Santen and colleagues’ 2020 clinical review discusses genitourinary symptoms and local vaginal treatment within personalized postmenopausal care. A specific symptom assessment is more useful than a general request to “balance hormones”.
Understand genitourinary symptoms
Genitourinary syndrome of menopause, often shortened to GSM, describes changes involving the vulva, vagina and lower urinary tract associated with declining estrogen. Dryness, irritation and pain can be part of the picture. However, infection, skin conditions, pelvic-floor problems and other causes can produce overlapping symptoms.
Tell your clinician where the discomfort occurs, whether it is constant or associated with sex, and whether urinary symptoms are present. A symptom should not be attributed to menopause without considering alternatives, particularly if it is new, persistent or associated with bleeding.
Local treatment has a different purpose
Lubricants can help reduce friction during sex; vaginal moisturizers are used regularly for comfort. For persistent symptoms, the 2020 review discusses low-dose vaginal estrogen and other prescription options. These treatments target genitourinary symptoms rather than treating hot flashes throughout the body.
Product choice depends on the symptom, medical history, preference and local availability. If you have a history of breast cancer, involve the relevant treating clinicians in the decision. An older article’s list of options is not proof that each option is suitable for every patient.