# Vaginal dryness, pain and bladder symptoms > Very common, very treatable, and rarely talked about Category: Perimenopause · 4 min read · Written by the Splash team · Sources checked October 2026 URL: https://splash.care/learn/perimenopause/vaginal-urinary-symptoms ## Quick answer - Vaginal and bladder symptoms are common and usually do not go away without treatment. - Moisturisers and lubricants help, and low-dose vaginal oestrogen is very effective and low risk. - Painful sex, bleeding after sex or repeat UTIs are worth telling a GP about. - You do not have to just put up with it. As [oestrogen](https://splash.care/learn/glossary/oestrogen) falls, the skin and lining of the [vagina](https://splash.care/learn/glossary/vagina), [vulva](https://splash.care/learn/glossary/vulva) and bladder can get thinner, drier and more easily irritated. It is one of the most common [menopause](https://splash.care/learn/glossary/menopause) problems, and unlike [hot flushes](https://splash.care/learn/perimenopause/hot-flushes) it usually does not get better by itself. The good news is that treatments are simple and they work. Doctors call these [Genitourinary symptoms](https://splash.care/learn/glossary#gsm). ## What it can feel like - Dryness, burning, soreness or itching in and around the vagina - Pain or discomfort during sex, or bleeding afterwards - Needing to pee more often or urgently, including at night - Leaking when you cough or laugh - More urinary tract infections, or symptoms that feel like a [UTI](https://splash.care/learn/glossary/uti) ## What you can do yourself - Use a water-based lubricant for sex. Do not use oil-based ones with condoms, as they can damage them. - Try a vaginal moisturiser, used regularly (not just before sex). A pharmacist can help you choose, in private. - Skip perfumed soaps, washes and douches. Use only products made for the vagina. - Take your time and enjoy lots of foreplay. ## What a doctor can offer NICE says vaginal [oestrogen](https://splash.care/learn/cycle-basics/hormones-explained) should be offered to people with these symptoms (including if you also take [HRT](https://splash.care/learn/glossary/hrt)). It comes as a cream, gel, tablet, pessary or ring, and you decide together which suits you. A tiny amount gets into your bloodstream, so serious side effects are very rare, and the NHS says it does not increase the risk of breast cancer or blood [clots](https://splash.care/learn/period-care/clots). It is safe to use long term. It works well alongside moisturisers and lubricants. - Symptoms often come back when you stop, and you can restart. - If you had breast cancer or cannot use vaginal oestrogen, non-hormonal moisturisers and lubricants come first. Your breast team or a menopause specialist can talk through other options. - If those do not work, NICE says other options include vaginal prasterone, or an oral medicine (ospemifene) in some situations. - NICE does not recommend vaginal laser treatment outside research trials. - For repeat UTIs, vaginal oestrogen can help prevent them. Ask [your GP](https://splash.care/learn/conditions/talk-to-your-doctor). - Low sex drive has many causes. HRT may help, and a specialist may consider testosterone. Relationship, [stress](https://splash.care/learn/cycle-basics/stress-travel-illness), pain and body image matter too. **Myth:** Painful sex is just part of getting older, so you have to put up with it. **Fact:** It is a treatable medical symptom. The NHS and NICE both set out simple treatments. You do not have to just cope. **Myth:** Vaginal oestrogen is the same as taking full HRT, with the same risks. **Fact:** The dose is very low and acts mostly where it is applied. The NHS says it does not carry the usual risks of HRT. It will not help hot flushes, mood or sleep, though. > **Splash says:** if bladder leaks are part of this, pelvic floor exercises can help, and so can a chat with a GP or pelvic health physio. ### When to see a doctor See a GP if dryness has lasted a few weeks despite self-help, it affects daily life or sex, you have unusual discharge, or you bleed after sex, between periods or after menopause. Get same-day help for UTI symptoms with a high temperature, shivering or back pain, as these can mean a kidney infection. ## Sources 1. [NHS: Vaginal dryness](https://www.nhs.uk/symptoms/vaginal-dryness/) 2. [NHS: Vaginal oestrogen](https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/vaginal-oestrogen/) 3. [NICE NG23: Menopause: identification and management](https://www.nice.org.uk/guidance/ng23) 4. [NICE NG112: Recurrent urinary tract infection](https://www.nice.org.uk/guidance/ng112) This is general information, not medical advice. Splash can’t diagnose. If you’re worried, talk to a GP, pharmacist or sexual health clinic. In an emergency call 999 (UK) or 911 (US).