Genitourinary syndrome of menopause 🌸
🧠 Clinical mechanism: Reduced oestrogen exposure produces urogenital tissue changes and can cause dryness, irritation, dyspareunia or urinary symptoms.
🔎 Recognise
- Vulvovaginal dryness, pain with intercourse, recurrent urinary discomfort or tenderness, especially peri/postmenopause.
🛟 First assessment and action
- Discuss preferences and symptom burden; consider local moisturisers/lubricants and NICE-recommended vaginal oestrogen where suitable.
🧪 Investigations and reassessment
- Clinical assessment for alternate causes including infection, skin disorders or malignancy; investigate unexplained vaginal bleeding.
⚠️ Pitfall / escalation
- Vaginal bleeding must not automatically be attributed to atrophy. In breast cancer survivors discuss individual options with appropriate specialists.
UK reference: Primary NHS/NICE/RCOG/GMC source.
Editorial draft, 7 November 2026: targeted source-supported educational summary, NOT independent consultant/pharmacist verification or a treatment protocol. Follow up-to-date BNF, NICE and local NHS pathways.
Related: Menopause and Menopausal Problems 🌸 · Painful Sexual Intercourse (Dyspareunia) · Post Menopausal Bleeding