{"id":2199,"date":"2026-05-12T04:36:07","date_gmt":"2026-05-12T04:36:07","guid":{"rendered":"https:\/\/wellfemme.com.au\/landing\/?page_id=2199"},"modified":"2026-06-19T02:40:12","modified_gmt":"2026-06-19T02:40:12","slug":"twcm-gsm","status":"publish","type":"page","link":"https:\/\/wellfemme.com.au\/landing\/twcm-gsm\/","title":{"rendered":"TWC- GSM"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2199\" class=\"elementor elementor-2199\" data-elementor-post-type=\"page\">\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-49bb57f e-flex e-con-boxed e-con e-parent\" data-id=\"49bb57f\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-880a7cf e-con-full e-flex e-con e-child\" data-id=\"880a7cf\" data-element_type=\"container\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-efde4cd e-con-full e-flex e-con e-child\" data-id=\"efde4cd\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e7555a4 elementor-widget elementor-widget-image\" data-id=\"e7555a4\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/wellfemme.com.au\/\" target=\"_blank\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"300\" height=\"132\" src=\"https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/02\/wellfemme.png\" class=\"attachment-full size-full wp-image-967\" alt=\"\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-10bba11 e-con-full e-flex e-con e-child\" data-id=\"10bba11\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e649b83 elementor-widget elementor-widget-image\" data-id=\"e649b83\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/terrywhitechemmart.com.au\/\" target=\"_blank\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"360\" height=\"132\" src=\"https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/02\/twc.png\" class=\"attachment-full size-full wp-image-968\" alt=\"\" srcset=\"https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/02\/twc.png 360w, https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/02\/twc-300x110.png 300w\" sizes=\"(max-width: 360px) 100vw, 360px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-3ddb60a e-con-full e-flex e-con e-child\" data-id=\"3ddb60a\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0d02b3a elementor-nav-menu--stretch elementor-nav-menu--dropdown-tablet elementor-nav-menu__text-align-aside elementor-nav-menu--toggle elementor-nav-menu--burger elementor-widget elementor-widget-nav-menu\" data-id=\"0d02b3a\" data-element_type=\"widget\" data-settings=\"{&quot;full_width&quot;:&quot;stretch&quot;,&quot;layout&quot;:&quot;horizontal&quot;,&quot;submenu_icon&quot;:{&quot;value&quot;:&quot;&lt;svg class=\\&quot;e-font-icon-svg e-fas-caret-down\\&quot; 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YOUR CHOICE.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-0512560 e-flex e-con-boxed e-con e-parent\" data-id=\"0512560\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-c0c6dec e-con-full e-flex e-con e-child\" data-id=\"c0c6dec\" data-element_type=\"container\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-70e36e9 e-con-full e-flex e-con e-child\" data-id=\"70e36e9\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cf097b1 elementor-widget elementor-widget-image\" data-id=\"cf097b1\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"769\" height=\"1024\" src=\"https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/05\/Untitled-design-25-scaled-e1778555559356-769x1024.png\" class=\"attachment-large size-large wp-image-2315\" alt=\"\" srcset=\"https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/05\/Untitled-design-25-scaled-e1778555559356-769x1024.png 769w, https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/05\/Untitled-design-25-scaled-e1778555559356-225x300.png 225w, https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/05\/Untitled-design-25-scaled-e1778555559356-768x1022.png 768w, https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/05\/Untitled-design-25-scaled-e1778555559356-1154x1536.png 1154w, https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/05\/Untitled-design-25-scaled-e1778555559356-1539x2048.png 1539w, https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2026\/05\/Untitled-design-25-scaled-e1778555559356.png 1792w\" sizes=\"(max-width: 769px) 100vw, 769px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-5b27a9d e-con-full e-flex e-con e-child\" data-id=\"5b27a9d\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bd2f177 elementor-widget-tablet__width-initial elementor-widget elementor-widget-heading\" data-id=\"bd2f177\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Vaginal &amp; Urinary Symptoms in Midlife: <br>What's Normal, What's Not<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c97f0d9 elementor-align-justify elementor-widget elementor-widget-button\" data-id=\"c97f0d9\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#affecting\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">check Your Symptoms<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-776b985 elementor-align-justify elementor-widget elementor-widget-button\" data-id=\"776b985\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/wellfemme.com.au\/landing\/twc\/\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Take Free Assessement<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-1736c0f e-flex e-con-boxed e-con e-parent\" data-id=\"1736c0f\" data-element_type=\"container\" id=\"symptoms\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-fee9b0e e-con-full e-flex e-con e-child\" data-id=\"fee9b0e\" data-element_type=\"container\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-22b16ad e-con-full e-flex e-con e-child\" data-id=\"22b16ad\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f1a0e27 elementor-widget elementor-widget-text-editor\" data-id=\"f1a0e27\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2><strong>Thrush or UTI again? Perhaps it&#8217;s not&#8230;<\/strong><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a6f73e2 elementor-widget elementor-widget-text-editor\" data-id=\"a6f73e2\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Genitourinary Syndrome of Menopause (GSM)<\/strong> refers to a collection of signs and symptoms of the female genital tract and urinary system that are caused by the fluctuation and decline of reproductive hormones. GSM affects the bladder, vagina, vulva and clitoris, and despite being very common it is largely under reported due to embarrassment and lack of awareness or education about the condition.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-fc739a3 e-con-full e-flex e-con e-child\" data-id=\"fc739a3\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9213759 elementor-widget elementor-widget-n-accordion\" data-id=\"9213759\" data-element_type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1530\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1530\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Learn More about GSM <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" role=\"region\" aria-labelledby=\"e-n-accordion-item-1530\" class=\"elementor-element elementor-element-c6e7113 e-con-full e-flex e-con e-child\" data-id=\"c6e7113\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-240b104 elementor-widget elementor-widget-text-editor\" data-id=\"240b104\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Although this term references menopause, it is important to recognise that symptoms can arise during other times of hormonal fluctuation such as during breastfeeding, during and post cancer treatment such as pelvic radiation and chemotherapy, progestin-only contraceptive use and other anti-estrogenic therapies.<\/p><p>GSM is a physically, psychologically and socially debilitating condition that can have a significant impact on quality of life and significantly contribute to healthcare economic burden. For example women are 3 times more likely to get a UTI post menopause. UTIs can increase the risk of confusion, falls, fractures, sepsis and ultimately death.<\/p><p>It is important to recognise the signs and symptoms, so the appropriate advice and treatment can be initiated.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1531\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1531\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> The Role of Hormones <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" role=\"region\" aria-labelledby=\"e-n-accordion-item-1531\" class=\"elementor-element elementor-element-2e98afe e-con-full e-flex e-con e-child\" data-id=\"2e98afe\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2073ba1 elementor-widget elementor-widget-text-editor\" data-id=\"2073ba1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Estrogen stimulates glycogen production in the vaginal lining. This glycogen provides fuel for the healthy bacteria that colonise the genitourinary tract, which in turn produce lactic acid keeping the vaginal pH low and the environment balanced.<\/p><p>As estrogen declines, glycogen levels fall, healthy bacteria reduce, and less lactic acid is produced. This leads to a higher vaginal pH, which can contribute to dryness, irritation, and an increased risk of urinary tract infections.<\/p><p>Estrogen also helps maintain healthy, well-lubricated tissues. It supports collagen and elastin production, which keeps tissues strong, resilient, and stretchy. Without enough estrogen, tissues can become thinner, drier, and more prone to micro-tears.<br \/>In addition, estrogen supports blood flow to the genitourinary system, improving oxygen delivery to tissues and helping maintain sexual response. In the bladder, it helps preserve mucosal thickness, vascularity, and receptor sensitivity, which is why urinary frequency, urgency, and discomfort can become more common during menopause.<\/p><p>It also plays a role in pelvic floor muscle function by supporting connective tissue integrity and neuromuscular health. When estrogen levels fall, the risk of prolapse can increase.<\/p><p>The genitourinary tract is also influenced by androgens such as testosterone that have similar function to estrogen but a different mechanism of action. Testosterone can help with tissue health and sexual function and not surprisingly, there is a high number of androgen receptors around the clitoris, vaginal opening and lower part of the vagina. Testosterone increases nerve density and function, increasing sexual arousal and pleasure. It is also involved in supporting blood flow, tissue integrity and production of lubrication.<\/p><p>The first step to treatment is an open honest discussion with your healthcare provider, so you receive appropriate advice and treatment.