Vaginal and bladder changes

What it is

As estrogen falls, the lining of the vagina becomes thinner, drier and less stretchy, and the urethra can get dry and irritated.¹ Together these changes are called genitourinary syndrome of menopause (GSM). At least half of women going through menopause show signs of it.²

The signs

• vaginal dryness, often the first sign
• burning, itching or spotting
• pain during sex
• needing to pee more often, or trouble holding it
• painful peeing
• urinary tract infections that keep coming back²

GSM doesn't get better on its own and can get worse without treatment.²

Myth: Painful sex after menopause is just something you have to accept.

Many people were never told it could be treated, so they stopped mentioning it. It's a common, treatable medical condition, and a doctor can help.^1,2

Treatment

• Vaginal moisturizers, used every 1 to 3 days, help the tissue hold moisture. Lubricants help during sex. Neither contains hormones.^1,2
• Local vaginal estrogen, as a cream, tablet or ring, treats the cause. It acts on the vaginal tissue without raising estrogen levels in the bloodstream.² For symptoms that over-the-counter products don't relieve, The Menopause Society recommends low-dose vaginal estrogen or other prescription options.³

Bladder leaks

Weak pelvic floor muscles can cause leaking when you cough, laugh or sneeze, and pelvic floor physical therapy, including Kegel exercises, can help.⁴

When to see a doctor

See a doctor for vaginal dryness or pain that bothers you, repeated UTIs, blood in your pee, or any bleeding after menopause.²