancer.

Hypoestrogenism (hypoestrogenemia): lower than normal estrogen levels, as in menopause. 

Hysterectomy: Surgical removal of the uterus. If the ovaries are removed during a hysterectomy as well, the women will experience a sudden loss of the hormone estrogen. This abrupt loss of estrogen is also known as “surgical menopause”. The estrogen deficiency can cause menopausal symptoms and can lead to osteoporosis.

Hysterectomy with oophorectomy: surgery that removes the uterus and one or both ovaries. 

Incontinence: involuntary leaking of urine such as when coughing or sneezing. It is correlated with the decline of estrogens levels and reflects a general loss of smooth muscle tone.

Indication: A condition or circumstance in which the use of a certain drug, treatment or diagnostic procedure is necessary or advisable.

Induced Menopause: is a menopause due to one of a number of medical interventions. Surgically removing both ovaries (bilateral oophorectomy) before natural menopause causes surgical menopause. Induced menopause can also occur if the ovaries are rendered inactive by pelvic radiation, chemotherapy, or certain other drugs. Due to their abrupt loss of ovarian hormones, women who experience induced menopause are more likely to have a sudden onset of hot flashes and other menopause-related disturbances such as a dry vagina. These women, as well as women who experience early natural menopause (before age 40) or prolonged time without menstrual periods due to excessive exercising or dieting, may be at greater risk later in life for health problems such as osteoporosis (thinning of bones) and heart disease since they spend more years without the protective effect of estrogen. A woman who has a hysterectomy (uterus removed but not the ovaries) prior to experiencing natural menopause usually continues to produce hormones and thus will not experience surgical menopause. However, sometimes removal of the uterus may interrupt the blood supply to the ovaries. In this unusual circumstance, a woman may experience earlier menopause-related changes.

Injection: Administration of a drug into a muscle, the bloodstream or under the skin. One of the routes used for administering hormones for hormonal contraception or hormone replacement therapy. In these cases, small amounts of hormone are continuously released into the bloodstream from a hormone depot injected into a muscle of the upper arm or buttock. 

Intermenstrual bleeding: Bleeding between two menstrual periods.

Intrauterine device (IUD): Formerly also called "coil". Method of contraception in which a usually T-shaped plastic device is placed in the uterine cavity.

Intrauterine system (IUS): Method of hormonal contraception in which a T-shaped intrauterine device is placed in the uterine cavity where it continuously releases small amounts of hormone. The IUS is also used for the treatment of excessively heavy and painful periods.

Laparoscopy: Procedure for direct inspection of the abdominal organs using a rod-shaped optical instrument (laparoscope). 

Libido: Sexual desire. 

Lipids: any of the various fats or fatlike substances; they are stored in the body and serve as an energy reserve but may be elevated in certain diseases. Kinds of lipids include cholesterol, fatty acids, neutral fat, and triglycerides. 

Low-dose birth control pill or low-dose oral contraceptive: generally, oral contraceptives containing 30 or 35 micrograms of estrogen per pill. There is now a new generation of oral contraceptives that contain 20 micrograms of ethinylestradiol per pill. 

Luteinizing hormone (LH): a hormone that stimulates the release (ovulation) of an egg cell from the ovary. 

Mammography: mammography is a special type of x-ray imaging used to create detailed images of the breast. An x-ray of the breast.

Mastectomy: surgery to remove the breast.

Menarche: first menstruation.

Menopausal symptoms: Typical physical symptoms; hot flashes, night sweats, palpitations, sleep problems and vaginal dryness which occur during menopause and are caused by hormone-related dysregulation of the autonomic nervous system. Many women also suffer from emotional problems during this time.

Menopause: Change of life; Climacteric. Strictly speaking the term menopause means the cessation of menstruation (“last menstruation”). However, it is commonly used to refer to the period in a woman's life when she passes out of her reproductive years. Menopause usually begins between the ages of 45 and 50 as the ovaries gradually cease to function. The number of follicles in the ovaries decreases. Production of the female sex hormones diminishes. The phase of fertility ends with the last menstruation which usually occurs around the age of 52. Doctors divide the menopause or climacteric into the premenopause, perimenopause and postmenopause. The hormone deficiency during menopause (particularly the estrogen deficiency) can have serious long-term consequences such as osteoporosis and cardiovascular disease. 

Menstrual cycle: the repeating cycle of change in the membrane lining (endometrium) of the uterus. The endometrium sheds during menstruation. It then regrows, thickens, is kept for several days through ovulation, and sheds at the next menstruation. The average length of the cycle, from the first day of bleeding of one cycle to the first of another, is 28 days. However, the length and character of the cycle vary greatly among women. 

Menstrual period (menstruation): the term menstrual period, or period refers to the days that a woman bleeds due to the shedding of the endometrium at the end of the menstrual cycle. A period lasts on average of 5 days.

Minipill: Oral contraceptive containing only a progestin. Also called the progestin-only pill. 

