What is the first treatment for genitourinary syndrome of menopause?

Lower oestrogen after menopause can make the vaginal and urinary tissues thinner, drier and more sensitive. This may cause burning, discomfort during sex, urinary urgency or repeated irritation. A regular vaginal moisturiser can ease ongoing dryness, while a lubricant reduces friction during sexual activity. These products support comfort but do not reverse every tissue change.

If symptoms affect daily life, sleep, intimacy or urination, a clinician may discuss low-dose vaginal oestrogen. It acts mainly in the treated area and may be available as a cream, tablet or ring. Your medical history, unexplained bleeding and any hormone-sensitive condition affect whether it is suitable.

Track which symptoms bother you, when they occur and whether intercourse or urination makes them worse. Use products as directed and avoid perfumed washes or douches, which can irritate delicate tissue. Arrange a review if symptoms do not settle, because infection, skin conditions and other urinary or vaginal problems can feel similar.

Ask whether vaginal oestrogen or another option fits your history. Vaginal dilator therapy may be discussed when narrowing or pain makes gentle penetration difficult; it should be introduced gradually with guidance.

Contact a clinician promptly for bleeding after menopause, blood in the urine, new sores, unusual discharge, fever, pelvic pain or pain that is worsening. Seek urgent help for severe pelvic pain, heavy bleeding, faintness or difficulty passing urine.

Could my symptoms be caused by genitourinary syndrome of menopause or another condition? Would a moisturiser, lubricant or vaginal oestrogen be appropriate for me? What should I do if treatment causes irritation?