This is the symptom women are most likely to suffer with in silence — so let's talk about it plainly, because it's common and very treatable.

What's happening. The tissues of the vulva, vagina, and bladder are rich in oestrogen receptors. As oestrogen falls after menopause, these tissues become thinner, drier, and less elastic — doctors call this "genitourinary syndrome of menopause." It can cause dryness, itching or burning, discomfort or pain during sex, and more frequent or urgent urination or urinary infections.

Why it matters that it doesn't just "pass." Unlike hot flushes, these changes relate to a sustained low-oestrogen state, so they tend to persist or progress without support. That's not a reason to despair — it's a reason to treat it.

The options, from gentle to medical:

• Vaginal moisturisers (used regularly, not just for sex) and lubricants (for comfort during sex) help many women and are available without prescription.
• Local vaginal oestrogen (creams, pessaries, or a ring) delivers a very low dose directly to the tissue. It's highly effective for these symptoms, and because it acts locally, it's suitable for many women — including some who don't take, or can't take, systemic HRT. Discuss it with your clinician.
• Staying sexually active (alone or with a partner) supports blood flow and tissue health.
• Pelvic floor support can help with the urinary side of things.

Please don't be embarrassed to raise it. Clinicians hear about this every day, and a short conversation can change your comfort and your intimate life completely.

Comfort and closeness don't have to end at menopause. With the right approach, most women find real relief.

Common questions

Does vaginal dryness after menopause go away on its own?

Usually not — it relates to lasting low oestrogen, so it tends to persist without treatment. The good news is that effective options exist.

Is vaginal oestrogen safe?

For many women it is, because it acts locally at a very low dose. It's an individual decision to discuss with your clinician.

Keep reading: Where did my libido go? · The truth about HRT · Take the free Hormone Quiz