GSM and menopause

GSM may cause vaginal dryness, burning, irritation, soreness during sex, reduced comfort or changes in sexual desire. Urinary symptoms can include urgency, frequency, burning or repeated infections. Symptoms may develop gradually and can continue after periods stop. They are common effects of tissue changes, but bleeding, unusual discharge or significant pain needs assessment rather than being attributed to menopause automatically.

GSM is separate from hot flushes, night sweats and mood changes, although these can occur during the same menopausal transition. Pelvic floor changes can also contribute to pressure or bulging, including with pelvic organ prolapse.

Arrange a confidential appointment if symptoms affect sex, sleep, exercise, urination or daily comfort. A clinician can review medicines, examine the area when appropriate and discuss non-hormonal moisturisers, lubricants, pelvic floor support or local oestrogen. The suitable option depends on your symptoms, health history and preferences. Avoid fragranced washes and products that sting, and use a gentle approach to vulval skin.

Keep a brief record of dryness, urinary changes, pain, bleeding and triggers. This can help your clinician distinguish GSM from infection, skin conditions or another pelvic problem.

Seek prompt medical advice for bleeding after sex, bleeding after periods have stopped, blood in urine, fever, severe pelvic pain, a new lump or discharge with a strong odour. Contact a clinician when urinary burning persists or symptoms repeatedly return, because infection and GSM can feel similar.

Ask whether your symptoms fit GSM, what other causes should be excluded and which moisturiser, lubricant or prescription option suits your history. Ask how long to try it, how improvement will be reviewed and what changes should lead you back for assessment.