<\/p><p>Download your <strong><a href=\"https:\/\/wellfemme.com.au\/wp-content\/uploads\/2026\/06\/The-Role-of-Hormones-in-Genitourinary-Health.pdf\" target=\"_blank\" rel=\"noopener\">free factsheet.<\/a><\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1532\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1532\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Downloadable Factsheets &amp; Guides <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" role=\"region\" aria-labelledby=\"e-n-accordion-item-1532\" class=\"elementor-element elementor-element-6bb0f23 e-flex e-con-boxed e-con e-child\" data-id=\"6bb0f23\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1274b4d elementor-widget elementor-widget-text-editor\" data-id=\"1274b4d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><a href=\"https:\/\/wellfemme.com.au\/wp-content\/uploads\/2026\/06\/The-Role-of-Hormones-in-Genitourinary-Health.pdf\" target=\"_blank\" rel=\"noopener\">The Role of Hormones in Genitourinary Health<\/a> &#8211; A comprehensive resource exploring how hormonal changes influence vaginal, vulval, and urinary health during midlife, with practical advice, treatment options, and support strategies to improve quality of life.<\/p><p><a href=\"https:\/\/wellfemme.com.au\/wp-content\/uploads\/2026\/06\/Vaginal-Urinary-Symptoms-in-Midlife-1.pdf\" target=\"_blank\" rel=\"noopener\">Vaginal &amp; Urinary Symptoms in Midlife<\/a> &#8211; Explore the hormonal changes that can affect vaginal and urinary health during menopause, including symptoms, risk factors, and strategies to improve comfort and wellbeing.<\/p><p><a href=\"https:\/\/wellfemme.com.au\/wp-content\/uploads\/2026\/06\/Sexual-Pain-Worksheet-NEW.pdf\" target=\"_blank\" rel=\"noopener\">Sexual Pain Worksheet<\/a> &#8211; record your answers and discuss with your GP.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1533\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"4\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1533\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Resources <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" role=\"region\" aria-labelledby=\"e-n-accordion-item-1533\" class=\"elementor-element elementor-element-6a2359a e-flex e-con-boxed e-con e-child\" data-id=\"6a2359a\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-305fa07 elementor-widget elementor-widget-text-editor\" data-id=\"305fa07\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><a href=\"https:\/\/sti.guidelines.org.au\/\" target=\"_blank\" rel=\"noopener\">STI Guidelines<\/a><\/p><p><a href=\"https:\/\/www.health.gov.au\/our-work\/endometriosis-and-pelvic-pain-clinics?language=en\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Endometriosis and pelvic\u00a0 pain clinics<\/span><\/a><\/p><p><a href=\"https:\/\/www.continence.org.au\/about-incontinence\/urinary-incontinence\/\" target=\"_blank\" rel=\"noopener\">Urinary Incontinence<\/a><\/p><p><a href=\"https:\/\/www.pelvicpain.org.au\/\" target=\"_blank\" rel=\"noopener\">Pelvic Pain Foundation Australia<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1534\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"5\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1534\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Books <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" role=\"region\" aria-labelledby=\"e-n-accordion-item-1534\" class=\"elementor-element elementor-element-8ece7d2 e-flex e-con-boxed e-con e-child\" data-id=\"8ece7d2\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-28145f4 elementor-widget elementor-widget-text-editor\" data-id=\"28145f4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\"><a href=\"https:\/\/kellycaspersonmd.com\/you-are-not-broken-book\/\" target=\"_blank\" rel=\"noopener\">You Are Not Broken<\/a>&#8211;\u00a0 Kelly Casperson MD<\/span><\/p><p><span style=\"font-weight: 400;\"><a href=\"https:\/\/kellycaspersonmd.com\/the-menopause-moment-book\/\" target=\"_blank\" rel=\"noopener\">The Menopause Moment<\/a>&#8211; Kelly Casperson MD<\/span><\/p><p><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.penguin.com.au\/books\/where-did-my-libido-go-9781864711561\" target=\"_blank\" rel=\"noopener\">Where Did My Libido Go?<\/a>&#8211; Dr Rosie King<\/span><\/p><p><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.drginni.com.au\/products\/the-m-word-how-to-thrive-in-menopause\" target=\"_blank\" rel=\"noopener\">The M Word<\/a>&#8211; Dr Ginni Mansberg<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-63f85ac elementor-widget elementor-widget-heading\" data-id=\"63f85ac\" data-element_type=\"widget\" id=\"affecting\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Are These Symptoms Affecting You? Click for Treatment Options<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b406d58 elementor-widget elementor-widget-text-editor\" data-id=\"b406d58\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em>Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a6f7d98 elementor-hidden-desktop elementor-widget elementor-widget-eael-adv-tabs\" data-id=\"a6f7d98\" data-element_type=\"widget\" data-widget_type=\"eael-adv-tabs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t        <div data-scroll-on-click=\"no\" data-scroll-speed=\"300\" id=\"eael-advance-tabs-a6f7d98\" class=\"eael-advance-tabs eael-tabs-vertical eael-tab-auto-active \" data-tabid=\"a6f7d98\">\n            <div class=\"eael-tabs-nav\">\n                <ul class=\"\" role=\"tablist\">\n                                            <li id=\"vaginal-dryness\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"true\" data-tab=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"vaginal-dryness-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Vaginal Dryness<\/span>                                                    <\/li>\n                                            <li id=\"burning-or-irritation\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"2\" role=\"tab\" tabindex=\"-1\" aria-controls=\"burning-or-irritation-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Burning or Irritation<\/span>                                                    <\/li>\n                                            <li id=\"itching\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"3\" role=\"tab\" tabindex=\"-1\" aria-controls=\"itching-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Itching<\/span>                                                    <\/li>\n                                            <li id=\"pain-with-sex\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"4\" role=\"tab\" tabindex=\"-1\" aria-controls=\"pain-with-sex-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Pain with Sex<\/span>                                                    <\/li>\n                                            <li id=\"recurrent-thrush\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"5\" role=\"tab\" tabindex=\"-1\" aria-controls=\"recurrent-thrush-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Recurrent &#8220;Thrush&#8221;<\/span>                                                    <\/li>\n                                            <li id=\"bladder-leakage\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"6\" role=\"tab\" tabindex=\"-1\" aria-controls=\"bladder-leakage-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Bladder Leakage<\/span>                                                    <\/li>\n                                            <li id=\"urinary-frequency\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"7\" role=\"tab\" tabindex=\"-1\" aria-controls=\"urinary-frequency-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Urinary Frequency<\/span>                                                    <\/li>\n                                    <\/ul>\n            <\/div>\n            \n            <div class=\"eael-tabs-content\">\n\t\t        \n                    <div id=\"vaginal-dryness-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"vaginal-dryness-tab\">\n\t\t\t\t        <h5><strong>What it feels like:<\/strong><\/h5><p>Persistent dryness, burning, irritation, tightness, or discomfort during everyday activities or intimacy.<\/p><h5><strong>What it can be caused by:<\/strong><\/h5><p>Decreased lubrication and tissue thinning can cause irritation, dryness, pain on sitting or during activities as well as <a href=\"https:\/\/wellfemme.com.au\/pain-during-sex-causes-solutions\/\" target=\"_blank\" rel=\"noopener\">painful intercourse (dyspareunia).\u00a0<\/a><\/p><h5><strong>Practical Steps:<\/strong><\/h5><p>Avoid irritants, such as:<\/p><ul><li>Fragrance or perfumed soaps, washes or douches in or around your vagina<\/li><li>Constant wearing of panty liners or pads (sometimes a problem with bladder leakage)<\/li><li>Products containing glycerin, propylene glycol or petroleum-based products like petroleum jelly, which disrupt the vaginal environment and are not ideal for internal use.<\/li><li>Spermicides such as nonoxynol-9, which can increase irritation<\/li><li>Baby or adult wipes<\/li><li>Very hot water<\/li><li>Moisturisers that are not specifically for vaginal use<\/li><li>Very tight clothing and use 100% cotton underwear if possible<\/li><\/ul><h5><strong>Over-the-Counter Options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal moisturisers<\/span> &#8211; designed for ongoing dryness, not just sex-related lubrication.\u00a0 Used regularly, often a few times per week, they help hydrate the vaginal tissues, provide a protective barrier, improve elasticity and help reduce discomfort. It is important to read the label carefully and choose products that are pH balanced, fragrance free and ideally contain hyaluronic acid. Water based options are generally more soothing and safer for internal use. They can also be used with condoms and toys. Oil and silicone-based moisturisers may last longer but may be more irritating and are unsafe with condoms.<\/li><li><span style=\"text-decoration: underline;\">Vaginal lubricants <\/span>&#8211; used before or during intercourse to help reduce friction and\/or pain. Water-based lubricants are generally recommended as they are low irritant and can be used safely with condoms and toys. They can soak quickly into dry tissues during sex however, whereas oil and silicone lubricants stay slick and &#8220;glidier&#8221; for longer. Silicone lubes should be avoided with silicone-coated toys, and oil-based lubricants should be avoided with condoms. Once again, choose products that are fragrance and flavour free, pH balanced and avoid the same ingredients as moisturisers.