Menopause and Genitourinary Health

Menopause

Menopause is a natural part of aging Most women experience menopause between ages 45 and 56. Common symptoms include hot flashes, night sweats, mood changes, sleep problems, and vaginal dryness.
Help is available for menopause symptoms Treatments include hormone therapy (estrogen, sometimes with progestogen), non-hormonal medications (such as SSRIs, SNRIs, gabapentin, and fezolinetant), and lifestyle changes. Hormone therapy is most effective for hot flashes, but non-hormonal options are available for those who cannot or do not wish to use hormones
Genitourinary syndrome of menopause (GSM) can cause vaginal dryness, discomfort, pain with sex, and urinary symptoms. Non-hormonal vaginal moisturizers, lubricants, and medications like ospemifene can help. Vaginal estrogen is effective for GSM and is considered safe for most women

Urinary incontinence (leaking urine) is common, especially after childbirth and menopause. There are different types, including stress incontinence (leakage with coughing or exercise) and urge incontinence (sudden, strong need to urinate).
First-line treatment is pelvic floor muscle training (Kegel exercises) These exercises strengthen the muscles that support your bladder and can greatly reduce symptoms. Supervised pelvic floor physical therapy is often more effective than doing exercises alone.
Other helpful strategies Weight loss if overweight, adjusting fluid intake, avoiding caffeine, and quitting smoking can help with urinary symptoms.
Other helpful strategiesMedications may help with urge incontinence Options include antimuscarinic drugs and β-3 agonists, which relax the bladder muscle. These are usually considered if exercises and lifestyle changes are not enough.
Vaginal estrogen can help with urinary symptoms related to menopause It is safe for most women and can be used along with other treatments.
Pelvic floor physical therapy can also help with pelvic pain, prolapse, and sexual dysfunction A trained therapist can teach you exercises and techniques to improve your symptoms.

If symptoms persist, talk to your provider about other options. There are devices, injections, and surgical treatments for more severe cases

Remember Many women experience these symptoms, and effective treatments are available. Don’t hesitate to bring up any concerns with your healthcare provider—they are ready to help you feel your best.