Menopause results in a marked reduction in oestrogen levels, causing some unexpected problems. Oestrogen is responsible for keeping vaginal cells supple and functioning well, so once levels change, vulvovaginal symptoms can appear. Not all women get symptoms, but many do. Genitourinary symptoms of menopause (GSM) refers to the collection of vulvovaginal symptoms women may experience, including dryness, irritation, itching and discomfort. These treatments are in their element when treating GSM and is usually very successful at alleviating symptoms.