<\/li><li><span style=\"text-decoration: underline;\">Barrier creams<\/span> &#8211; for those times when your vulval area might be exposed to chemicals or soaps (like swimming or baths), or friction from bike\/ horse riding or chafing clothes, a barrier layer will help to coat and protect the delicate tissues. Ask your pharmacist about bland baby-safe zinc or barrier creams (external use only), or even an oil-based lubricant (we love Olive and Bee for this job), as well as intimate lubrication.<\/li><\/ul><h5><strong>Localised Hormonal Treatments:<\/strong><\/h5><p>In milder cases of vaginal dryness, it may be sufficient to use vaginal moisturisers and lubricants to treat the symptoms, however this does not treat the underlying cause of low hormones. In Australia, vaginal hormone preparations are prescription-only and should be discussed with a doctor or nurse practitioner.<\/p><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside and around the entrance of the vagina to improve tissue thickness and moisture.<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet:<\/span> A small pessary placed into the vagina, containing a form of low-dose oestrogen.<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone.\u00a0<\/li><li><span style=\"text-decoration: underline;\">Systemic hormone therapy:<\/span> May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels.<\/li><\/ul><p>\u00a0<\/p><p>Please note: Vaginal estrogens are a very safe and effective treatment for menopausal vaginal dryness and GSM; they may even be used after breast cancer (after discussion with the cancer specialists). They are localised topical treatments only and are not absorbed measurably into the bloodstream so they do not treat systemic symptoms like hot flushes.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"burning-or-irritation-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"burning-or-irritation-tab\">\n\t\t\t\t        <h5><strong>What it feels like:<\/strong>\u00a0<\/h5><p>A stinging, burning sensation inside or around the vagina, often worse with sex, peeing, or touching the area. May come with itching, rawness, or sensitivity that makes daily activities uncomfortable.<\/p><h5><strong>What it can be caused by:\u00a0<\/strong><\/h5><p>Burning &amp; irritation may be caused by infections, underlying conditions such as lichen sclerosis or reactions to irritants in addition to low hormones.<\/p><h5><strong>Practical Steps:\u00a0<\/strong><\/h5><ul><li>Wear cotton underwear and loose clothing to let the area breathe<\/li><li>Avoid irritants such as scented soaps, bubble baths, douches, perfumed wipes, or dyed toilet paper<\/li><li>Wash with plain water<\/li><li>Wipe front to back to avoid spreading bacteria from the bowel<\/li><li>Take cool sitz (salt water) baths for 10 mins at a time, or apply a cold pack wrapped in a cloth<\/li><li>Pat dry gently &amp; don\u2019t rub<\/li><li>Avoid sex or tampons until symptoms settle<\/li><\/ul><h5><strong>Over-the-Counter Options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal moisturisers <\/span>are designed for ongoing dryness, not just sex-related lubrication. Used regularly, often a few times per week, they help hydrate the vaginal tissues, provide a protective barrier, improve elasticity and help reduce discomfort. It is important to read the label carefully and choose products that are pH balanced, fragrance free and ideally contain hyaluronic acid. Water based options are generally more soothing and safer for internal use. They can also be used with condoms and toys. Oil and silicone based moisturisers may last longer but may be more irritating and oil-based lubes should not be used with condoms.<\/li><\/ul><h5><strong>Please discuss the following options with your pharmacist:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Antihistamine cream<\/span> for external itching: Thin layer 1-2x\/day max<\/li><li><span style=\"text-decoration: underline;\">Hydrocortisone 1% cream<\/span>: For vulval irritation only, short-term (3-5 days max)<\/li><li><span style=\"text-decoration: underline;\">Antifungal cream <\/span>(e.g. Canesten\/clotrimazole): If yeast infection suspected<\/li><li><span style=\"text-decoration: underline;\">Oral antifungal tablets<\/span>: for likely cases of thrush, and less irritant than creams [NOTE: if you think you have recurrent \u201cthrush\u201d but it persists or returns despite treatment, it may be something else. See your doctor for proper examination and diagnosis!]<\/li><li><span style=\"text-decoration: underline;\">Probiotic vaginal pessaries<\/span> may help support healthy vaginal bacteria<\/li><\/ul><h5><strong>Medications &amp; Hormonal Options: Prescription Only<\/strong><\/h5><ul><li>Burning &amp; irritation may be caused by infections or reactions to irritants in addition to low hormones.<\/li><\/ul><h5><strong>For infections:<\/strong><\/h5><p><span style=\"text-decoration: underline;\">Antibiotics<\/span> for bacterial vaginosis<\/p><p><span style=\"text-decoration: underline;\">Stronger antifungals<\/span> for recurrent or resistant thrush<\/p><p><span style=\"text-decoration: underline;\">Treatment<\/span> for STIs if relevant<\/p><p><span style=\"text-decoration: underline;\">Antibiotics<\/span> for urinary tract infection<\/p><h5><strong>Localised Hormonal Treatments:<\/strong><\/h5><p><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue thickness and moisture<\/p><p><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet<\/span>: A small pessary placed into the vagina, containing a form of low-dose oestrogen<\/p><p><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone<\/p><p><span style=\"text-decoration: underline;\">Systemic hormone therapy:<\/span> May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels<\/p><p><span style=\"text-decoration: underline;\">Specialist review if symptoms persist,<\/span> as some chronic or pre-cancerous conditions may cause similar symptoms<\/p><p>See your doctor promptly if symptoms persist or worsen, you have discharge\/ odour\/ fever, or suspect you have a urinary tract infection, a sexually transmitted disease, recurrent thrush or bacterial vaginosis.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"itching-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"itching-tab\">\n\t\t\t\t        <h5><strong>What it feels like:<\/strong>\u00a0<\/h5><p>Persistent urge to scratch inside or around the vagina or vulva, and perhaps even the anus. It can range from mild tickling to intense irritation that disrupts sleep or daily life and is often worse at night or after sweating.<\/p><h5><strong>What it can be caused by:<\/strong><\/h5><p>Low estrogen (menopause), yeast infections (thrush), bacterial vaginosis, allergies to soaps\/pads\/perfumes, skin conditions (lichen sclerosus, eczema), hormonal changes (PCOS), or sexually transmitted infections.<\/p><h5><strong>Practical Steps:\u00a0<\/strong><\/h5><ul><li>Wear breathable cotton underwear (avoid synthetics, tight clothing)<\/li><li>Wash once daily max with plain water or sorbolene cream-overwashing strips protective oils<\/li><li>Avoid irritants such as scented soaps, bubble baths, douches, perfumed pads\/wipes, or fabric softener<\/li><li>Wipe front to back after toilet use<\/li><li>Keep the area cool and dry use cotton pads in underwear if sweaty<\/li><li>Cold compress (10 mins, 2-3 times daily) to calm inflamed skin<\/li><li>Avoid scratching (trim nails, wear cotton gloves at night if needed<\/li><\/ul><h5><strong>Over-the-Counter Options:<\/strong><\/h5><ul><li>Please discuss the following options with your pharmacist<\/li><li><span style=\"text-decoration: underline;\">Oral antihistamines<\/span>, particularly to help reduce nighttime itching<\/li><li><span style=\"text-decoration: underline;\">Antihistamine cream<\/span> for external itching: Thin layer 1-2x\/day max<\/li><li><span style=\"text-decoration: underline;\">Hydrocortisone 1% cream<\/span>: For vulval itching only, short-term (3-5 days max)<\/li><li><span style=\"text-decoration: underline;\">Antifungal cream<\/span> (e.g. Canesten\/clotrimazole): If yeast infection (thrush) suspected<\/li><li><span style=\"text-decoration: underline;\">Oral antifungal tablets<\/span>: for likely cases of thrush, and less irritant than creams [NOTE: if you think you have recurrent \u201cthrush\u201d but it persists or returns despite treatment, it may be something else. See your doctor for proper examination and diagnosis!]<\/li><li><span style=\"text-decoration: underline;\">Probiotic vaginal pessaries<\/span> may help support healthy vaginal bacteria<\/li><li><span style=\"text-decoration: underline;\">Barrier cream<\/span> (zinc\/specified barrier cream or ointment): protects irritated skin from moisture\/urine<\/li><\/ul><h5><strong>Localised Hormonal Treatments:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue thickness and moisture<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet:<\/span> A small pessary placed into the vagina, containing a form of low-dose estrogen<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone<\/li><li><span style=\"text-decoration: underline;\">Systemic hormone therapy:<\/span> May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels.<\/li><\/ul>                    <\/div>\n\t\t        \n                    <div id=\"pain-with-sex-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"pain-with-sex-tab\">\n\t\t\t\t        <h5><strong>What it feels like:<\/strong><\/h5><p>Sharp or burning pain at the entrance, deep ache with thrusting, or soreness that lasts for some time after sex. It can make you tense up or avoid intimacy.<\/p><h5><strong>What it can be caused by:<\/strong><\/h5><p>Low estrogen (menopause, breastfeeding), vaginal dryness and tissue thinning, infections (thrush, BV), pelvic floor tension, endometriosis, vaginismus (involuntary vaginal muscle tightening), allergies to products or condoms, or insufficient arousal\/foreplay. <strong>Sexual pain is a complex issue<\/strong>, and some causes can be more serious; <a href=\"https:\/\/wellfemme.com.au\/pain-during-sex-causes-solutions\/\" target=\"_blank\" rel=\"noopener\">check out our full article here<\/a> for more information.