"Women can suffer stabbing pain, burning or chafing and may need to urinate more often as a result of the condition. In the absence of estrogen, vaginal tissue can regress, become thinner and more easily irritated, making intercourse painful. "A vagina on estrogen is like a pleated skirt: extensible and easy to move around. Vaginal atrophy is like a pencil skirt: narrow, nonextensible and irritating," explains Dr. Black."