Once we get to the other side of our periods, for many women the effects of the falling hormone levels become more and more apparent.

Just like the variety of symptoms that can occur in the Perimenopause stage, there is also a long list of possible symptoms for the Postmenopause, including hot flushes, insomnia, fatigue, joint pains and mood changes.

But unlike the perimenopause, women in the postmenopausal stage are much more likely to suffer with symptoms called GSM – Genitourinary Syndrome of Menopause.

Over 50% of postmenopausal women have symptoms of GSM but fewer than 10% are treated

GSM describes a range of symptoms.

Women have oestrogen receptors in the vagina, vulva, urethra and parts of the bladder.

Without the steady supply of hormones these areas have relied on, many women endure all kinds of uncomfortable symptoms:

• Vaginal dryness/soreness/itchiness
• Pain on passing urine
• Pain on having sex
• Passing urine too frequently
• Needing to pass urine urgently

Symptoms like this are not minor – they can affect our ability to concentrate at work, our sex life and our social life.

There are very safe and effective treatments for GSM

As a GP, I have seen countless women who have been silently suffering with unhappy ‘bits’ for years.

They either just thought it was normal and had to get on with it, or they were too embarrassed to mention it to anyone, including a doctor.

In reality, we have good treatments for these symptoms that are safe for long term use and can stop years of unnecessary discomfort for many women.