\u00a0<\/p><h5><strong>Practical Steps:\u00a0<\/strong><\/h5><ul><li>Extended foreplay (20+ mins) to allow natural lubrication<\/li><li>Use lubricants generously before and during sex<\/li><li>Try positions where you control depth and pace (e.g. woman on top), or use spacer devices like <a href=\"https:\/\/www.blossompelvichealth.com.au\/collections\/the-pelvic-people\/products\/ohnut-depth-limiting-rings\" target=\"_blank\" rel=\"noopener\">Ohnut<\/a><\/li><li>Pelvic floor relaxation exercises (deep breathing, reverse Kegels)<\/li><li>Communicate with your partner about what feels good\/painful<\/li><li>Empty bladder before sex to reduce pressure<\/li><li>Avoid sex if very dry, irritated or recovering from an infection; wait until symptoms settle<\/li><\/ul><h5><strong>Over-the-Counter Options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal lubricants<\/span> before or during intercourse<\/li><li><span style=\"text-decoration: underline;\">Vaginal moisturisers<\/span> (2-3 times per week to improve baseline comfort)<\/li><li><span style=\"text-decoration: underline;\">Paracetamol or ibuprofen<\/span>: 30 mins before sex if muscle tension contributes<\/li><li><span style=\"text-decoration: underline;\">Lidocaine 2-5% gel\/ointment<\/span>: Numbing gel for entry pain (short-term use only)<\/li><\/ul><h5><strong>Medications &amp; Hormonal Options:<\/strong><\/h5><ul><li>Prescription-only (discuss with your doctor or nurse prescriber)<\/li><li>For infections\/inflammation:<\/li><li><span style=\"text-decoration: underline;\">Antifungals<\/span> (fluconazole) or antibiotics (metronidazole) if infection present<\/li><li><span style=\"text-decoration: underline;\">Low-dose steroid cream<\/span> for vulval irritation<\/li><li>Your practitioner should also take a sexual history and ask questions to rule out possible sexually transmitted infection (STI), which is easy to treat with antibiotics in most cases. A vaginal swab or urine sample may be required for diagnosis<\/li><\/ul><h5><strong>Hormonal Treatments:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue thickness and moisture.<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet:<\/span> A small pessary placed into the vagina, containing a form of low-dose oestrogen.<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone.\u00a0<\/li><li><span style=\"text-decoration: underline;\">Systemic hormone therapy:<\/span> May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels.<\/li><\/ul><h5><strong>For Muscle Tension:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Pelvic floor<\/span> physiotherapy<\/li><li><span style=\"text-decoration: underline;\">Muscle relaxants<\/span> or Botox injections (specialist referral)<\/li><li><span style=\"text-decoration: underline;\">Psychological therapy<\/span> from a qualified sexual counsellor can help in cases of trauma, aversion or relationship issues causing sexual pain or avoidance.<\/li><\/ul><p>\u00a0<\/p><p>See your doctor if: Pain persists despite lubrication, new bleeding\/discharge, you have deep pelvic pain, a history of sexual trauma or violence, suspect an STI or are unable to have penetrative sex.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"recurrent-thrush-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"recurrent-thrush-tab\">\n\t\t\t\t        <h5><strong>What it feels like:\u00a0<\/strong><\/h5><p>Not everyone has all these symptoms, but they can include intense vaginal itching (especially at night), thick white \u201ccottage cheese\u201d discharge, redness\/swelling of vulva, soreness or burning with sex or peeing. Episodes return frequently despite treatment.<\/p><h5><strong>What it can be caused by:\u00a0<\/strong><\/h5><p>Recurrent thrush is four or more episodes per year of vaginal fungal overgrowth (Candida albicans most common). Risk factors include low estrogen, antibiotics, high blood sugar or diabetes, tight clothing, pregnancy, hypersensitive immune response, or atypical yeast strains.<\/p><h5><strong>Practical Steps:\u00a0<\/strong><\/h5><ul><li>Wear cotton underwear, avoid tight synthetics or damp clothing<\/li><li>Dry thoroughly after bathing\/swimming, use hairdryer on cool setting if needed<\/li><li>Wash with plain water only, skip soaps, bubble baths, douches<\/li><li>Wipe front to back, change pads\/tampons frequently<\/li><li>Avoid spermicides, perfumed products, glycerin-based lubricants<\/li><li>Manage blood sugar if diabetic &amp; check HbA1c regularly<\/li><li>Eat low-sugar diet, consider probiotic-rich foods (yoghurt, kefir)<\/li><li>Sleep naked or in cotton to keep area cool\/dry<\/li><\/ul><h5><strong>Over-the-Counter Options:<\/strong><\/h5><ul><li>For acute episodes (use 7-14 days):<\/li><li><span style=\"text-decoration: underline;\">Clotrimazole pessary\/cream<\/span> (Canesten 1-day\/3-day\/6-day)<\/li><li><span style=\"text-decoration: underline;\">Miconazole <\/span>(Gyno-Daktarin)<\/li><li><span style=\"text-decoration: underline;\">Oral antifungal tablets<\/span>: generally a single oral dose, and less messy and irritant than creams<\/li><li><span style=\"text-decoration: underline;\">Probiotic pessaries<\/span> (e.g. Fem Dophilus) to support good bacteria<\/li><li><span style=\"text-decoration: underline;\">Gentle hydrocortisone<\/span> 1% cream twice daily for external itching<\/li><\/ul><h5><strong>Short-term Prevention (trial for 1-2 months):<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Weekly clotrimazole<\/span> 500mg pessary after periods<\/li><li>Note: If episodes recur despite OTC treatment, see your doctor for testing<\/li><\/ul><h5><strong>Medications &amp; Hormonal Options:<\/strong><\/h5><ul><li>Prescription-only (discuss with your doctor\/nurse)<\/li><li>Induction treatment (for active infection):<\/li><li><span style=\"text-decoration: underline;\">Fluconazole<\/span> 150mg oral daily x 3-7 days OR clotrimazole 10-14 days<\/li><li><span style=\"text-decoration: underline;\">For non-albicans yeast<\/span>: Boric acid pessaries 600mg nightly x 14 days<\/li><\/ul><h5><strong>Maintenance\/suppression (6+ months, most effective):<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Fluconazole<\/span> 150mg oral weekly<\/li><li><span style=\"text-decoration: underline;\">Clotrimazole<\/span> 500mg pessary weekly or topical cream 2-3x\/week<\/li><\/ul><h5><strong>Hormonal Treatments:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue thickness and moisture<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet<\/span>: A small pessary placed into the vagina, containing a form of low-dose oestrogen<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone<\/li><\/ul><p>\u00a0<\/p><p>See your doctor if: you have many episodes per year, symptoms persist despite treatment, unusual discharge or odour, pain, diabetes symptoms, or pregnancy. They may test for resistant yeast or underlying causes.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"bladder-leakage-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"bladder-leakage-tab\">\n\t\t\t\t        <h5><strong>What it feels like:\u00a0<\/strong><\/h5><p>Small leaks when coughing, sneezing, laughing or exercising (stress leakage), sudden uncontrollable gush before reaching the toilet (urge leakage), or constant dribbling (overflow). Can feel embarrassing and limit activities.<\/p><h5><strong>What it can be caused by:\u00a0<\/strong><\/h5><p>Weak pelvic floor muscles (childbirth, menopause), low estrogen thinning urethral tissue, overactive bladder, obesity, chronic cough, constipation, prolapse, or neurological conditions.<\/p><h5><strong>How common is it:\u00a0<\/strong><\/h5><p>This is an incredibly common symptom, with leakage and other continence issues affecting more than half of postmenopausal women. It can be debilitating and keep women restricted in even leaving the house or going about their daily activities.<\/p><h5><strong>Practical Steps:\u00a0<\/strong><\/h5><ul><li>Pelvic floor exercises (Kegels): Check out Continence Australia\u2019s\u00a0<a href=\"https:\/\/continence.my.salesforce.com\/sfc\/p\/#A0000000KUc9\/a\/Oa0000029dx3\/bJCEAs18YUdxrsEZqysyIG.3WRkLAe6Vkcok7a_xsiM\" target=\"_blank\" rel=\"noopener\">guide to the pelvic floor<\/a>, and see a\u00a0<a href=\"https:\/\/choose.physio\/find-a-physio\" target=\"_blank\" rel=\"noopener\">pelvic floor physiotherapist<\/a>\u00a0to ensure you are doing the exercises correctly<\/li><li>Maintain healthy weight: Extra abdominal weight weakens pelvic floor<\/li><li>Avoid constipation: High-fibre diet, adequate water, regular toilet habit<\/li><li>Bladder training: Gradually increase time between bathroom visits; again, see a\u00a0<a href=\"https:\/\/choose.physio\/find-a-physio\" target=\"_blank\" rel=\"noopener\">pelvic floor physiotherapist<\/a>\u00a0for a thorough review and guidance in these techniques<\/li><li>Double voiding: Pee, wait 30 seconds, then try again to fully empty<\/li><li>Cut bladder irritants: Less caffeine, alcohol, fizzy drinks<\/li><li>Good lifting technique: Tighten pelvic floor before lifting<\/li><li>Timed toileting: Go every 3-4 hours even without urge<\/li><\/ul><h5><strong>Over-the-Counter Options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Incontinence pads and panties:<\/span> Absorbent protection while building control<\/li><li><span style=\"text-decoration: underline;\">Pelvic floor trainers:<\/span> App-guided exercise devices<\/li><li><span style=\"text-decoration: underline;\">Cranberry tablets:<\/span> May help prevent UTIs that worsen leakage<\/li><li><span style=\"text-decoration: underline;\">Ural sachets:<\/span> For bladder irritation\/discomfort<\/li><li><span style=\"text-decoration: underline;\">Paracetamol:<\/span> For pelvic discomfort during exercises<\/li><\/ul><h5><strong>Medications &amp; Hormonal Options:<\/strong><\/h5><ul><li>Prescription-only (discuss with your doctor\/nurse):<\/li><li>For stress incontinence:<\/li><li><span style=\"text-decoration: underline;\">Duloxetine<\/span> (sometimes used off-label)<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen<\/span> (Ovestin\/Vagifem): Strengthens urethral tissue<\/li><\/ul><h5>For urge incontinence:<\/h5><ul><li><span style=\"text-decoration: underline;\">Anticholinergics<\/span> (oxybutynin, tolterodine)<br \/>Mirabegron (eg. Betmiga , fewer side effects)<\/li><\/ul><h5><strong>Specialist Options:<\/strong><\/h5><ul><li><a href=\"https:\/\/choose.physio\/find-a-physio\" target=\"_blank\" rel=\"noopener\">Pelvic floor physiotherapy<\/a>\u00a0(biofeedback, electrical stimulation)<\/li><li><span style=\"text-decoration: underline;\">Pessary (vaginal support device for prolapse);<\/span> often recommended and fitted by pelvic floor physios<\/li><li><span style=\"text-decoration: underline;\">Urethral bulking<\/span> injections<\/li><li><span style=\"text-decoration: underline;\">Sling surgery<\/span> (mid-urethral sling, very effective)<\/li><li><span style=\"text-decoration: underline;\">Botox bladder<\/span> injections<\/li><\/ul><p>\u00a0<\/p><p>See your doctor if: leakage affects quality of life, sudden worsening, blood in urine, pelvic pain or prolapse symptoms. Pelvic floor assessment recommended.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"urinary-frequency-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"urinary-frequency-tab\">\n\t\t\t\t        <h5><strong>What it feels like:\u00a0<\/strong><\/h5><p>Sudden strong urge to pee that\u2019s hard to ignore, needing to go more often than usual (8+ times\/day), waking multiple times at night (nocturia), or leaking a little before you reach the toilet.