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Just more than half of the women characterized as suffering from female sexual dysfunction were those who reported a lack of interest in sex for a period of several months or more over the last twelve months. Another third or so reported arousal problems, that is, they reported having trouble lubricating for a period of several months or more in the past twelve months. Physical changes in the vagina As perimenopause progresses, the drop in estrogen can create thinning, tightening, and dryness in the vulva and vagina. These changes can lead to such discomfort that some women come to dread sex because of the pain. In our practice we’ve observed that former Premarin and PremPro users are more likely to suffer such changes to the vaginal area. The problems may take 6-12 months to develop after stopping the drugs. 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