During reproductive life, the vagina, vulva, pelvic floor muscles, endopelvic fascia, urethra, and bladder trigone display a significant amount of estrogen receptors (ERs, both α and β), which decline with menopause and may be restored by the use of systemic and local estrogen treatment. ERs are mainly expressed in the epithelium and in stromal and muscle cells of the human vagina. Even androgen receptors (ARs) are largely expressed at multiple levels (mucosa, submucosa, stroma, smooth muscles, and vascular endothelium) and cross-talk with ERs, influencing neurovascular and neuromuscular function under different endocrine conditions