MENOPAUSE AND INTIMATE HEALTH: WHAT EVERY WOMAN SHOULD KNOW
By Shetha Naji, Consultant Plastic Surgeon – October 15, 2025
When we talk about menopause, hot flushes and night sweats often dominate the conversation. But for nearly half of postmenopausal women, the most distressing changes are those seldom spoken about—changes in intimate health.
Vaginal dryness, discomfort during intimacy, and recurrent urinary issues are common, yet many women feel too embarrassed to bring them up. These symptoms aren’t “just part of getting older.” They are part of a recognised condition called genitourinary syndrome of
menopause (GSM)—and there are effective ways to manage them.
Let’s break the silence. Here’s what you need to know about menopause and your intimate health.
WHAT IS GSM (GENITOURINARY SYNDROME OF MENOPAUSE)?
As oestrogen levels decline during and after menopause, the tissues of the vulva, vagina, and urinary tract undergo changes. These changes lead to signs and symptoms, collectively termed genitourinary syndrome of menopause (GSM).
COMMON SYMPTOMS OF GSM INCLUDE
• Vulvovaginal symptoms: dryness, irritation, burning, itching, thinning of the skin, and changes in pubic hair.
• Sexual symptoms: vaginal dryness, pain during sexual intercourse, post-coital bleeding (bleeding following intercourse), and reduced libido.
• Urinary symptoms: frequency, urgency, discomfort, incontinence, and recurrent infections.
Studies show that up to 75% of women attending menopause centres in Italy reported vulvovaginal symptoms. Globally, between 27–84% of postmenopausal women are affected—yet many remain undiagnosed and untreated.
WHY INTIMATE HEALTH MATTERS
These changes are far more than “minor inconveniences.” GSM can have a profound impact on:
• Quality of life – owing to physical, psychological signs and symptoms
• Intimacy and sexual activity – painful intercourse or loss of desire.
• Self-esteem and body image – feeling less confident in your own skin.
• Relationships and mental health – strain on partnerships and emotional wellbeing.
No woman should feel she has to simply “put up with it.” Understanding what’s happening is
the first step toward finding relief.
TREATMENT OPTIONS FOR MENOPAUSAL INTIMATE HEALTH
The good news? There are safe, effective treatments that can significantly improve GSM symptoms.
LIFESTYLE & AT-HOME SUPPORT
• Vaginal lubricants – provide relief from dryness.
• Pelvic floor exercises – help with urinary symptoms by improving muscle tone.
• Avoiding irritants – like perfumed soaps or douches that can worsen dryness.
• Staying hydrated and active – supports circulation and tissue health.
MEDICAL TREATMENTS
• Local oestrogen therapy (creams, tablets, or vaginal rings): replenishes oestrogen directly to the affected tissues, improving elasticity and hydration. You must consult your doctor.
• Non-hormonal in clinic treatments, including:
Polynucleotides – a promising option for vulvovaginal atrophy (part of GSM). A 2019 study showed women experienced rapid and significant symptom relief, with reductions of 57–70% after treatment and reported improvements in intimacy and quality of life. While more large-scale trials are needed, current evidence suggests this is a low-risk, potentially life-changing option.
Every woman’s experience is unique, so the best approach is a personalised treatment plan based on your symptoms, health history, and preferences.
BREAKING THE SILENCE
As a doctor I have often seen patients hesitant to raise concerns that they feel are embarrassing or they feel “aren’t important enough”. Whatever the issues are, we must empower our patients to always ask the question. When something is affecting your comfort,
confidence, or relationships, it absolutely matters. We must talk about these issues.
By talking openly about GSM and menopause-related intimate health, we can reduce stigma, raise awareness, and ensure women know their options.
Remember: knowledge is power. With the right information and treatments, you can feel comfortable, confident, and in control again.
LET’S TALK ABOUT YOUR INTIMATE HEALTH
If you’d like to explore treatment options—such as polynucleotides—for GSM and intimate health after menopause, I’d be delighted to see you for a consultation. Together, we can create a personalised plan to restore comfort and confidence.
Tel: +44 (0) 7903 159640
Email: contact@shethanaji.com
Menopause is a new stage of life—but it should never mean giving up comfort, intimacy, or confidence.
References
Nappi R et al. Impact of vulvovaginal atrophy of menopause: prevalence and symptoms in
Italian women according to the EVES study. Gynecol Endocrinol. 2019; 35(5): 453-459