Natural family planning (NFP): Natural methods of contraception based on determination of the fertile and infertile days in a menstrual cycle and abstinence from sexual intercourse on fertile days. Also called periodic abstinence. The fertile days can be determined by regular measurement of the basal body temperature, by observation of the cervical mucus (Billings method, cervical mucus method), by charting the menstrual cycle (calendar method) or by the symptothermal method (combination of temperature measurement and observation of cervical mucus). Natural methods of contraception are not suitable during menopause.

Natural menopause: (see menopause) is a natural part of aging and occurs most commonly between the ages of 45 and 55 years but it may occur earlier or later without there being any abnormality. 

Neurotransmitters: Chemicals produced and stored by the nerve endings (e.g. adrenaline, noradrenaline, serotonin, dopamine) which are released in response to electrical impulses and transmit the impulses from one neuron (nerve cell) to the next. 

Oral administration: Administration by mouth, e.g. by swallowing a tablet or liquid. 

Oral contraceptives (OCs): Hormonal preparations for prevention of pregnancy which are taken by mouth. Commonly referred to as "the pill".

Osteoblasts: Cells responsible for building new bone (see osteoclasts).

Osteoclasts: Cells responsible for breaking down bone. In order to allow the bone to withstand mechanical stresses old bone mass is broken down by osteoclasts and new bone formed by osteoblasts. Disturbance of this continuous bone remodeling can lead to bone disorders such as osteoporosis.

Osteoporosis: Bone thinning. Loss of bone material causing the bones to become more and more porous. Osteoporosis is a characteristic disease of aging. Hormone deficiency (in women estrogens, in men testosterone) plays an important role in its development.

Ovaries: Female sex glands or gonads. The most important tasks of the ovaries are to supply fertilizable ova and produce the female sex hormones (estrogens and progesterone). 

Ovulation: The rupture of the dominant ovarian follicle on about day 14 of the cycle releasing a fertilizable egg which is taken up by the fallopian tube. 

Ovum (pl. ova): Egg, egg cell. The female cell of reproduction.

Pap Smear: Specimen material obtained from the surface of a mucous membrane for bacteriological or cytological examination. In gynecology particularly for diagnosis of cervical cancer. Cells are scraped from the surface of the cervix and from the lining of the cervical canal and examined under the microscope (cervical smear or Pap test, named after the doctor Papanicolaou).

Parenteral administration: Administration of a drug by a route that bypasses the gastrointestinal tract (e.g. by means of injections, patches, creams).

Parity: number of pregnancies.

Partial hysterectomy (subtotal hysterectomy): a surgical procedure in which the fundus of the uterus is removed, but the cervix is left in place. Because the ovaries are not removed, the body continues to produce estrogen and the symptoms of menopause are not experienced as a result of surgery but will occur naturally later in life. 

Pelvic exam: a procedure conducted by a physician in which the female reproductive tract is examined. Once a woman is over 18, it should be done once a year. The pelvic examination is used to discover defects or diseases of the reproductive tract. 

Perimenopause: Phase of menopause. It can be described as the phase of the "actual transition". It begins with the onset of menopausal symptoms and ends one year after the last period (menstruation). 

Phytoestrogens: Chemicals with estrogen-like action occurring in plants or fruits (phyto=plant). Phytoestrogens are contained in pulses, soy beans and products, whole-grain products and some fruits and vegetables. 

Pituitary gland: sometimes referred to as the “master gland,” the pituitary is the most important of the endocrine glands (glands that release hormones directly into the bloodstream). The pituitary regulates and controls the activities of other glands and many body processes. 

Placenta: The organ formed during pregnancy for supplying the developing child in the uterus with oxygen and nutrients and removing the waste products of metabolism. It is expelled after the birth of the child.

Postmenopausal blues, mood swings: In the past, just about every emotional blip or bout of the blues felt by women in their 40s or 50s was attributed to menopause. Women can become irritable when hot flashes rob them of a good night's sleep, but there is no correlation between menopause and serious depression. Since depression affects one woman in four at some point in life, however, persistent low moods should never be ignored. Other symptoms of depression include insomnia (or sleeping too much), loss of appetite (or eating too much), and feeling helpless, hopeless or worthless. If you experience these symptoms, be sure to talk to your health care provider.

Postmenopause: Last phase of menopause. Begins one year after the last period and ends at the age of 65. 

Premenopause: Phase of menopause covering a period of 5-10 years before the last period.

Premenstrual syndrome (PMS): Collective term for a number of symptoms (e.g. lower abdominal pain, headaches, edema, depression, irritability) which are experienced by many women 6 to 8 days before a period (menstruation). The premenstrual syndrome is probably hormone-related. 

Progestational hormones: Female sex hormones. Collective term for all natural and synthetic female sex hormones which have a similar effect to progesterone. 

Progesterone: Female sex hormone. Progesterone is the most potent natural progestational hormone. During pregnancy progesterone is also produced by the placenta. Progesterone regulates the female reproductive functions together with estrogen and plays a particular role in the maintenance of pregnancy. Synthetic hormones which have an effect similar to that of progesterone are called progestins.

Progestogens: name for a group of synthetic hormones with progesterone-like actions. 

Progestins: generic term for both the natural hormone progesterone and the synthetic progestogens, which have progesterone-like actions.

Prophylaxis: Measures for the prevention and early detection of disease.