<\/p><h5><strong>What it can be caused by:\u00a0<\/strong><\/h5><p>Low estrogen (such as GSM, causing bladder and urethral tissue thinning and bladder irritability), overactive bladder, urinary tract infections (UTIs), pelvic floor weakness, diabetes\/high blood sugar, caffeine or alcohol excess, overhydration, constipation, certain medications or anxiety\/stress.<\/p><h5><strong>Practical Steps:\u00a0<\/strong><\/h5><ul><li>Bladder training: Delay peeing by 5-10 mins when you feel the urge, gradually increase time between voids (pelvic floor\/ continence physiotherapists can help train you in this)<\/li><li>Cut irritants: Reduce caffeine (coffee, tea, cola), alcohol, fizzy drinks, artificial sweeteners<\/li><li>Sip, don\u2019t gulp: Spread fluid intake evenly through the day, aim for 1.5-2L water<\/li><li>Timed voiding: Pee every 3-4 hours even without urge to retrain bladder<\/li><li>Pelvic floor exercises: Kegels (squeeze\/release 10x, 3x\/day) or see pelvic physio<\/li><li>Good bowel habit: Prevent constipation with fibre, water, movement<\/li><li>Weight management: Extra weight increases bladder pressure<\/li><li>No \u201cjust in case\u201d peeing, train bladder to hold longer<\/li><\/ul><h5><strong>Over-the-Counter Options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Cranberry products<\/span> (tablets, juice): May help prevent UTIs (evidence mixed)<\/li><li><span style=\"text-decoration: underline;\">Paracetamol<\/span>: For discomfort if bladder is irritated<\/li><li><span style=\"text-decoration: underline;\">Probiotics:<\/span> Oral or vaginal to support urinary\/vaginal health<\/li><li><span style=\"text-decoration: underline;\">Bladder support supplements<\/span> (e.g. Ural sachets): Alkalinise urine for mild irritation<\/li><li><span style=\"text-decoration: underline;\">Pelvic floor training<\/span> e.g.: Guided Kegel trainers<\/li><li><span style=\"text-decoration: underline;\">Some OTC medications<\/span> can help prevent UTI\u2019s such as\u00a0methenamine hippurate and D-Mannose.<\/li><li><span style=\"text-decoration: underline;\">Some OTC medications<\/span> can relieve the symptoms of urinary discomfort, like urinary alkalinisers, eg. Ural, Citravescent<\/li><\/ul><h5><strong>Medications &amp; Hormonal Options:<\/strong><\/h5><ul><li>Prescription-only (discuss with your doctor\/nurse):<\/li><li>For overactive bladder:<\/li><li><span style=\"text-decoration: underline;\">Anticholinergics<\/span> (oxybutynin, tolterodine)<\/li><li><span style=\"text-decoration: underline;\">Beta-3 agonists<\/span> (mirabegron)<\/li><li><span style=\"text-decoration: underline;\">Desmopressin<\/span> for severe nocturia<\/li><li><span style=\"text-decoration: underline;\">Mirabegron<\/span> (eg. Betmiga)<\/li><\/ul><h5><strong>Hormonal Treatments:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue tone and moisture.<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet:<\/span> A small pessary placed into the vagina, containing a form of low-dose oestrogen.<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into oestrogen and androgens, such as testosterone.\u00a0<\/li><li><span style=\"text-decoration: underline;\">Systemic hormone therapy<\/span>: May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels.<\/li><\/ul><h5><strong>For infections:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Antibiotics<\/span> for confirmed UTIs; can be used for treatment and prevention (eg. nitrofurantoin, trimethoprim)<\/li><\/ul><h5><strong>Specialist options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Pelvic floor<\/span> physiotherapy<\/li><li><span style=\"text-decoration: underline;\">Sleep study<\/span> (lack of deep sleep increases night-time diuresis)<\/li><li><span style=\"text-decoration: underline;\">Botox bladder injections<\/span><\/li><li><span style=\"text-decoration: underline;\">Nerve stimulation<\/span> (sacral neuromodulation)<\/li><\/ul><p>\u00a0<\/p><p>See your doctor if: Leaking with urgency, blood in urine, fevers, chills, symptoms lasting over 2 weeks, or diabetes symptoms. Urine tests may be needed.<\/p>                    <\/div>\n\t\t                    <\/div>\n        <\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-4f6ed92 e-con-full e-flex e-con e-child\" data-id=\"4f6ed92\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1921526 elementor-hidden-tablet elementor-hidden-mobile elementor-widget elementor-widget-eael-adv-tabs\" data-id=\"1921526\" data-element_type=\"widget\" data-widget_type=\"eael-adv-tabs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t        <div data-scroll-on-click=\"no\" data-scroll-speed=\"300\" id=\"eael-advance-tabs-1921526\" class=\"eael-advance-tabs eael-tabs-horizontal eael-tab-auto-active \" data-tabid=\"1921526\">\n            <div class=\"eael-tabs-nav\">\n                <ul class=\"\" role=\"tablist\">\n                                            <li id=\"vaginal-dryness\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"true\" data-tab=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"vaginal-dryness-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Vaginal Dryness<\/span>                                                    <\/li>\n                                            <li id=\"burning-or-irritation\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"2\" role=\"tab\" tabindex=\"-1\" aria-controls=\"burning-or-irritation-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Burning or Irritation<\/span>                                                    <\/li>\n                                            <li id=\"itching\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"3\" role=\"tab\" tabindex=\"-1\" aria-controls=\"itching-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Itching<\/span>                                                    <\/li>\n                                            <li id=\"pain-with-sex\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"4\" role=\"tab\" tabindex=\"-1\" aria-controls=\"pain-with-sex-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Pain with Sex<\/span>                                                    <\/li>\n                                            <li id=\"recurrent-thrush\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"5\" role=\"tab\" tabindex=\"-1\" aria-controls=\"recurrent-thrush-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Recurrent &#8220;Thrush&#8221;<\/span>                                                    <\/li>\n                                            <li id=\"bladder-leakage\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"6\" role=\"tab\" tabindex=\"-1\" aria-controls=\"bladder-leakage-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Bladder Leakage<\/span>                                                    <\/li>\n                                            <li id=\"urinary-frequency\" class=\"inactive eael-tab-item-trigger eael-tab-nav-item\" aria-selected=\"false\" data-tab=\"7\" role=\"tab\" tabindex=\"-1\" aria-controls=\"urinary-frequency-tab\" aria-expanded=\"false\">\n                            \n                            \n                            \n                                                            <span class=\"eael-tab-title title-after-icon\" >Urinary Frequency<\/span>                                                    <\/li>\n                                    <\/ul>\n            <\/div>\n            \n            <div class=\"eael-tabs-content\">\n\t\t        \n                    <div id=\"vaginal-dryness-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"vaginal-dryness-tab\">\n\t\t\t\t        <h5><strong>What it feels like:<\/strong><\/h5><p>Persistent dryness, burning, irritation, tightness, or discomfort during everyday activities or intimacy.<\/p><h5><strong>What it can be caused by:<\/strong><\/h5><p>Decreased lubrication and tissue thinning can cause irritation, dryness, pain on sitting or during activities as well as <strong><a href=\"https:\/\/wellfemme.com.au\/pain-during-sex-causes-solutions\/\" target=\"_blank\" rel=\"noopener\">painful intercourse (dyspareunia).\u00a0<\/a><\/strong><\/p><h5><strong>Practical steps:<\/strong><\/h5><p>Avoid irritants, such as:<\/p><ul><li>Fragrance or perfumed soaps, washes or douches in or around your vagina<\/li><li>Constant wearing of panty liners or pads (sometimes a problem with bladder leakage)<\/li><li>Products containing glycerin, propylene glycol or petroleum-based products like petroleum jelly, which disrupt the vaginal environment and are not ideal for internal use.<\/li><li>Spermicides such as nonoxynol-9, which can increase irritation<\/li><li>Baby or adult wipes<\/li><li>Very hot water<\/li><li>Moisturisers that are not specifically for vaginal use<\/li><li>Very tight clothing and use 100% cotton underwear if possible<\/li><\/ul><h5><strong>Over-the-counter options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal moisturisers<\/span> &#8211; designed for ongoing dryness, not just sex-related lubrication.\u00a0 Used regularly, often a few times per week, they help hydrate the vaginal tissues, provide a protective barrier, improve elasticity and help reduce discomfort. It is important to read the label carefully and choose products that are pH balanced, fragrance free and ideally contain hyaluronic acid. Water based options are generally more soothing and safer for internal use. They can also be used with condoms and toys. Oil and silicone-based moisturisers may last longer but may be more irritating and are unsafe with condoms.<\/li><li><span style=\"text-decoration: underline;\">Vaginal lubricants<\/span> &#8211; used before or during intercourse to help reduce friction and\/or pain. Water-based lubricants are generally recommended as they are low irritant and can be used safely with condoms and toys. They can soak quickly into dry tissues during sex however, whereas oil and silicone lubricants stay slick and &#8220;glidier&#8221; for longer. Silicone lubes should be avoided with silicone-coated toys, and oil-based lubricants should be avoided with condoms. Once again, choose products that are fragrance and flavour free, pH balanced and avoid the same ingredients as moisturisers.<\/li><li><span style=\"text-decoration: underline;\">Barrier creams<\/span> &#8211; for those times when your vulval area might be exposed to chemicals or soaps (like swimming or baths), or friction from bike\/ horse riding or chafing clothes, a barrier layer will help to coat and protect the delicate tissues. Ask your pharmacist about bland baby-safe zinc or barrier creams (external use only), or even an oil-based lubricant (we love Olive and Bee for this job), as well as intimate lubrication.