Genitourinary symptoms of the menopause (GSM)

At least half of menopausal individuals will have symptoms related to oestrogen depletion in their bladder, vulva and vaginal regions.
Symptoms associated with GSM that physiotherapy can help with or advice on:

• Urinary Problems (such as Urinary Urgency, UTIs),
• Vaginal Dryness
• Vaginal Discomfort
• Vaginal Discharge
• Vaginal/Vulval Itch
• Pain or Discomfort during penetrative Intercourse
• Loss of interest in sex

• Avoid Perfumed Shower Gels/Soaps/Intimate wipes and sanitary products.
• Avoid Perfumed Preparations/Bubble Bath/Essential Oils in the bath.
• Avoid washing your hair when you are in the bath. Aim to wash your hair in the shower, put your head under the stream, but keep your lower body out to avoid shampoo/conditioner running down your body.
• Try using a soap substitute to wash your whole body, not just the vulval area
• Cotton Underwear/”breathable” clothing
• Avoid all fabric softeners, including “sensitive” types. Avoid 2-in-1 laundry products
• If using a pad to help with containment of leakage, use incontinence pads/washable underwear rather than sanitary towels.

Treatment

• Emollient Lotions/Soap Substitutes
• Vaginal Moisturisers*
• Vaginal Lubricant*
• Local, or “topical” Oestrogen (Localised restoration of oestrogen hormone to vagina, vulva, bladder and urethra). These can come as creams, gels, vaginal tablets, pessaries or rings containing oestrogen. This can take several months to notice,
• Systemic HRT
   

*Popular Brands Yes, Sylk and Liquid Silk. You can obtain free samples from Yes brand at All YES Products.

**Just to note that some oil based preparations are not compatible with use of condoms, this includes coconut and olive oil. Some lubricants can contain shellfish or kiwi extracts, so be mindful if you have a known allergy (you may want to speak to your local pharmacist/GP for advice). Some vaginal moisturisers/lubricants can contain parabens, which have “oestrogen like properties”. These should be avoided if your medical provider has advised to avoid hormones due to hormone dependent cancers (like breast cancer).

Please note if you have any unexplained vaginal spotting or bleeding, unusual discharge, burning, soreness or painful intercourse to seek help from your GP