Radical hysterectomy: a radical hysterectomy involves removal of the uterus, the cervix, the top portion of the vagina, and most of the tissue around the cervix; the lymph nodes in the pelvic area may also be removed. 

Screening: Measures for the early detection of diseases. 

SERMs (Selective Estrogen Receptor Modulators): Class of synthetic substances which act selectively as estrogens or anti-estrogens, depending on the tissue. They have a positive effect on bone metabolism and prevent osteoporosis (estrogenic action), and at the same time prevent excessive growth of the uterine lining (anti-estrogenic action). So far only one SERM has been licensed. It is used for the prevention of osteoporosis during menopause. SERMs are not suitable for the treatment of menopausal symptoms. 

Sex hormones: The hormones responsible for regulation of reproduction and for the development of the male and female sexual characteristics. Sex hormones are produced chiefly by the gonads (ovaries in women, testes in men). Estrogens and progesterone are referred to as female sex hormones, androgens as male sex hormones.

Sterilization: Rendering infertile by a surgical procedure. 

Stress Incontinence: involuntary loss of urine due to an effort.

Stress / Urge Incontinence: involuntary loss of urine due to an effort and impossibility to delay the urination.

Subtotal hysterectomy (partial hysterectomy): a surgical procedure in which the fundus of the uterus is removed but the cervix is left in place. Because the ovaries are not removed, the body continues to produce estrogen and symptoms of menopause are not experienced due to this surgery, but may be experienced naturally later in life. 

Surgical menopause: the onset of menopause that occurs soon after the surgical removal of the ovaries in a woman who is still menstruating. 

Symptom: An indication of a disease or disorder that is experienced by the patient. Indications seen by the doctor are called signs. 

Testosterone: a male sex hormone that stimulates bone and muscle growth and sexual development. It is produced by the testes in men and in very small amounts by the ovaries in women.

Three-month injection: Injectable contraceptive. Method of contraception in which a progestin depot is injected into the muscle.

Thrombosis: Formation of a blood clot (thrombus) in an artery or vein. The thrombus can obstruct the flow of blood in the vessel. Parts of the blood clot can also become detached from the clot and carried by the bloodstream to other sites (thromboembolism). If a thrombus or embolus blocks a blood vessel supplying a vital organ this can result in pulmonary embolism, heart attack or stroke, depending on the site of the blockage.

Timing of Menopause: In the Western world, the majority of women experience natural menopause on average at about age 51, but it can occur as early as in a woman's 30s and, rarely, as late as in her 60s. Contrary to previous opinion, there is no correlation between the time of a woman's first period and her age at menopause. In addition, age at menopause is not influenced by race, height, the number of children a woman has had, or whether she took oral contraceptives for birth control. However, cigarette smoking can influence the age of menopause; smokers and even former smokers can reach menopause two years earlier than non-smokers.

Total abdominal hysterectomy, bilateral salpingo-oophorectomy (TAH-BSO): surgical removal of the ovaries and fallopian tubes along with the entire uterus. When both ovaries are removed, the onset of menopause will probably occur within days after surgery. 

Total hysterectomy: surgery involving the removal of the entire uterus, including the fundus (the upper portion) and the cervix. Because the ovaries are not removed during this operation, the symptoms of menopause will not occur following this surgery but may occur naturally later in life. 

Transdermal therapy, the “Patch” (transdermal medication): a means of administering medication through the skin. This technique is often used in the administration of estrogen via a patch containing estrogen. 

Triphasic pills: triphasic pills contain three different hormonal doses of estrogen and progestin that mimic a woman’s natural menstrual cycle. 

Unilateral oophorectomy: surgery to remove one ovary. It may be done for a variety of reasons including to take out a lump (cyst) or a tumor, or to treat endometriosis. Since one ovary is still intact, surgical menopause will not occur due to surgery. 

Urinary incontinence: Loss of bladder control, inability to hold urine in the bladder. There are two main types of incontinence: urge incontinence (constant desire to pass urine) and stress incontinence (leakage of urine during exercise, coughing, sneezing etc.). 

Uterine lining (endometrium): the lining of the uterus. The endometrium becomes thicker as the menstrual cycle advances in preparation for a fertilized egg. If no fertilization occurs, the endometrium is shed with each menstrual flow. 

Uterine prolapse: the falling, sinking, or sliding of the uterus from its normal location in the body.

Uterus: Womb. Female reproductive organ. The uterus is a pear-shaped, muscular, hollow organ. The lower third or the neck of the uterus is called the cervix. The uterus is lined on the inside with a mucous membrane (endometrium). In the first half of the menstrual cycle, the endometrium thickens under the influence of estrogen. After ovulation, progesterone prepares the endometrium to take up a fertilized ovum and the child then develops within the uterus. If the ovum is not fertilized the endometrium is shed during menstruation. 

Vagina: Organ of female reproductive system which accepts the penis in sexual intercourse.

Vaginal atrophy, vaginal dryness: a condition, which causes the lining of the vagina to become dry and lose its elasticity. Can also cause urinary tract infections. Often results in painful intercourse.

Vulva: The external organs of the female reproductive system.