<\/li><\/ul><h5><strong>Localised hormonal treatments:<\/strong><\/h5><p>In milder cases of vaginal dryness, it may be sufficient to use vaginal moisturisers and lubricants to treat the symptoms, however this does not treat the underlying cause of low hormones. In Australia, vaginal hormone preparations are prescription-only and should be discussed with a doctor or nurse practitioner.<\/p><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside and around the entrance of the vagina to improve tissue thickness and moisture.<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet<\/span>: A small pessary placed into the vagina, containing a form of low-dose oestrogen.<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA<\/span> (dehydroepiandrosterone) pessary: A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone.<\/li><li><span style=\"text-decoration: underline;\">Systemic hormone therapy<\/span>: May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels.<\/li><\/ul><h5>Please note:<\/h5><p>Vaginal estrogens are a very safe and effective treatment for menopausal vaginal dryness and GSM; they may even be used after breast cancer (after discussion with the cancer specialists). They are localised topical treatments only and are not absorbed measurably into the bloodstream so they do not treat systemic symptoms like hot flushes.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"burning-or-irritation-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"burning-or-irritation-tab\">\n\t\t\t\t        <h5><strong>What it feels like:<\/strong>\u00a0<\/h5><p>A stinging, burning sensation inside or around the vagina, often worse with sex, peeing, or touching the area. May come with itching, rawness, or sensitivity that makes daily activities uncomfortable.<\/p><h5><strong>What it can be caused by:\u00a0<\/strong><\/h5><p>Burning &amp; irritation may be caused by infections, underlying conditions such as lichen sclerosis or reactions to irritants in addition to low hormones.<\/p><h5><strong>Practical steps:\u00a0<\/strong><\/h5><ul><li>Wear cotton underwear and loose clothing to let the area breathe<\/li><li>Avoid irritants such as scented soaps, bubble baths, douches, perfumed wipes, or dyed toilet paper<\/li><li>Wash with plain water<\/li><li>Wipe front to back to avoid spreading bacteria from the bowel<\/li><li>Take cool sitz (salt water) baths for 10 mins at a time, or apply a cold pack wrapped in a cloth<\/li><li>Pat dry gently &amp; don\u2019t rub<\/li><li>Avoid sex or tampons until symptoms settle<\/li><\/ul><h5><strong>Over-the-counter options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal moisturisers <\/span>are designed for ongoing dryness, not just sex-related lubrication. Used regularly, often a few times per week, they help hydrate the vaginal tissues, provide a protective barrier, improve elasticity and help reduce discomfort. It is important to read the label carefully and choose products that are pH balanced, fragrance free and ideally contain hyaluronic acid. Water based options are generally more soothing and safer for internal use. They can also be used with condoms and toys. Oil and silicone based moisturisers may last longer but may be more irritating and oil-based lubes should not be used with condoms.<\/li><\/ul><h5><strong>Please discuss the following options with your pharmacist:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Antihistamine cream<\/span> for external itching: Thin layer 1-2x\/day max<\/li><li><span style=\"text-decoration: underline;\">Hydrocortisone 1% cream<\/span>: For vulval irritation only, short-term (3-5 days max)<\/li><li><span style=\"text-decoration: underline;\">Antifungal cream <\/span>(e.g. Canesten\/clotrimazole): If yeast infection suspected<\/li><li><span style=\"text-decoration: underline;\">Oral antifungal tablets<\/span>: for likely cases of thrush, and less irritant than creams [NOTE: if you think you have recurrent \u201cthrush\u201d but it persists or returns despite treatment, it may be something else. See your doctor for proper examination and diagnosis!]<\/li><li><span style=\"text-decoration: underline;\">Probiotic vaginal pessaries<\/span> may help support healthy vaginal bacteria<\/li><\/ul><h5><strong>Medications &amp; hormonal options: prescription only<\/strong><\/h5><p>Burning &amp; irritation may be caused by infections or reactions to irritants in addition to low hormones.<\/p><p><strong>For infections:<\/strong><\/p><p><span style=\"text-decoration: underline;\">Antibiotics<\/span> for bacterial vaginosis<\/p><p><span style=\"text-decoration: underline;\">Stronger antifungals<\/span> for recurrent or resistant thrush<\/p><p><span style=\"text-decoration: underline;\">Treatment<\/span> for STIs if relevant<\/p><p><span style=\"text-decoration: underline;\">Antibiotics<\/span> for urinary tract infection<\/p><h5><strong>Localised hormonal treatments:<\/strong><\/h5><p><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue thickness and moisture<\/p><p><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet<\/span>: A small pessary placed into the vagina, containing a form of low-dose oestrogen<\/p><p><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone<\/p><p><span style=\"text-decoration: underline;\">Systemic hormone therapy:<\/span> May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels<\/p><p><span style=\"text-decoration: underline;\">Specialist review if symptoms persist,<\/span> as some chronic or pre-cancerous conditions may cause similar symptoms<\/p><p>See your doctor promptly if symptoms persist or worsen, you have discharge\/ odour\/ fever, or suspect you have a urinary tract infection, a sexually transmitted disease, recurrent thrush or bacterial vaginosis.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"itching-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"itching-tab\">\n\t\t\t\t        <h5><strong>What it feels like:<\/strong>\u00a0<\/h5><p>Persistent urge to scratch inside or around the vagina or vulva, and perhaps even the anus. It can range from mild tickling to intense irritation that disrupts sleep or daily life and is often worse at night or after sweating.<\/p><h5><strong>What it can be caused by:<\/strong><\/h5><p>Low estrogen (menopause), yeast infections (thrush), bacterial vaginosis, allergies to soaps\/pads\/perfumes, skin conditions (lichen sclerosus, eczema), hormonal changes (PCOS), or sexually transmitted infections.<\/p><h5><strong>Practical steps:\u00a0<\/strong><\/h5><ul><li>Wear breathable cotton underwear (avoid synthetics, tight clothing)<\/li><li>Wash once daily max with plain water or sorbolene cream-overwashing strips protective oils<\/li><li>Avoid irritants such as scented soaps, bubble baths, douches, perfumed pads\/wipes, or fabric softener<\/li><li>Wipe front to back after toilet use<\/li><li>Keep the area cool and dry use cotton pads in underwear if sweaty<\/li><li>Cold compress (10 mins, 2-3 times daily) to calm inflamed skin<\/li><li>Avoid scratching (trim nails, wear cotton gloves at night if needed<\/li><\/ul><h5><strong>Over-the-counter options:<\/strong><\/h5><ul><li>Please discuss the following options with your pharmacist<\/li><li><span style=\"text-decoration: underline;\">Oral antihistamines<\/span>, particularly to help reduce nighttime itching<\/li><li><span style=\"text-decoration: underline;\">Antihistamine cream<\/span> for external itching: Thin layer 1-2x\/day max<\/li><li><span style=\"text-decoration: underline;\">Hydrocortisone 1% cream<\/span>: For vulval itching only, short-term (3-5 days max)<\/li><li><span style=\"text-decoration: underline;\">Antifungal cream<\/span> (e.g. Canesten\/clotrimazole): If yeast infection (thrush) suspected<\/li><li><span style=\"text-decoration: underline;\">Oral antifungal tablets<\/span>: for likely cases of thrush, and less irritant than creams [NOTE: if you think you have recurrent \u201cthrush\u201d but it persists or returns despite treatment, it may be something else. See your doctor for proper examination and diagnosis!]<\/li><li><span style=\"text-decoration: underline;\">Probiotic vaginal pessaries<\/span> may help support healthy vaginal bacteria<\/li><li><span style=\"text-decoration: underline;\">Barrier cream<\/span> (zinc\/specified barrier cream or ointment): protects irritated skin from moisture\/urine<\/li><\/ul><h5><strong>Localised hormonal treatments:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue thickness and moisture<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet:<\/span> A small pessary placed into the vagina, containing a form of low-dose estrogen<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone<\/li><li><span style=\"text-decoration: underline;\">Systemic hormone therapy:<\/span> May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels.<\/li><\/ul>                    <\/div>\n\t\t        \n                    <div id=\"pain-with-sex-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"pain-with-sex-tab\">\n\t\t\t\t        <h5><strong>What it feels like:<\/strong><\/h5><p>Sharp or burning pain at the entrance, deep ache with thrusting, or soreness that lasts for some time after sex. It can make you tense up or avoid intimacy.<\/p><h5><strong>What it can be caused by:<\/strong><\/h5><p>Low estrogen (menopause, breastfeeding), vaginal dryness and tissue thinning, infections (thrush, BV), pelvic floor tension, endometriosis, vaginismus (involuntary vaginal muscle tightening), allergies to products or condoms, or insufficient arousal\/foreplay. <strong>Sexual pain is a complex issue<\/strong>, and some causes can be more serious; <strong><a href=\"https:\/\/wellfemme.com.au\/pain-during-sex-causes-solutions\/\" target=\"_blank\" rel=\"noopener\">check out our full article here<\/a><\/strong> for more information.