The genitourinary symptoms can take longer to develop than many of the other symptoms of the menopause and because women often feel embarrassed to bring this up with their doctor it may take many years after that for a woman to access help. Consequently it is often 10 years or more before a woman plucks up the courage to speak to someone about their symptoms.

This time gap from menopause to vaginal and urinary symptoms can mean women and healthcare professionals alike may not immediately connect the symptoms to the menopause which occurred some years earlier, and thus vaginal oestrogen replacement is often missed as the necessary treatment for the symptoms.

Women may have been recurrently treated for thrush due to an increased discharge only to find it doesn’t help or have had many courses of antibiotics for urinary tract infections. An itchy sore vulva can drive women to use lots of different products to try and alleviate their discomfort- only to find that this actually adds to the irritation and soreness.