10/09/2026
One of our patients brought it into clinic with her this week. She is 49 and has been dealing with severe genitourinary symptoms of menopause for years. With her permission we wanted to share the story behind it.
By the time she came to see us, she had already tried several forms of HRT alongside different vaginal treatments, including estriol, Vagifem/Vagirux and Intrarosa.
Eventually, she had been left feeling as though there really wasn’t much else that could be done.
But when we went back through everything together, there were still conversations to have. We discussed Estring as another local oestrogen option, reviewed whether fluoxetine might be contributing to some of the s*xual symptoms she was experiencing, and looked again at the wider HRT picture rather than treating each symptom in isolation.
We are not sharing this to criticise the care she had before. We are sharing it because this scenario is still far too common.
Genitourinary symptoms of menopause can be profoundly distressing, yet because they involve vaginal symptoms, bladder symptoms and s*x, they are still difficult for many women to talk about and their impact can be underestimated.
These symptoms are common and treatable, and they deserve the same careful, joined-up review as any other symptom affecting someone’s quality of life. Women should not have to become their own case manager before they are taken seriously.