\u00a0<\/p><h5><strong>Practical steps:\u00a0<\/strong><\/h5><ul><li>Extended foreplay (20+ mins) to allow natural lubrication<\/li><li>Use lubricants generously before and during sex<\/li><li>Try positions where you control depth and pace (e.g. woman on top), or use spacer devices like <strong><a href=\"https:\/\/www.blossompelvichealth.com.au\/collections\/the-pelvic-people\/products\/ohnut-depth-limiting-rings\" target=\"_blank\" rel=\"noopener\">Ohnut<\/a><\/strong><\/li><li>Pelvic floor relaxation exercises (deep breathing, reverse Kegels)<\/li><li>Communicate with your partner about what feels good\/painful<\/li><li>Empty bladder before sex to reduce pressure<\/li><li>Avoid sex if very dry, irritated or recovering from an infection; wait until symptoms settle<\/li><\/ul><h5><strong>Over-the-counter options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal lubricants<\/span> before or during intercourse<\/li><li><span style=\"text-decoration: underline;\">Vaginal moisturisers<\/span> (2-3 times per week to improve baseline comfort)<\/li><li><span style=\"text-decoration: underline;\">Paracetamol or ibuprofen<\/span>: 30 mins before sex if muscle tension contributes<\/li><li><span style=\"text-decoration: underline;\">Lidocaine 2-5% gel\/ointment<\/span>: Numbing gel for entry pain (short-term use only)<\/li><\/ul><h5><strong>Medications &amp; hormonal options:<\/strong><\/h5><ul><li>Prescription-only (discuss with your doctor or nurse prescriber)<\/li><li>For infections\/inflammation:<\/li><li><span style=\"text-decoration: underline;\">Antifungals<\/span> (fluconazole) or antibiotics (metronidazole) if infection present<\/li><li><span style=\"text-decoration: underline;\">Low-dose steroid cream<\/span> for vulval irritation<\/li><li>Your practitioner should also take a sexual history and ask questions to rule out possible sexually transmitted infection (STI), which is easy to treat with antibiotics in most cases. A vaginal swab or urine sample may be required for diagnosis<\/li><\/ul><h5><strong>Hormonal treatments:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue thickness and moisture.<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet:<\/span> A small pessary placed into the vagina, containing a form of low-dose oestrogen.<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone.\u00a0<\/li><li><span style=\"text-decoration: underline;\">Systemic hormone therapy:<\/span> May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels.<\/li><\/ul><h5><strong>For muscle tension:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Pelvic floor<\/span> physiotherapy<\/li><li><span style=\"text-decoration: underline;\">Muscle relaxants<\/span> or Botox injections (specialist referral)<\/li><li><span style=\"text-decoration: underline;\">Psychological therapy<\/span> from a qualified sexual counsellor can help in cases of trauma, aversion or relationship issues causing sexual pain or avoidance.<\/li><\/ul><p>See your doctor if: Pain persists despite lubrication, new bleeding\/discharge, you have deep pelvic pain, a history of sexual trauma or violence, suspect an STI or are unable to have penetrative sex.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"recurrent-thrush-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"recurrent-thrush-tab\">\n\t\t\t\t        <h5><strong>What it feels like:\u00a0<\/strong><\/h5><p>Not everyone has all these symptoms, but they can include intense vaginal itching (especially at night), thick white \u201ccottage cheese\u201d discharge, redness\/swelling of vulva, soreness or burning with sex or peeing. Episodes return frequently despite treatment.<\/p><h5><strong>What it can be caused by:\u00a0<\/strong><\/h5><p>Recurrent thrush is four or more episodes per year of vaginal fungal overgrowth (Candida albicans most common). Risk factors include low estrogen, antibiotics, high blood sugar or diabetes, tight clothing, pregnancy, hypersensitive immune response, or atypical yeast strains.<\/p><h5><strong>Practical steps:\u00a0<\/strong><\/h5><ul><li>Wear cotton underwear, avoid tight synthetics or damp clothing<\/li><li>Dry thoroughly after bathing\/swimming, use hairdryer on cool setting if needed<\/li><li>Wash with plain water only, skip soaps, bubble baths, douches<\/li><li>Wipe front to back, change pads\/tampons frequently<\/li><li>Avoid spermicides, perfumed products, glycerin-based lubricants<\/li><li>Manage blood sugar if diabetic &amp; check HbA1c regularly<\/li><li>Eat low-sugar diet, consider probiotic-rich foods (yoghurt, kefir)<\/li><li>Sleep naked or in cotton to keep area cool\/dry<\/li><\/ul><h5><strong>Over-the-counter options:<\/strong><\/h5><ul><li>For acute episodes (use 7-14 days):<\/li><li><span style=\"text-decoration: underline;\">Clotrimazole pessary\/cream<\/span> (Canesten 1-day\/3-day\/6-day)<\/li><li><span style=\"text-decoration: underline;\">Miconazole <\/span>(Gyno-Daktarin)<\/li><li><span style=\"text-decoration: underline;\">Oral antifungal tablets<\/span>: generally a single oral dose, and less messy and irritant than creams<\/li><li><span style=\"text-decoration: underline;\">Probiotic pessaries<\/span> (e.g. Fem Dophilus) to support good bacteria<\/li><li><span style=\"text-decoration: underline;\">Gentle hydrocortisone<\/span> 1% cream twice daily for external itching<\/li><\/ul><h5><strong>Short-term prevention (trial for 1-2 months):<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Weekly clotrimazole<\/span> 500mg pessary after periods<\/li><li>Note: If episodes recur despite OTC treatment, see your doctor for testing<\/li><\/ul><h5><strong>Medications &amp; hormonal options:<\/strong><\/h5><ul><li>Prescription-only (discuss with your doctor\/nurse)<\/li><li>Induction treatment (for active infection):<\/li><li><span style=\"text-decoration: underline;\">Fluconazole<\/span> 150mg oral daily x 3-7 days OR clotrimazole 10-14 days<\/li><li><span style=\"text-decoration: underline;\">For non-albicans yeast<\/span>: Boric acid pessaries 600mg nightly x 14 days<\/li><\/ul><h5><strong>Maintenance\/suppression (6+ months, most effective):<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Fluconazole<\/span> 150mg oral weekly<\/li><li><span style=\"text-decoration: underline;\">Clotrimazole<\/span> 500mg pessary weekly or topical cream 2-3x\/week<\/li><\/ul><h5><strong>Hormonal treatments:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue thickness and moisture<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet<\/span>: A small pessary placed into the vagina, containing a form of low-dose oestrogen<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into estrogen and androgens, such as testosterone<\/li><\/ul><p>See your doctor if: you have many episodes per year, symptoms persist despite treatment, unusual discharge or odour, pain, diabetes symptoms, or pregnancy. They may test for resistant yeast or underlying causes.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"bladder-leakage-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"bladder-leakage-tab\">\n\t\t\t\t        <h5><strong>What it feels like:\u00a0<\/strong><\/h5><p>Small leaks when coughing, sneezing, laughing or exercising (stress leakage), sudden uncontrollable gush before reaching the toilet (urge leakage), or constant dribbling (overflow). Can feel embarrassing and limit activities.<\/p><h5><strong>What it can be caused by:\u00a0<\/strong><\/h5><p>Weak pelvic floor muscles (childbirth, menopause), low estrogen thinning urethral tissue, overactive bladder, obesity, chronic cough, constipation, prolapse, or neurological conditions.<\/p><h5><strong>How common is it:\u00a0<\/strong><\/h5><p>This is an incredibly common symptom, with leakage and other continence issues affecting more than half of postmenopausal women. It can be debilitating and keep women restricted in even leaving the house or going about their daily activities.<\/p><h5><strong>Practical steps:\u00a0<\/strong><\/h5><ul><li>Pelvic floor exercises (Kegels): Check out Continence Australia\u2019s\u00a0<strong><a href=\"https:\/\/continence.my.salesforce.com\/sfc\/p\/#A0000000KUc9\/a\/Oa0000029dx3\/bJCEAs18YUdxrsEZqysyIG.3WRkLAe6Vkcok7a_xsiM\" target=\"_blank\" rel=\"noopener\">guide to the pelvic floor<\/a>, <\/strong>and see a\u00a0<a href=\"https:\/\/choose.physio\/find-a-physio\" target=\"_blank\" rel=\"noopener\"><strong>pelvic floor physiotherapist<\/strong><\/a>\u00a0to ensure you are doing the exercises correctly<\/li><li>Maintain healthy weight: Extra abdominal weight weakens pelvic floor<\/li><li>Avoid constipation: High-fibre diet, adequate water, regular toilet habit<\/li><li>Bladder training: Gradually increase time between bathroom visits; again, see a\u00a0<strong><a href=\"https:\/\/choose.physio\/find-a-physio\" target=\"_blank\" rel=\"noopener\">pelvic floor physiotherapist<\/a>\u00a0<\/strong>for a thorough review and guidance in these techniques<\/li><li>Double voiding: Pee, wait 30 seconds, then try again to fully empty<\/li><li>Cut bladder irritants: Less caffeine, alcohol, fizzy drinks<\/li><li>Good lifting technique: Tighten pelvic floor before lifting<\/li><li>Timed toileting: Go every 3-4 hours even without urge<\/li><\/ul><h5><strong>Over-the-counter options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Incontinence pads and panties:<\/span> Absorbent protection while building control<\/li><li><span style=\"text-decoration: underline;\">Pelvic floor trainers:<\/span> App-guided exercise devices<\/li><li><span style=\"text-decoration: underline;\">Cranberry tablets:<\/span> May help prevent UTIs that worsen leakage<\/li><li><span style=\"text-decoration: underline;\">Ural sachets:<\/span> For bladder irritation\/discomfort<\/li><li><span style=\"text-decoration: underline;\">Paracetamol:<\/span> For pelvic discomfort during exercises<\/li><\/ul><h5><strong>Medications &amp; hormonal options:<\/strong><\/h5><ul><li>Prescription-only (discuss with your doctor\/nurse):<\/li><li>For stress incontinence:<\/li><li><span style=\"text-decoration: underline;\">Duloxetine<\/span> (sometimes used off-label)<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen<\/span> (Ovestin\/Vagifem): Strengthens urethral tissue<\/li><\/ul><h5><strong>For urge incontinence:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Anticholinergics<\/span> (oxybutynin, tolterodine)<br \/>Mirabegron (eg. Betmiga , fewer side effects)<\/li><\/ul><h5><strong>Specialist options:<\/strong><\/h5><ul><li><strong><a href=\"https:\/\/choose.physio\/find-a-physio\" target=\"_blank\" rel=\"noopener\">Pelvic floor physiotherapy<\/a>\u00a0<\/strong>(biofeedback, electrical stimulation)<\/li><li><span style=\"text-decoration: underline;\">Pessary (vaginal support device for prolapse);<\/span> often recommended and fitted by pelvic floor physios<\/li><li><span style=\"text-decoration: underline;\">Urethral bulking<\/span> injections<\/li><li><span style=\"text-decoration: underline;\">Sling surgery<\/span> (mid-urethral sling, very effective)<\/li><li><span style=\"text-decoration: underline;\">Botox bladder<\/span> injections<\/li><\/ul><p>See your doctor if: leakage affects quality of life, sudden worsening, blood in urine, pelvic pain or prolapse symptoms. Pelvic floor assessment recommended.<\/p>                    <\/div>\n\t\t        \n                    <div id=\"urinary-frequency-tab\" class=\"clearfix eael-tab-content-item inactive\" data-title-link=\"urinary-frequency-tab\">\n\t\t\t\t        <h5><strong>What it feels like:\u00a0<\/strong><\/h5><p>Sudden strong urge to pee that\u2019s hard to ignore, needing to go more often than usual (8+ times\/day), waking multiple times at night (nocturia), or leaking a little before you reach the toilet.