Urogenital symptoms
Urinary and genital symptoms occur due to the effects of diminishing oestrogen levels, which cause thinning and shrinking of the tissues of the vulva, vagina, urethra and bladder.
Multiple symptoms can result including vaginal dryness and irritation, and urinary symptoms such as a frequent need to urinate and also urinary tract infections.
Loss of oestrogen changes the urethral and vaginal bacterial flora, resulting in a higher (more alkaline) pH, predisposing both to infection.
As women age, a loss of muscular tone in the pelvic floor muscles together with thinning of vaginal and urethral tissue can lead to urinary incontinence. There may be insufficient vaginal secretions for comfortable sexual activity, so discomfort or pain on intercourse (dyspareunia) may be experienced.
Vaginal dryness and urinary symptoms tend to increase in severity over time and in some women may not present until five to 10 years after the menopause.
Musculoskeletal symptoms
Joint, bone and muscle pain may be experienced and are commonly reported.