Written by the AccessGP Team and reviewed by Dr Zamiel Hussain, Lead GP at AccessGP and Dr Tasnimah Miah, Women’s Health Advocate at AccessGP
Menopause: A Natural Transition That Deserves Better Support
Menopause is a significant biological transition, usually occurring between the ages of 45 and 55. It is diagnosed once a woman has had no periods for twelve consecutive months, although symptoms begin much earlier during perimenopause.
Hormonal changes influence many body systems. Symptoms can vary in intensity and may fluctuate from one month to the next.
Common symptoms include
• Hot flushes
• Night sweats
• Brain fog
• Mood changes
• Irregular periods
• Vaginal dryness
• Joint pains
• Reduced libido
• Sleep disturbance
These symptoms can affect work, relationships and daily functioning. Many women tolerate them for years because they expect menopause to be difficult. The reality is that evidence based treatment can improve quality of life at every stage.
Genitourinary Syndrome of Menopause: The Symptom Cluster Many Women Do Not Discuss
Genitourinary Syndrome of Menopause, often referred to as GSM, describes a group of symptoms linked to reduced oestrogen affecting the vagina, vulva and urinary tract. GSM is very common, particularly after menopause, but often goes unrecognised.
Symptoms can include
• Vaginal dryness
• Discomfort or burning
• Pain during intimacy
• Recurrent urinary infections
• Urinary frequency or urgency
• Vaginal irritation or itching
Because symptoms can be intimate or gradual, many women delay seeking advice. GSM is not an inevitable part of ageing. With structured treatment, most women experience a clear improvement.
The Latest British Menopause Society (BMS) Consensus Update
The British Menopause Society has released an updated Consensus Statement on GSM, reinforcing several important clinical points. This update provides timely guidance that supports early recognition and better outcomes.
Key messages from the new BMS update include
• GSM should be actively asked about during menopause consultations
• Local vaginal oestrogen remains first line and is safe for long term use
• Moisturisers and lubricants are essential supportive options
• Treatment is most effective when used consistently
• Symptoms often recur if treatment is stopped
• GSM should be evaluated alongside broader menopausal symptoms
This aligns with clinical experience at AccessGP. Once treatment is introduced and maintained, women commonly report meaningful improvements within weeks.
How GSM Is Treated
Treatment is tailored to the individual. Many women benefit from a combination approach.
1. Vaginal moisturisers and lubricants
Useful for dryness, irritation and discomfort. These are available without prescription and can be used alone or alongside hormonal therapy.
2. Local vaginal oestrogen
A low dose, targeted treatment that restores vaginal tissue, improves lubrication and reduces urinary symptoms. Available as pessaries, creams, gels or a vaginal ring. Local oestrogen does not raise systemic hormone levels significantly and is considered safe for long term use for most women.
3. Systemic HRT
For women with additional symptoms such as hot flushes, mood changes or sleep disturbance, systemic HRT can be added alongside GSM treatment.
4. Lifestyle considerations
Regular sexual activity, pelvic floor support, hydration and the use of appropriate products all contribute to better symptom control.
Menopause and Bone Health
Falling oestrogen levels accelerate bone turnover. Over time this reduces bone density and increases the risk of osteopenia and osteoporosis. Women may not notice any symptoms until a low impact fracture occurs, which is why proactive assessment matters.
Risk factors for reduced bone health include
• Family history of osteoporosis
• Low body weight
• Early menopause
• Smoking
• Long term steroid use
• Previous fragility fractures
Weight bearing exercise, adequate calcium and vitamin D, sleep optimisation, and reducing smoking or alcohol intake can help maintain strong bones. Systemic HRT can also offer bone protective benefits when clinically appropriate.
At AccessGP we assess bone health as part of a comprehensive menopause review and can arrange blood tests or DEXA scans when indicated.
Why Early Assessment Matters
Untreated GSM or poorly managed menopausal symptoms can lead to
• Recurrent urinary infections
• Persistent discomfort
• Sleep disruption
• Pain during intimacy
• Reduced quality of life
• Avoidance of daily activities or sexual contact
With updated BMS guidance and wider awareness, women should feel empowered to seek help earlier. Effective treatments are available and safe for the majority of patients.
How AccessGP Supports Menopausal Health
Through structured video consultations, we provide
• A full menopausal symptom review
• Assessment for GSM
• Discussion of local and systemic treatment options
• Advice on bone health
• A personalised plan based on medical history, lifestyle and preference
• Ongoing follow up when required
Tailored menopause care helps women feel confident, informed and supported at every stage.
Final Thoughts
Menopause is a major life stage. With the right support, it can be approached with clarity rather than uncertainty. The updated BMS guidance emphasises how common GSM is and how easily symptoms can improve with consistent treatment.
If you recognise any of these symptoms or would like an assessment, our clinicians at AccessGP are ready to help.
Key sources: British Menopause Society – GSM Consensus Statement Update; NHS – Menopause Health Information; NICE – Menopause: Diagnosis and Management.