While hot flushes and night sweats are widely recognised menopause symptoms, many women experience changes affecting vaginal and urinary health that are rarely discussed. These symptoms are collectively known as Genitourinary Syndrome of Menopause (GSM) and can significantly affect comfort, relationships and quality of life.
What Is Genitourinary Syndrome of Menopause?
GSM describes a group of symptoms caused by reduced oestrogen levels affecting the vulva, vagina and lower urinary tract.
Common symptoms include:
- Vaginal dryness
- Burning or irritation
- Pain during sexual activity
- Recurrent urinary tract infections
- Urinary urgency or discomfort
- Reduced vaginal elasticity
Unlike hot flushes, which often improve over time, GSM symptoms usually persist or worsen without treatment.
Why These Symptoms Occur
Oestrogen supports the health of vaginal and urinary tissues. During menopause, falling oestrogen levels lead to thinning of the vaginal lining, reduced natural lubrication and decreased blood flow.
These changes may lead to vaginal dryness, irritation and increased susceptibility to infections.
Because symptoms develop gradually, many women assume they are simply a normal part of ageing rather than a treatable medical condition.
Treatment Options for GSM
The good news is that GSM is very treatable.
Common treatment approaches include:
Vaginal moisturisers and lubricants
These can improve comfort and reduce dryness, particularly for women with mild symptoms.
Local vaginal oestrogen therapy
Low-dose vaginal oestrogen is considered a highly effective treatment for GSM and works directly on vaginal tissues with minimal systemic absorption [1].
Other treatments
Depending on symptoms, clinicians may discuss additional options including vaginal DHEA or other specialist therapies.
Why Many Women Do Not Seek Help
Despite the prevalence of GSM, studies suggest many women do not seek medical advice due to embarrassment or the belief that symptoms are inevitable.
Open discussion and education are essential to ensure women receive appropriate care.
When to Speak to a Specialist
Women should consider discussing symptoms if they experience:
- Persistent vaginal dryness or discomfort
- Pain during intimacy
- Recurrent urinary infections
- Urinary urgency or irritation
Effective treatments are available and can significantly improve quality of life.
Support at The Menopause Medic
The Menopause Medic provides personalised care for women experiencing GSM and other menopause symptoms. Consultations are available in Berkhamsted and St Albans, with remote appointments for women across Hertfordshire and the UK.
References
[1] British Menopause Society. Management of genitourinary syndrome of menopause.
https://thebms.org.uk/publications/tools-for-clinicians/gsm/