Menopause isn’t just a quirky phase with hot flushes and mood swings—it’s a whole journey that can throw some unexpected curveballs at your body, especially in your intimate areas. And while words like “vaginal atrophy” might sound clinical and downright awful (who in their right mind wants to admit that their vagina—the scene of plumped bits and juicy orgasms—is now as dried up as a craisin?), there’s a better way to talk about it.

Instead of letting harsh words define our experience, we can use a non-judgmental, honest term: GSM, or Genitourinary Syndrome of Menopause. It’s a catchall phrase that acknowledges a range of issues linked to menopause while giving us permission to show our vag* a little more love and get the support it needs so it can keep loving us back.

*When I use the term vag – I am also referring in this instance to the vulva as well.

What Exactly Is GSM?

GSM covers a whole spectrum of symptoms caused by a drop in oestrogen. Oestrogen does a lot for us—it keeps our vaginal and urethral tissues thick, elastic, and moist. When those levels dip, as they naturally do during menopause (or sometimes even before), the tissues can become thinner, drier, and more fragile. And that’s when those pesky symptoms start to show up. Instead of blaming our vag with terms like “atrophy,” we acknowledge GSM as a natural part of the menopausal transition—a signal that things are changing down there and that it might be time to give it a bit of extra TLC.

This isn’t just a theoretical concept. GSM is super common, affecting somewhere between 50 and 70% of postmenopausal women. Even before menopause, if you’re in a hypoestrogenic state—whether that’s early menopause, postpartum, breastfeeding, or due to certain medications—similar symptoms can occur. Unlike some menopause symptoms that fade away over time, GSM often sticks around and can even worsen if left untreated. And too many women suffer in silence, either out of embarrassment or simply not knowing there’s help available.

The Real Symptoms of GSM

Let’s get straight about what GSM can look like:

• Vaginal Dryness and Irritation: More than 90% of women with GSM experience a persistent dry or itchy sensation. Imagine your intimate area feeling less like a soft, welcoming haven and more like it’s perpetually in need of rehydration.
• Painful Sex (Dyspareunia): Up to 80% of women dealing with GSM report discomfort or burning during sex. It’s not just about reduced libido—it’s a real physical hurdle that can make intimacy less enjoyable.
• Vaginal Burning or Discomfort: Beyond dryness, you might feel a constant rawness or heat in your vaginal area.
• Urinary Urgency or Frequency: That sudden, pressing need to pee all the time? Yep, GSM can do that.
• Urinary Incontinence: Trouble controlling your bladder or unexpected leaks can also be part of the picture.
• Recurrent UTIs: With the natural protective environment compromised, it’s easier for infections to sneak in.

These symptoms can seriously affect your sexual health, bladder function, and overall well-being, making it all the more important to tackle GSM head-on.

Insights from Dr. Kelly Casperson

Dr. Kelly Casperson—a brilliant mind in women’s health—hits the nail on the head when she says

“GSM isn’t just an inevitable part of aging. It’s your body’s way of saying, “Hey, something’s up here, and I need a bit of care!”

Her message is clear: by recognising and addressing GSM early, you can take back control of your comfort and confidence. Her approach encourages us to have open, honest conversations with our healthcare providers rather than letting embarrassment or outdated terminology keep us from seeking help.

I really enjoy Kelly’s Podcast – You Are Not Broken and her empowering way of framing information.

And I also enjoyed Sonya Lovell’s podcast Dear Menopause – in this episode Sonya interviewed Dr. Kelly. It’s great!

The Magic of Vaginal Oestrogen

Now, let’s chat about one of my favourite solutions: vaginal oestrogen. I can’t say enough good things about this topical treatment. It’s ridiculously safe, and because you apply it right where you need it, it works wonders without messing with your whole body. Many women have affectionately dubbed it “magic cream”—and for good reason.

When applied directly, vaginal oestrogen helps restore the moisture, thickness, and elasticity of your vaginal tissues. This isn’t just about comfort during sex (though that’s a huge bonus); it can also help with symptoms like mild prolapse by plumping and strengthening the tissues around your vulva and vagina. And here’s a fun fact: in England, you can actually buy it over the counter, making it super accessible if you’re ready to give your vag the love it deserves.

The Joys of Lube

Let’s not overlook another simple yet brilliant tool in our GSM arsenal—lube. When your natural lubrication isn’t quite up to the job anymore, a good lube can be a total game-changer. Not only does it reduce friction and discomfort during intimacy, but it also protects your sensitive skin from further irritation.

My personal favourite? A silicone-based lube called Pjur. It feels amazing, and you don’t have to wait til things feel dry to feel the benefits! A little word of caution: because Purr is silicone-based, it’s best not to use it with silicone toys (swap in a water-based lube for that scenario—even though they can sometimes get sticky). The point is that quality lube can transform your intimate moments from a struggle into something you can actually look forward to.

If you want your sticky, tricky questions answered and if you are local to Melbourne – I thoroughly recommend a visit to Passionfruit Sensuality Shop. They have some great blogs around this too!

Treatment Options and Lifestyle Adjustments

Of course, vaginal oestrogen and lube are just parts of the puzzle. Managing GSM often calls for a more holistic approach. Hormonal therapies, whether systemic or local, can help rebalance your body’s chemistry, but if you’re wary of hormones, non-hormonal options like moisturisers and lubricants offer immediate relief.

Lifestyle adjustments can also make a significant difference. Regular sexual activity helps keep your tissues in good shape, while pelvic floor exercises can boost support. Even mindfulness practices can help you tune in to your body and manage the emotional side of these physical changes. But here’s something important: if your relationship is less than stellar, no amount of cream or lube is going to fix that. A toxic relationship can be a serious handbrake on your desire and overall well-being. So, make sure you’re also experiencing a nurturing, supportive, loving environment both in and out of the bedroom.

Taking Control of Your Menopausal Journey

At the end of the day, GSM is a very real part of the menopausal journey for many women—but it doesn’t have to dictate your life. By recognising the signs and understanding your options, you can take proactive steps to care for your body. It’s all about showing your vag a little more love, giving it the support it needs, and ensuring it can continue being the vibrant, pleasure-giving part of you that it’s meant to be.

It might seem daunting at first, but knowledge is power. When you swap out outdated, judgemental terms for something like GSM—a phrase that acknowledges both the challenges and the solutions—you’re opening the door to a world of support and treatment options that can truly make a difference.

Final Thoughts

GSM might sound clinical at first, but don’t let that fool you. Behind the jargon is a very real set of symptoms that affect your quality of life. From dryness and irritation to painful sex and urinary troubles, these issues are part of the menopausal landscape for many of us. And while the idea of our vaginas “drying up” might feel like a slap in the face to our vibrant, pleasure-loving selves, it doesn’t have to be a life sentence.

With effective treatments like vaginal oestrogen—our modern-day “magic cream”—and the everyday relief provided by a good lube like Purr, you have all the tools you need to give your vag the love it deserves. It’s time to ditch the negative labels and embrace a more compassionate, proactive approach to your intimate health.

So if any of this resonates with you, take a moment to listen to your body. Get informed, have those honest chats with your healthcare provider, and remember: your vag is counting on you to treat it right.