What are the symptoms of genitourinary syndrome of menopause?

Lower oestrogen can make the vaginal and vulval tissues thinner, drier and less flexible. You may notice soreness, irritation or a feeling of tightness. Sex may become uncomfortable, and light bleeding after sex can occur when delicate tissue is rubbed.

Urinary symptoms can include needing to pass urine more often, urgency, burning or repeated urinary infections. Some people also notice leakage, discomfort while sitting or walking, or less interest in sex because intimacy has become uncomfortable. Symptoms may develop gradually and can continue after periods stop.

Record which symptoms you have, when they occur and whether they affect sex or urination. A clinician can check for other causes, including infection, and discuss moisturisers, lubricants or local treatment. Vaginal Oestrogen Therapy may help some vaginal and urinary symptoms; Vaginal Dilator Therapy may be discussed when tightness or pain limits comfortable penetration.

Arrange a clinical assessment for new, persistent or troublesome symptoms. Seek prompt care for bleeding after sex, blood in the urine, fever, severe pelvic pain or difficulty passing urine. Bleeding after menopause should always be assessed, even when it is light.

Could an infection or another condition explain these symptoms? Which moisturiser, lubricant or local treatment suits me? What should I do if sex or urination remains painful?