What Your Body Didn't Tell You About Menopause (and You Should Know)

Dryness, burning, discomfort when urinating, pain during sex... these are symptoms many women live with in silence, sometimes without even mentioning them at their gynaecology appointment. They have a medical name, genitourinary syndrome of menopause (GSM), and they're far more common than people talk about.

Why it happens

Oestrogen keeps the tissues of the vagina, vulva and urinary tract healthy. When levels fall for good in menopause, these tissues become thinner, lose elasticity and grow more sensitive. Hence the dryness, the burning and, in some cases, more urinary infections.

What the evidence says

• GSM affects roughly half of postmenopausal women.
• Unlike hot flashes, which tend to improve over time, GSM tends to get progressively worse if left untreated.
• Recent clinical guidelines (2024-2025) confirm that low-dose vaginal oestrogen is the go-to option for improving dryness, discomfort and recurrent urinary tract infections.

Silence has a real cost

Avoiding sex, feeling embarrassed or simply assuming "it's part of getting older" has a direct impact on quality of life and on relationships. The good news: GSM is among the menopause conditions with the most effective, well-studied treatment options.

When to see a doctor without waiting any longer

• Persistent dryness or discomfort, whether or not you're sexually active.
• Pain with penetration.
• Burning when urinating, or urinary infections that keep coming back.
• Any bleeding after menopause: this must always be checked.

Dr. Alma García, Vive Tu Balance

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