What are the treatment options for genitourinary syndrome of menopause?

Lower oestrogen after menopause can make vaginal and vulval tissues thinner, drier and more sensitive. Urinary burning, urgency, recurrent urinary symptoms and pain during sex can occur alongside irritation. Genitourinary Syndrome of Menopause describes this group of symptoms and can continue without hot flushes or other menopause symptoms.

Treatment is tailored to the symptoms and to your medical history. Regular vaginal moisturiser may help ongoing dryness, while a water-based or silicone lubricant can reduce friction during sexual activity. These products support comfort but do not replace assessment of bleeding or infection.

Vaginal Oestrogen Therapy delivers a small amount of oestrogen locally and may help dryness, irritation, urinary discomfort and painful sex. Your clinician will check whether it is suitable, explain how to use it and review your response.

Vaginal Dilator Therapy uses graduated devices with guidance to gently maintain or improve comfort with insertion. It may be useful when tightness, pain or scarring makes penetration difficult. Pelvic-floor support, gentle routines and treatment of an identified urinary infection may be included in the plan.

Arrange an assessment for bleeding after menopause, blood in the urine, new pelvic pain, unusual discharge, sores, fever or urinary symptoms that persist or return. Seek urgent help for severe pain, heavy bleeding, fever with flank pain or inability to pass urine.

Ask which symptoms fit this condition, whether infection or another cause should be excluded, and which local treatment suits your history. Discuss expected improvement, how long to try each option, and what to do if sex, insertion or urination remains painful.