Vaginal and urinary symptoms are very common in the menopause, but often accepted as part of ageing, meaning women don’t always get the help they need. They can start at any stage of the menopause, sometimes developing much later, and tend to get worse, not better with time.

Without oestrogen, vaginal and vulval tissues can become thinner, dry, and less stretchy. Making them feel itchy, dry and sore. This can be a problem during sex or have more of an impact on everyday life.

Passing urine can become more frequent, urgent and painful with urine infections happening more often. Embarrassing leaks can happen, both due to urgency and a weaker pelvic floor.

Fortunately, there are effective, safe treatments; vaginal moisturisers help to rehydrate the tissues and mimic natural lubrication, and during sex, lubricants are helpful.

Vaginal oestrogens are safe for most women. As very little is absorbed into the bloodstream, most of it works where it’s needed. There are several options from pessaries to gels, creams and a vaginal ring.

Bladder training helps reduce how frequently and how urgently you need to go to the toilet, and pelvic floor exercises and physio can help with incontinence.

Restricting fluids makes things worse, so staying hydrated as well as reducing caffeine is important.