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Genitourinary symptoms

Changes to the vagina, bladder and surrounding areas, known as genitourinary syndrome of menopause (GSM).

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What is GSM?

Around and after menopause, there are changes to the vagina, bladder and surrounding areas. Together, these are known as genitourinary syndrome of menopause (GSM).

Vaginal dryness

With menopause, the skin of the vagina becomes dry and flaky, and there is less natural lubrication. This can lead to:

Vaginal dryness and lack of lubrication
Discomfort and pain during sex
Chafing, burning and tearing of the vaginal skin
Bleeding, including during or after sex
Infections and itchiness

Painful sex, together with a lower sex drive (loss of libido), can make some women lose interest in sex completely.

Always get bleeding checked

Any bleeding after your periods have stopped for a year or more, or bleeding after sex, must be checked by a doctor, even if you think it is due to dryness.

Bladder problems

The most common bladder symptoms are:

urgency (a sudden, strong need to pass urine) and needing to go to the toilet often
painful or difficult urination
repeated urinary tract (urine) infections

Many women also have leaking of urine (incontinence). There are two main types:

Stress incontinence

Leaking urine when laughing, sneezing or coughing.

Urge incontinence (overactive bladder)

Not being able to reach the toilet in time.

Not just ageing

The pelvic floor muscles can be weakened by childbirth. Other conditions, such as diabetes, nerve damage and multiple sclerosis, can affect the nerves that control the bladder. So leaking urine may not be due only to ageing and weak pelvic muscles.

Talk to your doctor

These symptoms are common, and nothing to be embarrassed about. Your doctor can check the cause and talk you through treatments that can help. Read about treatment and therapies.

See a doctor soon if you see blood in your urine, have a urine infection with fever or back pain, or cannot pass urine.

Your doctor can help you work out what is going on and talk you through your options.

When to consult a doctor