<\/p><h5><strong>What it can be caused by:\u00a0<\/strong><\/h5><p>Low estrogen (such as GSM, causing bladder and urethral tissue thinning and bladder irritability), overactive bladder, urinary tract infections (UTIs), pelvic floor weakness, diabetes\/high blood sugar, caffeine or alcohol excess, overhydration, constipation, certain medications or anxiety\/stress.<\/p><h5><strong>Practical steps:\u00a0<\/strong><\/h5><ul><li>Bladder training: Delay peeing by 5-10 mins when you feel the urge, gradually increase time between voids (pelvic floor\/ continence physiotherapists can help train you in this)<\/li><li>Cut irritants: Reduce caffeine (coffee, tea, cola), alcohol, fizzy drinks, artificial sweeteners<\/li><li>Sip, don\u2019t gulp: Spread fluid intake evenly through the day, aim for 1.5-2L water<\/li><li>Timed voiding: Pee every 3-4 hours even without urge to retrain bladder<\/li><li>Pelvic floor exercises: Kegels (squeeze\/release 10x, 3x\/day) or see pelvic physio<\/li><li>Good bowel habit: Prevent constipation with fibre, water, movement<\/li><li>Weight management: Extra weight increases bladder pressure<\/li><li>No \u201cjust in case\u201d peeing, train bladder to hold longer<\/li><\/ul><h5><strong>Over-the-counter options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Cranberry products<\/span> (tablets, juice): May help prevent UTIs (evidence mixed)<\/li><li><span style=\"text-decoration: underline;\">Paracetamol<\/span>: For discomfort if bladder is irritated<\/li><li><span style=\"text-decoration: underline;\">Probiotics:<\/span> Oral or vaginal to support urinary\/vaginal health<\/li><li><span style=\"text-decoration: underline;\">Bladder support supplements<\/span> (e.g. Ural sachets): Alkalinise urine for mild irritation<\/li><li><span style=\"text-decoration: underline;\">Pelvic floor training<\/span> e.g.: Guided Kegel trainers<\/li><li><span style=\"text-decoration: underline;\">Some OTC medications<\/span> can help prevent UTI\u2019s such as\u00a0methenamine hippurate and D-Mannose.<\/li><li><span style=\"text-decoration: underline;\">Some OTC medications<\/span> can relieve the symptoms of urinary discomfort, like urinary alkalinisers, eg. Ural, Citravescent<\/li><\/ul><h5><strong>Medications &amp; hormonal options:<\/strong><\/h5><ul><li>Prescription-only (discuss with your doctor\/nurse):<\/li><li>For overactive bladder:<\/li><li><span style=\"text-decoration: underline;\">Anticholinergics<\/span> (oxybutynin, tolterodine)<\/li><li><span style=\"text-decoration: underline;\">Beta-3 agonists<\/span> (mirabegron)<\/li><li><span style=\"text-decoration: underline;\">Desmopressin<\/span> for severe nocturia<\/li><li><span style=\"text-decoration: underline;\">Mirabegron<\/span> (eg. Betmiga)<\/li><\/ul><h5><strong>Hormonal treatments:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Vaginal estrogen cream<\/span>: Applied inside the vagina to improve tissue tone and moisture.<\/li><li><span style=\"text-decoration: underline;\">Vaginal estrogen pessary\/tablet:<\/span> A small pessary placed into the vagina, containing a form of low-dose oestrogen.<\/li><li><span style=\"text-decoration: underline;\">Vaginal DHEA (dehydroepiandrosterone) pessary:<\/span> A pessary containing DHEA that once inserted in the vagina, the vaginal cells will convert the DHEA into oestrogen and androgens, such as testosterone.\u00a0<\/li><li><span style=\"text-decoration: underline;\">Systemic hormone therapy<\/span>: May be considered if vaginal dryness occurs alongside hot flushes or other menopausal symptoms. This may be given as tablets, patches, or gels.<\/li><\/ul><h5><strong>For infections:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Antibiotics<\/span> for confirmed UTIs; can be used for treatment and prevention (eg. nitrofurantoin, trimethoprim)<\/li><\/ul><h5><strong>Specialist options:<\/strong><\/h5><ul><li><span style=\"text-decoration: underline;\">Pelvic floor<\/span> physiotherapy<\/li><li><span style=\"text-decoration: underline;\">Sleep study<\/span> (lack of deep sleep increases night-time diuresis)<\/li><li><span style=\"text-decoration: underline;\">Botox bladder injections<\/span><\/li><li><span style=\"text-decoration: underline;\">Nerve stimulation<\/span> (sacral neuromodulation)<\/li><\/ul><p>See your doctor if: Leaking with urgency, blood in urine, fevers, chills, symptoms lasting over 2 weeks, or diabetes symptoms. Urine tests may be needed.<\/p>                    <\/div>\n\t\t                    <\/div>\n        <\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-b5e1f5e e-con-full e-flex e-con e-child\" data-id=\"b5e1f5e\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-79648d3 elementor-widget elementor-widget-text-editor\" data-id=\"79648d3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5><strong>When to See a Doctor<\/strong><\/h5><p>It is important to remember that there are many other causes of vulvovaginal symptoms like itching and pain, for example infections and skin conditions (some of which may be quite serious). Don\u2019t assume that because you are menopausal it must be GSM, especially if treatments aren\u2019t working. You should see your GP for an examination prior to starting any treatment.\u00a0<\/p><p><b><i>If you can\u2019t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.\u00a0<\/i><\/b><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-430010f e-con-full e-flex e-con e-child\" data-id=\"430010f\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7d97045 elementor-widget elementor-widget-text-editor\" data-id=\"7d97045\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>If you are curious about hormonal treatments, check out our detailed information and resources <strong><a href=\"https:\/\/wellfemme.com.au\/landing\/twcm-mht\/\" target=\"_blank\" rel=\"noopener\">HERE<\/a><\/strong><strong>,<\/strong>\u00a0<strong><a href=\"https:\/\/wellfemme.com.au\/landing\/twc\/\" target=\"_blank\" rel=\"noopener\">more signs &amp; symptoms of menopause,\u00a0<\/a><\/strong>and <strong><a href=\"https:\/\/wellfemme.com.au\/landing\/twcm-menopause-symptoms\/\" target=\"_blank\" rel=\"noopener\">Peri &amp; Menopause Symptoms: What Works?\u00a0<\/a><\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8fd4718 elementor-align-justify elementor-widget__width-initial elementor-widget elementor-widget-button\" data-id=\"8fd4718\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/wellfemme.com.au\/landing\/twc\/\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Take Free Assessment or Book a Consultation<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e3c8ca5 elementor-widget elementor-widget-n-accordion\" data-id=\"e3c8ca5\" data-element_type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-2380\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-2380\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> References <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" role=\"region\" aria-labelledby=\"e-n-accordion-item-2380\" class=\"elementor-element elementor-element-6684c9f e-con-full e-flex e-con e-child\" data-id=\"6684c9f\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-505858e elementor-widget elementor-widget-text-editor\" data-id=\"505858e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32852449\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">The NAMS 2020 GSM Position Statement Editorial Panel. The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society. Menopause. 2020 Sep<\/span><\/a><\/p><p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38415685\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Lambrinoudaki I, Mili N, Augoulea A, Armeni E, Vlahos N, Mikos T, Grimbizis G, Rodolakis A, Athanasiou S. The LADY study: epidemiological characteristics of prevalent and new genitourinary syndrome of menopause cases in Greece. Climacteric. 2024 Jun<\/span><\/a><\/p><p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38032828\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Micks E, Reed SD, Mitchell C. The Postmenopausal Vaginal Microbiome and Genitourinary Syndrome of Menopause. Clin Obstet Gynecol. 2024 Mar .<\/span><\/a><\/p><p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37508246\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Sanyaolu LN, Cooper E, Read B, Ahmed H, Lecky DM. Impact of Menopausal Status and Recurrent UTIs on Symptoms, Severity, and Daily Life: Findings from an Online Survey of Women Reporting a Recent UTI. Antibiotics (Basel). 2023 Jul<\/span><\/a><\/p><p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31480774\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Scavello I, Maseroli E, Di Stasi V, Vignozzi L. Sexual Health in Menopause. Medicina (Kaunas). 2019 Sep 2<\/span><\/a><\/p><p><span style=\"font-weight: 400;\">Currently there is insufficient evidence to support the use of vaginal laser therapy for GSM.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-46470da e-flex e-con-boxed e-con e-parent\" data-id=\"46470da\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-44da9c7 e-con-full e-flex e-con e-child\" data-id=\"44da9c7\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d7c773d elementor-widget elementor-widget-image\" data-id=\"d7c773d\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"132\" src=\"https:\/\/wellfemme.com.au\/landing\/wp-content\/uploads\/2025\/07\/logo-Wf-white-no-tagline.png\" class=\"attachment-full size-full wp-image-725\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-07ca935 e-con-full e-flex e-con e-child\" data-id=\"07ca935\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-939cdcd elementor-widget elementor-widget-heading\" data-id=\"939cdcd\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">&copy; 2026 WellFemme. 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YOUR CHOICE. Vaginal &amp; Urinary Symptoms in Midlife: What&#8217;s Normal, What&#8217;s Not check Your Symptoms Take Free Assessement Thrush or UTI again? Perhaps it&#8217;s not&#8230; Genitourinary Syndrome of Menopause (GSM) refers to a collection of signs and symptoms of the female genital tract and urinary system that are caused by the fluctuation and [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_canvas","meta":{"footnotes":""},"class_list":["post-2199","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>TWC- GSM - WellFemme<\/title>\n<meta name=\"robots\" content=\"noindex, nofollow\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"TWC- GSM - WellFemme\" \/>\n<meta property=\"og:description\" content=\"YOUR JOURNEY. YOUR CHOICE. 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